Published on Vietnam News— Surgeons at HCM City’s City International Hospital successfully performed a 15-hour cerebrovascular surgery on a 57-year-old woman recently to remove a grade-IV brain tumor.


Patient N.T.K.T's MRI  appearance  of Brain stem glioma

The patient from the city’s District 6 had been admitted to the hospital in Bình Tân District on March 8 with paralysis of her right side, drooping left eyelid, lower cranial nerve palsies, and incontinence. Her physical examination was unremarkable. She was alert, interactive, oriented, and able to answer questions appropriately. Three years ago she had been diagnosed with hemangioblastoma, which are benign and highly vascular tumors in the left temporal lobe.

An emergency surgical intervention was done for intramedullary hematoma, or an abnormal collection of blood outside of a blood vessel and tumor. She developed post-operative hydrocephalus, or a build-up of fluid in cavities deep within the brain, and she was placed on a ventriculoperitoneal shunt, a medical device that relieves pressure on the brain caused by fluid accumulation, for three months in March last year. But an imbalance between the intra- and extra-cranial pressures led to excessive drainage, and she has suffered from cognitive disorders and extremity weakness since then.

City Plus Program's multidisciplinary second opinion diagnosis 

30 March 2019, a blood analysis, biochemical analyses, and an MRI investigation of the brain were performed by Dr. Tran Chi Cuong, senior consultant and  Director of CIH-SIS Stroke Center. Pathological examination confirmed the diagnosis of hemangioblastoma in the left temporal lobe. An emergency surgical intervention of the intramedullary hematoma and tumor was performed. 

Dr. Huynh Hong Chau, lead neuro-surgeon & Department Head, Neurosurgery "This case of adult malignant Grade 4 brain tumor are over-the-top challenging which has very little life expectancy. We guarantee to do our best for her long-term survival, although adults with of high-grade gliomas still have a poor prognosis similar to that glioblastoma multiform. We work with whatever long-term issues arise, whether it's double vision or diabetes insipidus or sleep disorders."

Intra-operative computed tomography image-guided navigation (Navigation) system helps the surgeon navigate and locate brain tumors compared to the position of the skull

When hospitalised this time, doctors prescribed a blood analysis, biochemical analyses and an MRI investigation of the brain. A pathological examination confirmed the diagnosis of hemangioblastoma in the left temporal lobe and the need for emergency surgical intervention. The surgery was done on March 31.

Dr Huỳnh Hồng Châu, head of the hospital’s neurosurgery department, said: "This case of adult malignant grade- IV brain tumor is extremely challenging and life expectancy is very low.” The surgery to remove a giant tumor used intra-operative computed tomography image-guided navigation (Navigation). Several surgical techniques and technological innovations have been introduced recently to help surgeons achieve maximal safe resection of tumours while reducing the odds of post-operative complications, Châu said.

" We work with whatever long-term issues arise, Continuity of care is so important." Dr. Hong Chau said. 

Neuro-navigation has become a common tool in the surgical management of brain tumours. It helps surgeons navigate and locate brain tumours relative to the position of the skull. Accurate positioning of the skin incision and the opening of the skull and clearly distinguishing between tumour margins and the surrounding tissue help remove tumors least invasively and with limited brain damage, especially in case of tumors deep in the brain. 

The patient’s health has been improving, the hospital said. VNS

City International Hospital’s City Plus Program 

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