Patient from Ghana undergoes brain tumour surgery without blood transfusion

The patient - Adan (name changed) - presented with symptoms of left-sided weakness persisting for a year and headaches worsening over eight months. The weakness affected his left upper and lower limbs progressively, leading to difficulty grasping objects with his left hand and walking difficulty. Subsequently, he had a seizure episode, which worsened his headache and neurological deficits.

A 34-year person hailing from Ghana, adhering to Jehovah’s Witnesses beliefs, underwent a surgery for removal of a giant meningioma without blood transfusion in a private hospital in Bengaluru.

The patient - Adan (name changed) - presented with symptoms of left-sided weakness persisting for a year and headaches worsening over eight months. The weakness affected his left upper and lower limbs progressively, leading to difficulty grasping objects with his left hand and walking difficulty. Subsequently, he had a seizure episode, which worsened his headache and neurological deficits.

He was then admitted to Sakra World Hospital in Bengaluru last year in January, where doctors detected a right parietal convexity meningioma, a large 10x 9 cm tumour abutting the right side of his brain. A team of doctors led by Arjun Srivatsa, Director and Head of the Department at the Institute of Neurosciences and Shylesh M.P., Associate Consultant - Neurosurgery, conducted a successful craniotomy for tumour excision.

A meningioma is a tumour that grows from the membranes that surround the brain and spinal cord, called the meninges. “A meningioma is not a brain cancer, but it may press on the adjacent brain, nerves and vessels and can cause trouble. Most meningiomas grow very slowly over the years without any symptoms. However, certain tumours can grow rapidly and behave aggressively. Sometimes, their effects on nearby brain tissue, nerves or vessels can cause serious disability,” explained Dr. Srivatsa.

“Because most meningiomas grow slowly, often without symptoms, they do not always need treatment right away, instead, they may be watched over time. However, large meningiomas causing compression of the brain require immediate attention, he said.

“Adan being a follower of Jehovah’s Witnesses sect, who refuse transfusion of blood or any forms of blood products like platelets, plasma etc., it was a challenging situation for the surgeons and the anaesthetic team to handle the intraoperative blood loss. As meningiomas are highly vascular tumours, they tend to bleed profusely during the surgery. Hence, a meticulous surgical technique and haemostasis has to be achieved during the surgery to minimise the amount of blood loss. This patient had a significant amount of bleeding during the surgery in spite of all the necessary precautions. There was a significant dip in his haemoglobin levels,” the doctor said.

“The team made all efforts to ensure the entire tumour was resected without much complications. While the patient recovered well without any neurological deficits, the drop in his haemoglobin levels was concerning. However, we were able to manage without any blood transfusion. He has been under follow up for the past eight months and is doing fine now,” he said.