Patient’s Name : Vuddagiri Rohith Kumar

Patient’s Age : 6

Patient’s Gender : Male

Dr. Mohana Rao Patibandla, MCh (NIMS), iFAANS(USA), FESBSS (USA), FPNS (UCD, USA), FEVNS (UVA, USA), FNSORS (UVA, USA), FMINS (OSU, USA), FPNS (UCD, USA)

The patient and his parents visited Dr Rao’s Hospital which is  the best neurology hospital in Guntur with the following Symptoms:

• GCS was E4M6V4
• Ataxia
• Slurred speech

1. Suboccipital craniectomy and complete excision of the tumour.

2. Navigation guided; microscopic, assisted resection was done using the SONOSTAR dynamic machine.

The patient was admitted to the MNICU and was attended by Dr. Mohana, who is considered the best neurosurgeon in Andhra Pradesh. When he was admitted to the hospital his GCS was E4M6V4, ataxia and slurred speech. He was taken for surgery on the same day and. Dr. Mohana Rao spoke to the family and showed films to parents and after having an extensive discussion with parents and his well-wishers and with agreement consent, we proceeded for surgery under regional anaesthesia.

He was placed on high dose steroids with dexamethasone, GI protection with pantoprazole and given seizure prophylaxis with Levetiracetam and then did emergency decompressive suboccipital craniectomy with the removal of the tumour for saving a life.

Later, we performed the above-said procedures for the above-mentioned tumour to completely remove the lesion and sent for the biopsy. The patient tolerated the procedure well and there were no intraoperative complications. Perioperative antibiotics were administered all the time for the procedures.

Postoperatively, the patient was brought to the neurosurgical ICU where he underwent routine postoperative observation on the ventilator for few hours. He was resuscitated with IV fluids postoperatively and Dexamethasone.

The patient returned to his neurologic baseline with recognizing people, moving all four limbs and no deficits. He was improved. On the POD # 2 patient was seen by the Physical Therapy and Occupational Therapy Services and found to have no further inpatient needs. 

At this time vital signs and laboratory examination were unremarkable. The examination demonstrated voluntary movements and normal sensory function.  The patient was having appropriate bowel movements and bladder function. The incision was clean, dry, and intact and sutures were intact. Therefore, with pain well-controlled and actively taking p.o. intake, the patient was considered stable for discharge.

• Tab. Linezolid 600 mg half tablet twice daily for 10 days
• Inj. Amikacin 250 mg once daily
• Inj. Dexamethasone 2 mg thrice daily for 3 days, twice daily for 3 days, once daily for 3 days.
• Tab. DART half tablet thrice for a week
• Tab. Rabeprazole 20 and Levosulpiride 30 mg half tablet daily before breakfast and before dinner
• Tab. Ondansetron 4 mg twice daily for 5 days
• Cap. Cobaroot B Once daily for 30 days
• Syp. L carnosine 5 ml twice daily
• High protein diet 50 mg per day for the next 30 days
• Cap. Pre and probiotics twice daily
• Physiotherapy – speech therapy, active walking and balance exercises
• Free Lax plus Syrup 15 ml as needed for constipation.

Dr. Mohana Rao called the patient over after a few weeks for suture removal.