Happy Clients

Superior sagittal sinus thrombosis is a rare cerebrovascular accident commonly linked to conditions that might cause thrombosis by causing hypercoagulability, local circulation stasis, and arterial wall abnormalities. It is a relatively infrequent cause of stroke.

Focal neurological abnormalities may follow raised intracranial pressure symptoms. SSS thrombosis is indicated by headache, hemiparesis, and focal epilepsy in relatively younger patients. 

With a focal cerebral injury, symptoms might appear due to ischemia, infarction, or hemorrhage. Angiography, computed tomography (CT) scan, or magnetic resonance imaging (MRI) are used to confirm the diagnosis.

Detailed Description

It was night 10:30 pm on 27th August 2021 when Dr. Gurneet Sawhney, one of the famous neurosurgeons in Mumbai, was on the verge of finishing a 13-hour long CP angle tumor surgery when he got a call from an emergency that a patient had arrived with a very low GCS of 3/15. 

The patient was a 34 years old male unconscious since afternoon and was referred to Fortis Hospital, Mulund, for further treatment. The patient was intubated on arrival and was taken up for an MRI scan. It showed superior sagittal sinus thrombosis with left frontoparietal hemorrhage with massive cerebral edema and herniation. 

Dr. Gurneet Sawhney hurriedly finished the closure of the previous surgery and went to see the patient. On examination, Dr. Sawhney found that the patient had anisocoria (unequal pupils), a dire emergency. Immediately, Dr. Sawhney rushed the patient to OT after explaining the prognosis to the relatives.

Dr. Gurneet Sawhney performed craniotomy in 20 minutes. The brain was very oedematous with very feeble pulsations. The pulsations gradually improved, and closure was done. Dr. Sawhney looked at the time after the case. It was 2:30 am. He was exhausted but satisfied. The doctor saw the patient's pupils, which returned to normal size. The doctor took a sigh of relief. 

Gliomas are a broad category of brain tumors that arise from glial cells, playing various supportive roles in the brain. Gliomas of the brain stem form immediately above the back of the neck, connecting the base of the brain to the spinal cord. 

The brain stem is divided into three sections:

• The midbrain, which grows into its stem, emerges from the brain's center.
• The pons is a region of the brain that lies between the midbrain and the medulla oblongata. The majority of brainstem gliomas start in this area of the brain stem.
• The top of the spinal cord forms the medulla oblongata, which spreads out near the brain base.

Dorsally exophytic gliomas are tumors in the brainstem that protrude into the fourth ventricle or the cerebellopontine angles. Because the tumor inhibits the passage of cerebrospinal fluid (CSF), they commonly induce hydrocephalus (a build-up of fluid in the brain).

The majority of these tumors form in the pons region of the brain stem, making surgical treatment extremely difficult. A portion of a localized brainstem glioma can sometimes be excised. However, surgery for a brainstem glioma is frequently deemed too challenging due to the danger of side effects.

If hydrocephalus is present, patients may be offered a cerebral spinal fluid (CSF) shunt to help alleviate the symptoms. The shunt is implanted during a neurosurgery procedure and functions to drain excess fluid from the brain.

Detailed Description

A two years and seven months old girl came to us from Mauritius in a very moribund state. According to the history given by her parents, she was absolutely fine about 1 ½ months back when they noticed that she was limping and swaying towards the right side. 

Gradually, the weakness on her right side increased over the next few days, and she started to fall while walking. They also noticed that she had some facial deviation with drooling of saliva from her mouth. Over the next few weeks, she became bed-bound and was unable to sit on her own. 

MRI brain showed a space-occupying lesion at the dorsal pons, which was reported to be suggestive of a high-grade tumor. The child was denied surgery in Mauritius and also in the UK. She came to Fortis Hospital Mulund on 15th July 2021 with GCS 14/15 with left facial palsy and right-sided hemiplegia with no trunk and head control. 

Dr. Gurneet Singh Sawhney, one of the famous neurosurgeon in India, ordered a repeat MRI. It showed a large exophytic dorsal pontine lesion (which had increased to double the size of the previous scan done 15 days prior) with hydrocephalus. 

After explaining the poor prognosis to the parents, Dr. Gurneet Sawhney planned a VP shunt as an initial step which was done on 18/7/2021. The patient showed some clinical improvement after the shunt. Hence, she was scheduled for craniotomy and microsurgical tumor excision on 20/7/2021. We were able to remove the tumor successfully. 

The left and right hemispheres of the brain are naturally balanced. A groove runs between both sides of the brain midline to the body. The spinal cord arises from the brain's central base and travels along the spine's center.

When anything moves the brain's natural centerline to the right or left, it causes a midline shift. The pressure imposed by the buildup of blood and edema around the damaged brain structures is intense enough to push the entire brain off-center, causing a midline shift. This is a medical emergency, and it's a warning sign.

When a midline shift is apparent, the most critical treatment is to relieve the pressure that is pushing the brain off-center. If a blood clot, such as a subdural hematoma, is the reason, surgery will be required to remove the blood clot and stop the bleeding.

