The groundbreaking procedure was carried out through a tiny puncture in the patient's thigh, allowing doctors to access and treat the abnormal blood vessels in the brain without opening the skull. The successful intervention not only reduced surgical risks but also significantly shortened the patient's recovery time, enabling her to return to normal life much sooner than would have been possible with conventional surgery.
A Sudden Medical Emergency
The teenage girl, a school student from Tamil Nadu's Tiruvallur district, was rushed for medical evaluation after experiencing symptoms that were later found to be caused by bleeding in the brain. Further investigations revealed the presence of a cerebral micro-arteriovenous malformation (AVM), a rare vascular condition in which abnormal connections develop between arteries and veins in the brain.
AVMs can disrupt normal blood circulation and oxygen flow, increasing the risk of bleeding, stroke, seizures, and neurological complications. While AVMs themselves are uncommon, micro-AVMs are even rarer and can be particularly challenging to diagnose because of their small size.
To accurately identify the condition, doctors performed a cerebral digital subtraction angiography (DSA), an advanced imaging technique that provides detailed visualization of blood vessels within the brain. The investigation confirmed the presence of the micro-AVM and helped specialists determine the most appropriate treatment strategy.
Advanced Treatment Without Open Surgery
Traditionally, treating brain AVMs often requires open neurosurgery, which involves opening the skull to directly access and remove the abnormal blood vessels. Such procedures can involve longer recovery periods and higher risks, especially in younger patients.
However, the medical team at Rela Hospital opted for a minimally invasive endovascular approach. Instead of operating directly on the brain, surgeons inserted a catheter through a tiny puncture in the girl's thigh and carefully navigated it through the body's vascular system to reach the affected blood vessels in the brain.
The advanced neuro-intervention suite where the surgery was performed
The surgical team behind the rare minimally invasive procedure
Using sophisticated imaging guidance and specialized instruments, the team successfully treated the abnormal vascular connection from within the blood vessels themselves. The entire procedure was completed in just one hour and forty-five minutes.
The innovative approach enabled the doctors to avoid opening the skull altogether, minimizing trauma to surrounding tissues and significantly reducing the risks associated with conventional brain surgery.
Expertise Behind the Success
The surgery was led by Dr. Muralidharan Vetrivel, Consultant Neurosurgeon – Cerebrovascular and Neuro-Oncology, along with a multidisciplinary team of specialists.
Speaking about the case, Dr. Muralidharan emphasized the rarity of the condition and the importance of early diagnosis and advanced treatment options. "It is rare for a teenager to collapse due to bleeding in the brain secondary to micro-AVM. Our team has successfully performed the procedure and avoided an open brain surgery. Following the surgery, which lasted only one hour and forty-five minutes, the girl is expected to resume her usual activities after taking the necessary rest," he said.
Patient-centred, multidisciplinary care
The successful outcome demonstrates the growing role of minimally invasive neuro-interventional procedures in treating complex neurological disorders. Such techniques are increasingly becoming the preferred option for suitable patients because they offer shorter hospital stays, reduced postoperative discomfort, fewer complications, and faster recovery.
The Importance of Early Detection
Medical experts point out that AVMs can remain undetected for years because many patients may not experience symptoms until a bleeding episode occurs. Warning signs can include severe headaches, seizures, dizziness, weakness, vision disturbances, or sudden neurological deficits.
In younger patients, timely diagnosis is especially critical because untreated AVMs carry a lifelong risk of bleeding. Advances in imaging technologies such as MRI, CT angiography, and digital subtraction angiography have greatly improved the ability of physicians to identify these abnormalities before they result in catastrophic complications.
The successful management of this case underscores how specialized neurovascular centres equipped with advanced diagnostic and therapeutic technologies can make a life-changing difference in patient outcomes.
A calm, modern hospital environment
A New Era in Neurosurgical Care
Minimally invasive neurovascular procedures represent one of the most significant developments in modern neuroscience. By accessing the brain's blood vessels through the body's natural vascular pathways, surgeons can treat conditions that once required highly invasive operations.
The benefits include smaller incisions, reduced blood loss, lower infection risk, shorter intensive care stays, and quicker return to normal activities. For young patients and their families, these advantages can be particularly meaningful, reducing both physical and emotional stress during treatment. The successful treatment of the Tiruvallur teenager is another example of how cutting-edge medical technology and specialist expertise are transforming patient care in India.
About Rela Hospital
Rela Hospital is one of India's leading quaternary care healthcare institutions, recognized for its advanced clinical expertise, state-of-the-art infrastructure, and commitment to delivering world-class patient care. Located in Chennai, the hospital has emerged as a major destination for complex medical and surgical treatments across a wide range of specialties.
Founded under the leadership of renowned liver transplant surgeon Dr. Mohamed Rela, the hospital is particularly known for its excellence in liver transplantation, multi-organ transplantation, hepatology, gastroenterology, neurosciences, cardiology, oncology, orthopaedics, nephrology, critical care, and advanced surgical services.
Setting international benchmarks in clinical care
The hospital houses modern operation theatres, advanced imaging systems, sophisticated intensive care units, and highly specialized centres dedicated to complex medical disciplines. Its multidisciplinary approach enables specialists from different departments to collaborate closely in managing challenging and high-risk cases.
Rela Hospital's Institute of Neurosciences is equipped with advanced technologies for the diagnosis and treatment of neurological disorders, including stroke, brain tumours, cerebrovascular diseases, epilepsy, spinal disorders, and neuro-oncological conditions. The institute combines expertise in neurosurgery, neurology, neuro-intervention, neuroradiology, and critical care to provide comprehensive treatment solutions.
The hospital has earned a reputation for introducing innovative treatment methods and adopting minimally invasive procedures that improve patient outcomes while reducing recovery times. Its team of highly skilled doctors, surgeons, nurses, and healthcare professionals continues to perform complex procedures that were once available only in a handful of centres worldwide.
By combining cutting-edge technology, clinical excellence, and a patient-centric philosophy, Rela Hospital continues to strengthen its position as one of South India's most trusted healthcare institutions and a leading centre for advanced medical care.