Name
Dr. Hariharasudan Ranganathan
Institute / Department
Neuro Surgery
Qualification
MS.,Mch(Neurosurgery)
Designation
Brain, Spine & Neuro Endovascular Surgeon
Years in Practice
5
Associations (Nos)
Indian Medical Association IMA)
Medical Happenings
Diagnose Early
56 year old lady with recently diagnosed Breast lump 10 days back. Tru cut biopsy suggestive of malignant tumor. On evaluation for secondaries found to have a solitary lesion in her right frontal lobe of brain with mass effect and midline shift of 8mm. Gross total excision of tumor done and patient discharged on second post op day without any deficits. Patient will be started on chemotherapy and radiotherapy in Dharan cancer centre. A holistic management for malignant tumor with high safety and affordability is now available at Dharan hospitals, salem
A Rare Case of Spinal AVM
70 Year old female had a difficulty in walking for past 1 year. She came to us in completely bedridden and inability to walk since last 1-2 weeks. She underwent MRI which showed Spinal Myelopathy due to Spinal Vascular Malformation. Our Interventional Radiologist performed Spinal Angiogram which showed Filum Terminale arteriovenous fistula causing Spinal Cord Congestion and Edema. After multi-disciplinary discussion she underwent surgical exclusion of the Filum Terminale Arteriovenous Fistula based on the anatomical localisation in Spinal Angiogram. Post-surgery, she was able to walk and regained her mobility. Filum Terminale Arteriovenous Fistula is rare condition and reported less than 100 cases in literature. Spinal Myelopathy due to Spinal Vascular Malformation can be completely cured if and treated early and appropriately.
A Case of Ruptured intra-cranial Aneurysm
49 year old lady came to emergency in an unconscious state with two days history of severe headache and two episodes of vomiting on the day of admission. Her CT brain revealed a right Sylvian fissure grade III Sub arachnoid hemorrhage. An aneurysm rupture was suspected and patient underwent Digital subtraction angiography. Angiogram revealed a multiple lobed right Middle cerebral artery bifurcation aneurysm.
She underwent clipping of aneurysm and post clipping she was monitored in hospital for vasospasm for ten days. Her post-operative period was uneventful and she was discharged on 11th post op day with no weakness of limbs or speech difficulties. She was able to return to all her routine activities the very next day.
Our teams of critical care Physicians, Interventional Radiologist and Neurologist / Neurosurgeons are able to provide quality care 24/7 at an affordable cost to the people of Salem at par with care available in METRO Cities.
Spinal Stabilization for Paraplegia in Chronic Liver Disease / Hepatic Failure Patient
44 year old male in liver failure with L1 vertebral body fracture following a trivial fall. He was paraplegia post fall and referred to us for surgical stabilisation of the spine. Patient had a platelet of 30,000 and Hb of 8 due to Chronic Liver Disease and related portal hypertension, splenomegaly. After explaining in detail regarding the complications and post op liver failure he was taken up for surgery. Since it was a transition segment 4 level pedicle screws was planned.
Case was discussed with Anesthesia team and Gastroenterologist. Since there was splenomegaly and patient already in liver dysfunction any platelet transfusion will not improve his levels. So, he was planned for surgery with 2 single donor platelet and 4 fresh frozen plasma on flow. The procedure was completed in 1.30 hrs and patient extubated by 2 hrs and shifted to ward after observing for any liver failure signs. He went in for liver failure on second post op day and platelets dropped to 10k and bilirubin to 15 and Hb to 6. All these were previously anticipated and managed very well by Dr. Gopalakrishnan. He was mobilised and weight bearing exercises started on 5th Post Operative Delirium.. Now the patient is walking on his own. We wanted to highlight the outcome of this patient which was possible only due to the team effort.
Diagnose Early
56 year old lady with recently diagnosed Breast lump 10 days back. Tru cut biopsy suggestive of malignant tumor. On evaluation for secondaries found to have a solitary lesion in her right frontal lobe of brain with mass effect and midline shift of 8mm. Gross total excision of tumor done and patient discharged on second post op day without any deficits. Patient will be started on chemotherapy and radiotherapy in Dharan cancer centre. A holistic management for malignant tumor with high safety and affordability is now available at Dharan hospitals, salem
A Rare Case of Spinal AVM
70 Year old female had a difficulty in walking for past 1 year. She came to us in completely bedridden and inability to walk since last 1-2 weeks. She underwent MRI which showed Spinal Myelopathy due to Spinal Vascular Malformation. Our Interventional Radiologist performed Spinal Angiogram which showed Filum Terminale arteriovenous fistula causing Spinal Cord Congestion and Edema. After multi-disciplinary discussion she underwent surgical exclusion of the Filum Terminale Arteriovenous Fistula based on the anatomical localisation in Spinal Angiogram. Post-surgery, she was able to walk and regained her mobility. Filum Terminale Arteriovenous Fistula is rare condition and reported less than 100 cases in literature. Spinal Myelopathy due to Spinal Vascular Malformation can be completely cured if and treated early and appropriately.
A Case of Ruptured intra-cranial Aneurysm
49 year old lady came to emergency in an unconscious state with two days history of severe headache and two episodes of vomiting on the day of admission. Her CT brain revealed a right Sylvian fissure grade III Sub arachnoid hemorrhage. An aneurysm rupture was suspected and patient underwent Digital subtraction angiography. Angiogram revealed a multiple lobed right Middle cerebral artery bifurcation aneurysm.
She underwent clipping of aneurysm and post clipping she was monitored in hospital for vasospasm for ten days. Her post-operative period was uneventful and she was discharged on 11th post op day with no weakness of limbs or speech difficulties. She was able to return to all her routine activities the very next day.
Our teams of critical care Physicians, Interventional Radiologist and Neurologist / Neurosurgeons are able to provide quality care 24/7 at an affordable cost to the people of Salem at par with care available in METRO Cities.
Spinal Stabilization for Paraplegia in Chronic Liver Disease / Hepatic Failure Patient
44 year old male in liver failure with L1 vertebral body fracture following a trivial fall. He was paraplegia post fall and referred to us for surgical stabilisation of the spine. Patient had a platelet of 30,000 and Hb of 8 due to Chronic Liver Disease and related portal hypertension, splenomegaly. After explaining in detail regarding the complications and post op liver failure he was taken up for surgery. Since it was a transition segment 4 level pedicle screws was planned.
Case was discussed with Anesthesia team and Gastroenterologist. Since there was splenomegaly and patient already in liver dysfunction any platelet transfusion will not improve his levels. So, he was planned for surgery with 2 single donor platelet and 4 fresh frozen plasma on flow. The procedure was completed in 1.30 hrs and patient extubated by 2 hrs and shifted to ward after observing for any liver failure signs. He went in for liver failure on second post op day and platelets dropped to 10k and bilirubin to 15 and Hb to 6. All these were previously anticipated and managed very well by Dr. Gopalakrishnan. He was mobilised and weight bearing exercises started on 5th Post Operative Delirium.. Now the patient is walking on his own. We wanted to highlight the outcome of this patient which was possible only due to the team effort.
