Minimally Invasive Endoscopic Acqueductoplasty Performed on 11 year old Girl

Hyderabad, January 12th, 2018: Md. Sheriff, a Mauzan in Masjid e Babar Uddin Shah in Habeeb Nagar, Nampally, woke up one fine day in Nov 2018, to see his youngest daughter, Baby Khatija, 10 years old and a 4th-grade student, complaining of extreme giddiness, unable to stand, walk and losing balance.

The father took the girl to a couple of hospitals, and soon a battery of investigations suggested that she had posterior 3rd Ventricular Arachnoid Cyst with Hydrocephalus (A form of watery cyst in the brain with fluid build-up). Khatija discontinued school, as her condition was progressively deteriorating, she was bedridden and was barely able to move and eat.

The worried father, Md. Sheriff, who comes from a modest economic background and stays in a single bedroom house within the Masjid Compound, earning a meagre Rs 5000/ - per month, was struggling to raise funds estimated to be about Rs 3 - 4 lacs to save his daughter’s life.  At this point, he was informed by a musali (member of the mosque) to approach city-based NGO, Helping Hand Foundation.

“When we heard about this case, we immediately contacted our panel Neuro Surgeon, and decided to launch a fund raiser campaign. The total ask was Rs 2.5 lacs (Special Package) and by the grace of God and support of our donors, within three hours of posting the case we mobilised the target amount and the girl was operated the very next morning and discharged the same day,” said Mr. Mujtaba Hasan Askari of Helping Hand Foundation.

Highlighting the complexity of this case, Dr. Amir Basha Paspala, Sr. Neuro Surgeon who carried out the procedure said, 3rd Ventricular Cyst is typically located in the center of the brain and is basically water filled sac, extremely challenging to reach, and hence it was decided to opt for the endoscopic procedure. The doctor further added, while he was able to reach the cyst through the endoscope with precision, what he incidentally observed was that the inlet of the “ Aqueduct”, a narrow passage that connects the 3rd and 4th ventricle of the brain, was obstructed with a membrane, and using the same endoscope the membrane was punctured. The obstruction of the inlet which was not visible in the MRI was an incidental finding and was the root cause of Hydrocephalus (Cerebral Fluid) built up in the Brain.

Minimally invasive endoscopic neuro procedures are carried out in a few corporate hospitals today and turned out to be a live saver for young Khatija. In the conventional surgery route the aqueduct inlet obstruction would not have been located, as it is deeply embedded right in the center of the brain, said Dr. Basha, who seemed visibly elated about carrying out the rare and complex procedure that helped save the life of a young girl from a weak economic background.