Ghana makes medical history:-Deep Brain Surgery

Medical history was made and a major breakthrough in brain surgery in Ghana recorded last week, when a team of brain surgeons at the Tema International Neuro-Center (TIN), which is housed in the Narh-Bita Hospital at Tema, successfully performed a seven-hour operation to treat a patient suffering from Parkinson's disease.

"For the first time in Ghana and indeed sub-Saharan Africa, a patient with Parkinson's disease had a brain pacemaker placed within the sensitive structure of the brain, in order to stop the disabling, abnormal movements in the patient", the leader of the team of surgeons, Dr Nii Bonney Andrews, explained.

Parkinson's disease is a disorder of the nervous system characterised by violent trembling of the hands, arms, legs, jaw, and face as well as stiffness of the limbs and trunk. Victims of Parkinson's disease have great difficulty walking and only manage to shuffle along.

Other symptoms of the disease include difficulty in swallowing, chewing, speaking, urinary problems, constipation, skin problems, and sleep disruptions.

Dr Andrews said Parkinson's disease patients also had great difficulty getting up, after sitting for a while. "They literally get stuck in chairs after sitting for some time", he said.

The brain surgeon said the 63-year old patient who underwent DBS surgery last week made significant progress within hours of the operation. The patient was able to walk better, his tremors decreased considerably and 48 hours after the surgery, he was able to sit for more than an hour, playing an exciting game of chess which is his favourite pastime, Dr Andrews said.

There are currently no blood or laboratory tests that have been proven to help in diagnosing the Parkinson's disease, which tends to afflict people in their 50s and older, Dr Andrews said a diagnosis of the disease is therefore mainly based on the medical history and a neurological examination of persons suspected to be suffering from early stages of the disease.

Dr Andrews said Deep Brain Stimulation (DBS), which is employed to correct these abnormalities, was performed for the first time ever in 1994, in Greno, France. Since then, numerous clinical reports from all over the world have confirmed major improvements for all Parkinson's disease symptoms in patients who have undergone DBS surgery", the Ghanaian brain surgeon said.

He told the Daily Graphic that the patient had been suffering from Parkinson's disease for 20 years and had not been able to walk steadily. He fell frequently and had multiple shoulder dislocations as a result. He also shook uncontrollably and had great difficulty rising from a chair.

The surgeon described DBS as "a very complex and delicate operation requiring highly specialised skills and technology" and said its successful performance in Ghana "is a fine example of Ghanaian expertise linking up with international know-how, to improve medical outcomes in patients and expand medical knowledge."

According to Dr Andrews, "there was an air of great excitement among the surgeons, as the first electrode was passed deep into the brain of the patient." He said this was because for the first time in surgical intervention in Ghana, "the electrical charge from living and functioning cells deep within the human brain could be heard by surgeons as specific rhythmic sounds."

Dr Andrews gave an account of the dramatic events which unfolded on that memorable day last week, culminating in the historic medical feat. He said the operation started in the Scan Suite of the Medlab Building at Roman Ridge in Accra at 8 a.m.

A specialised metal frame called a Leksell frame was first placed round the patient's head. A special scan of the patient's head was next performed in order to obtain a detailed map of the brain, to identify the location of the brain where an electrode/wire was to be placed.

All calculations were "triple checked using special computer software." With the metal frame still attached to the patient's head, the patient was transported by ambulance to the Narh-Bita Hospital in Tema, at 9 a.m., the surgeon recounted.

In the operating suite at Narh-Bita, the electrode was very delicately guided into the patient's brain directly. After its placement had been checked using x-ray control films, a second electrode/wire was placed in the second side of the patient's brain and also checked. Both wires were then attached to a battery-powered simulator. At 4pm the procedure was complet�ed, the surgeon explained.

The work of Tema Interna�tional NeuroCenter at the Narh�-Bita Hospital is funded by the medical NGO NeuroGHANA. Dr Andrews revealed that since its inception in 1996, the medical NGO has promoted and pio�neered the use of modern techniques in brain surgery, key-hole video surgery, as well as Gamma Knife (GK) or "incisionless" surgery in Ghana.

The surgeon told the Daily Graphic that NeuroGHANA which is an indigenous NGO, dependent on its resources, is willing to link up with medical professionals and institutions dedicated to helping people fight serious diseases such as brain tumors, strokes, neck pain, back pain and paralysis.

Following last week's successful DBS surgical operation, he told the Daily Graphic, a special center was being set up to manage Parkinson's disease in Ghana , Six Parkinson's disease patients from the United States, Europe and Asia have been lined up for DBS surgery at the Neuro-Center.

The brain surgeon told the Daily Graphic that many patients suffering from Parkinson's disease confuse their condition with stroke. "When we administer drugs to Parkinson's disease patients at the Neuro-Centre and their condition improves, they spread the news that there is a doctor at the Narh-Bita Hospital who cures stroke." Dr Andrews said.

Dr Andrews's team included Doctors Van den Mencken and Rick Shuurman of the Academic Medical Centre in Amsterdam and Dr Philip Batiade of Germany. The three foreign brain surgeons have been pursuing an advanced post-doctoral course in stereo tactic surgery at the International Neuro-Centre at the Narh-Bita Hospital.

They were assisted by neuro-surgical theatre technologist, Grace Fiagbe, radiology technologists,Theodore Ntiri and Thomas Kweku Aperko, Dr L. John, a specialist in deep brain surgery anaesthesia and Steve Bati, a nurse anesthetist of the Narh-Bita Hospital.

The brain surgeon attributed the success of the Neuro-Centre to the support it receives from the Narh-Bita Hospital administration. Dr Andrews said the Narh-Bita Hospital which is already famous for its "community friendly spirit", had made another significant contribution to medical progress in Ghana.

The brain surgeon said that Dr Edward Narh, the Medical Director of the hospital has been outlining productive medical service concepts and inviting suitable partners to develop them for an expansion in the range of specialised medical services at the facility.

"Dr Narh does not interfere in the work of specialists, but allows them to employ their creativity and skills to achieve results. That accounts for the numerous medical service innovations and successes chalked by the hospital", the brain surgeon said.

Dr Narh, who has won several local and international awards for his contribution to medical service and nursing education in Ghana, attributed the achievements of the hospital to "God's divine grace and guidance. He said the various Narh-Bita medical institutions in Tema had been founded on "Christian Principles."

Daily Graphic

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