The life of the four-year-old was saved. The operation conducted at Medcare Orthopedics was a success. It was the first of its kind to be performed in the UAE.

The rare genetic disease is called moyamoya disease, meaning ‘smoke’ in Japanese. The disorder caused both of the carotid arteries that carried blood to her brain to be narrowed to the point that one was over 90% blocked.

The novel technique restored blood flow. It is the first such surgical procedure performed by surgeons in the UAE. Dr. Gopalakrishnan, head of Neurosurgery at Medcare Spine Hospital, and his team performed the operation.

About Moyamoya Disease

Medication may be used initially, but when the disease becomes severe or recurrent, surgical procedures are necessary. This rare disease causes the carotid artery responsible for the brain’s blood supply to narrow. It is most common among five to ten-year-old children.

Dr. Gopalakrishnan further explained that the narrowing of blood vessels leads to the formation of collateral blood. The disease is also the most prevalent in East Asian countries.

Symptoms

The child often incurred ischemic attacks that lasted several minutes. Ischemia is an inadequate supply of blood resulting from an obstructed blood vessel, essentially a small stroke. She would incur right arm weakness, slurred speech, and facial imbalance.

An MRI and angiogram divulged the narrowing of part of her carotid arteries, agreeing with the moyamoya diagnosis. The team opted for surgery involving a bypass and using the EDAMS (encephaloduroarteriomyosangiosis) technique, providing optimum sources for restoration of the organ that has ischemia.

An additional risk materialized in that EDAMS had not yet been performed in the UAE. This would be among the first attempts.

About the Surgery

Dr. Gopalakrishnan explained that bypass surgery is preferred for this disease. The surgeon fastens the carotid artery’s terminal branches to the middle of the cerebral artery, thereby providing oxygenated blood to the brain. This improves blood supply.

In comparison, with indirect bypass, the surgeon utilizes branches of temporal arteries and muscle flaps. They are placed on the brain’s surface and assist the brain in the creation of new blood vessels. Cranial holes were used to encourage collateral blood flow to the brain’s surface. In most cases, children’s vessels are too small to sustain a direct bypass.

Therefore, the patient received the EDAMS procedure for arteries on both sides.

Outstanding Care

The child’s parents expressed their gratitude to Dr. Gopalakrishnan and his team for the outstanding dedication and compassion they showed to their daughter.

Dr. Gopalakrishnan acknowledged that they are very proud of their accomplishment and their success. He commented on the massive leaps the UAE has made in the field of medical science and in technology. He wants parents to know that they no longer have to travel abroad for treatment.

Dr. Gopalakrishnan was especially pleased that the patient is healthy and back to her normal life.