Detailed Description :

A patient named Ganeshdutt Dubey got admitted to Fortis Hospital, Mulund, on 10/12/2020 for Acute Anterior wall myocardial infarction. The patient underwent primary PTCA stent placement to LAD. His procedure was uneventful and was planned for discharge on 14/12/2020. 

On the morning of his discharge, he developed sudden onset of severe headache with vomiting followed by unconsciousness. An urgent CT Brain was done, which showed large right-sided acute SDH with midline shift and herniation. Dr. Gurneet Singh Sawhney, one of the experienced neurosurgeon in Mumbai, was called immediately, and he rushed to see the patient. 

On examination, Dr. Sawhney found the patient’s GCS to be 3/15, and his pupils were bilaterally dilated and fixed. This was a dire emergency. 

Dr. Sawhney rushed the patient to OT, explaining the prognosis to the relatives. As the pupils had already become dilated and non-reactive, the thought hovering over Dr. Sawhney’s mind was that probably his whole effort might be just futile. But still, Dr. Sawhney’s intuition pushed him to take the patient for surgery immediately. 

Dr. Gurneet Singh Sawhney, one of the leading neurosurgeon in India, did the craniotomy and decompressed the brain in just 20 mins. After removing the SDH, the brain slowly started pulsating, and by the end of the surgery, it had surfaced and was well pulsatile. 

Retrosigmoid Suboccipital Craniotomy and 

Microsurgical Tumour Excision of Vestibular Schwannoma

This case study describes critical clinical findings in a patient with right-sided hearing loss and walking imbalance. A right vestibular schwannoma was detected in the patient. After a thorough diagnosis, Dr. Gurneet Singh Sawhney, one of the best neurosurgeon in India, recommended surgery to remove the tumour.

Moreover, Dr. Gurneet Singh Sawhney has gained extensive skills and experience performing minor to complex neuro and spinal surgeries from the past 14 years. Hence, patients have immense trust in him. Thus, they prefer him for complicated neurosurgeries like craniotomies, brain surgeries, and tumour excisions.

Abstract:

In this case, the patient has been diagnosed with a right vestibular schwannoma. Acoustic neuroma, also known as vestibular schwannoma, is a benign tumour that develops on the major (vestibular) nerve, connecting the inner ear to the brain. Branches of this nerve directly influence balance and hearing. Pressure from an acoustic neuroma can induce hearing loss, ringing in the ear, and instability.

Early detection of an acoustic neuroma can help prevent the tumour from developing large enough to cause significant repercussions like total hearing loss. Rarely, it can grow to the point that it presses against the brain, interfering with vital functions. Regular monitoring, radiotherapy, and surgical removal are all options for acoustic neuroma treatment. 

Case Presentation:

A 32-year-old air hostess with complain of right-sided hearing loss and imbalance while walking consulted Dr. Gurneet Sawhney. He is one of the best neurosurgeon in Mumbai, India.  After examining the patient’s condition, Dr. Sawhney suggested an MRI scan. She was diagnosed with right vestibular schwannoma. 

The brain MRI showed a large tumour arising from the right-sided vestibulocochlear nerve or the hearing nerve and was compressing on the brain stem. Further, Dr. Sawhney recommended surgery for the same.

After explaining the procedure and receiving detailed consent, the patient underwent right retrosigmoid suboccipital craniotomy and microsurgical tumour excision under intraoperative neuromonitoring. The biggest challenge in this surgery was preserving the facial nerve, or the patient may suffer a drooping paralyzed face throughout her life. Dr. Gurneet Singh Sawhney was able to preserve her facial nerve. 

At present, after a year of her surgery, the patient looks confident, beautiful, and smiling gloriously. Her current MRI showed no residual tumour.

Images:

The purpose of this case study is to highlight key clinical findings in a patient diagnosed with subdural hematoma. larger hematomas are treated with decompression surgery. Additional surgery may be needed to remove large or thick blood clots if present. Sometimes hematomas cause few or no symptoms and are small enough that they don’t require surgical treatment. Dr. Sawhney specializes in performing complex brain surgeries and brain tumor surgery in Mumbai, in this fashion for more than fourteen years. Dr. Gurneet Sawhney, regarded as one of the best neurosurgeon in Mumbai for performing Microneurosurgery, Neuroendoscopy, and Minimally Invasive Spine Surgeries.

The current case study describes a patient with subdural hematoma. Its life-threatening condition is caused by a sudden hemorrhage or bleeding between the brain and its outermost covering. subdural hematoma is a medical emergency and can be fatal if it is not treated within time. With treatment, however, the prognosis is good.

A 45 YO man arrived at the emergency room in a semi-conscious state with a low pulse rate. He was unable to open his eyes or move his left side. He was not responding to any of the commands either. A CT scan was done to confirm the diagnosis of growing pressure within the skull (intracranial pressure). Also, it was necessary to understand the extent of internal bleeding between the brain and its outermost covering.

A life-saving surgery was performed on him to remove the hemorrhage after seeking the consent of his family. After the surgery, the pressure on the brain was reduced to a great extent. The patient was kept on a ventilator for 1 day to ensure improvement in brain functioning. The post-surgery CT scan revealed recovery in the brain.

