Doctors make breakthrough in treating stroke in Bangladesh

Neurologists at BSMMU have treated a type of deadly haemorrhagic stroke for the first time in Bangladesh with a new technique that requires no brain surgery.

Brain haemorrhage due to aneurysm is usually being treated by opening bone in the head in Bangladesh.

But three young doctors at Bangladesh’s lone medical university did the procedure on a 60-year-old woman using ‘coiling’ method, which is like an extension of angiogram.

The method is common even in India, but this has been used for the first time in Bangladesh.

The patient’s son told bdnews24.com his mother was recuperating in the intensive care unit (ICU).

Bangabandhu Sheikh Mujib Medical University (BSMMU) in a statement said its two assistant professors of neurology Dr Md Shahidullah Sabuj and Dr Suvash Kanti Dey, and a consultant Dr Anis Ahmed performed the two-hour long procedure on Tuesday.

The patient was suffering from a kind of stroke due to aneurysmal subarachnoid haemorrhage.

It is a type of stroke caused by bleeding in and around the brain. And the bleeding occurs due to rupture of a cerebral aneurysm - a balloon-like bag protrudes from an artery wall, causing it to thin and become weak.

The size increases as blood fills into it, raising the risk of bursting.

Sudden and very severe headache, being sick, seizures and loss of consciousness are the symptoms of the disease.

Conventionally, doctors open the bone in the head and place a clip across the aneurysm where it rises from the blood vessel to prevent blood flow from entering into it.

But in coiling method they follow the angiogram procedure.

“It’s an extension of angiogram,” Dr Sabuj said.

“In angiogram doctors reach the heart through femoral artery (large artery in the thigh), but we go up to the brain through the same route,” he said.

He said coils were being packed into the aneurysm to prevent blood from entering into it.

He said the treatment costs depend on the size of the aneurysm.

Saidur Rahman, son of the patient, told bdnews24.com he was “happy” with the treatment, though it costs slightly higher than the conventional surgery.

“I spent around 2 lakh (0.2 million), but I wanted my mother’s treatment to go without surgery,” he said.

Rahman said his mother used to suffer sudden severe headache in the last one year.

“Suddenly (on Aug 8/9) she was feeling numbness in her hands and legs,” he said, “then I rushed her to a private hospital”.

“Doctors there suggested operation, but I was looking for treatment with medicines. Then one doctor suggested me to contact them (the BSMMU group) to see what they can do. They did it without operation,” he said.

Rahman said his mother was in the intensive care unit now. “She started responding”.

This type of stroke accounts for five percent of the total stroke, but it was highly fatal, Dr Sabuj said.

Once the aneurysm bursts, studies show up to 50 percent patients die within a month – 15 percent of those before reaching hospital, he said.

This new method is the latest addition to the Bangladesh’s burgeoning medical sector.

With some additional training neurologist can successfully perform this procedure, the experts say.

Dr Sabuj said they took their training in different overseas institutions.

“We also saw international neurologists come here in Dhaka and perform this in workshop. But for the first time we did it independently,” he said.

But he lamented lack of facilities in their department.

“We did it at the paediatric department,” he said, “using their cath lab”.

This type of technique requires a special catheterisation laboratory or cath lab that the neurology department does not have, making it a challenge for them to offer the procedure regularly for patients.