The purpose of this case study is to highlight key clinical findings in a patient diagnosed with pituitary apoplexy. Recent advances in minimally invasive endonasal endoscopic skull base surgery have revolutionized surgery for pituitary tumors. 

Visualization is significantly improved with a direct endoscopic view, and patients recover much faster with less discomfort. Typically this has reduced hospital stay to one or two days, even following complex surgery. 

Dr. Sawhney specializes in performing complex brain surgeries and has successfully performed a variety of parasellar tumor resections and brain tumor surgery in Mumbai, in this fashion for more than fourteen years. 

Dr. Gurneet Sawhney, regarded as one of the best neurosurgeon in Mumbai for performing Microneurosurgery, Neuroendoscopy, and Minimally Invasive Spine Surgeries.

The current case study describes a patient with pituitary apoplexy. It's a rare but life-threatening condition caused by sudden hemorrhage or infarction of the pituitary gland. Pituitary apoplexy is a medical emergency and can be fatal if it is untreated or neglected. With treatment, however, the prognosis is good.

A 41-year-old man came with a complaint of sudden onset of severe headache associated with vomiting and was unable to open his left eye. MRI of the brain was done and was found to have a pituitary tumor. The condition is called pituitary macroadenoma with apoplexy. 

On examination, he was found to have III new palsy because of which he was unable to open his left eyelid and also move his left eye on either side. He was optimized and taken up for Endoscopic Transnasal Transsphenoidal surgery under Neuronavigation guidance and the complete tumor was removed.

The purpose of this case study is to highlight key clinical findings in a patient diagnosed with brain tumor affecting the speech area. The “awake” portion is what makes this technique unique and different from the standard asleep craniotomy. Due to the complexity of awake craniotomies, the procedure is very rare. Dr. Sawhney is highly trained in performing complex brain surgeries and has successfully performed a variety of parasellar tumor resections and craniotomies for more than fourteen years. Dr. Gurneet Sawhney, regarded as one of the best neurosurgeon in Mumbai for performing Microneurosurgery, Neuroendoscopy, and Minimally Invasive Spine Surgeries.

The current case study describes a patient with a large left frontal tumor in the speech area. Awake craniotomy is the appropriate technique for operating on such cases. When a brain tumor is near critical speech areas of the brain, it may be important to determine the exact location of these speech-related areas. Awake speech mapping may be carried out by applying mild electrical current to the surface of the exposed brain while the patient performs various tasks, such as reading, speaking etc. If the stimulation hinders the task, then that area of the brain is marked and preserved. Typically, the patients feel minimal or no discomfort while being awake during the surgery.

Mr. Ramda Chopade visited the OPD with focal seizures and word-finding difficulty. Brain MRI showed a large left frontal tumor in the speech area. Functional MRI was done which specifically defined the speech area and found that this area is involved with the tumor. Now the difficulty was to remove the tumor without affecting his speech. So I decided to remove his tumor while he is speaking to me. This advanced technique is called Awake craniotomy done at very few centers in the world. We took him to the operation and explained the procedure. While operating we urged him to speak partial phrases and number counting and also showed him pictures so that he can name it. On stimulating partial areas in the brain he stopped answering our questions and we identified the actual speech area. I removed his complete tumor saving his speech. It was one-of-a-kind surgery.

The purpose of this case study is to highlight key clinical findings in a patient diagnosed with brain tumor present at the occipital region. However, upon further investigation, it seemed to be a noncancerous tumor. Dr. Sawhney is highly trained in performing complex brain surgeries and has successfully performed a variety of tumor resections and craniotomies for more than fourteen years. Dr. Gurneet Sawhney, regarded as one of the best neurosurgeon in Mumbai for performing Microneurosurgery, Neuroendoscopy, and Minimally Invasive Spine Surgeries.

The current case study describes a patient with a very large brain tumour, of the size of a large apple present at the occipital region arising from torcula. Upon further investigation post-surgery, it was ruled out to be cancerous. Often an MRI scan can reveal the tumor type, but in many cases, a biopsy is required. Even if a brain tumor is benign and growing slowly, eventually the brain won’t be able to tolerate that, and symptoms will develop, which can be life-threatening.

A 65-year-old lady came to me in OPD of persistent headache and visual disturbance. She had an MRI of the brain done which showed a very large brain tumor. size of a large apple present at the occipital region arising from torcula (which is the largest vessel in the brain to which all the other vessels attach. Damage to this part of the brain cause death. The tumour looked to be a non-cancerous or benign tumor. The treatment of such a tumour is only surgery. The patient gets cured after a successful surgery.

So after explaining the procedure and taking detailed consent, the patient was electively taken for brain tumour surgery. The surgery went on for 12 hours where Dr. Gurneet Sawhney was able to remove the whole tumor. She was then taken to ICU Patient recovered very fast and was shifted to the ward on the next day and was discharged from the hospital on the 3rd day after surgery. Postoperative CT scan showed complete tumour removal. Presently the patient is very happy with her recovery and is back to her daily routine.