A team of hybrid Mumbai doctors have successfully treated an elderly man from abalpur who was suffering from a large subdural hematoma (SDH), a condition in which blood collects between the brain and its outer covering due to bleeding. The man, who was taking blood-thinning medication for an existing heart condition, was advised conventional open brain surgery because of the size of the bleed and mass effect.
However, as he was unwilling to undergo open surgery, the team successfully treated him using an advanced minimally invasive Middle Meningeal Artery (MMA) embolisation, allowing him to recover without opening the skull. On follow-up, the man is doing well and has resumed his clinic and is treating patients like before.
The 67-year-old practicing doctor had dedicated his life to caring for others and guiding them through medical emergencies. However, he suddenly began experiencing weakness on one side of his body, difficulty walking, and confusion. He realised something was seriously wrong. Despite being a doctor himself, the thought of undergoing open brain surgery while taking blood-thinning medication for his heart condition left him deeply concerned. Determined to explore a safer alternative, he travelled to Gleneagles Hospital in Mumbai’s Parel, after learning about its advanced minimally invasive treatment for subdural hematoma, hoping for a solution that would allow him to recover without major surgery.
Dr. Nitin Dange, director Neurosurgery & Neuro-vascular intervention, said, “The patient arrived at the hospital on March 24 with imbalance, confusion, and altered sensorium. Brain scans showed a 22 mm thick subdural hematoma with a 14 mm midline shift, indicating significant pressure on the brain. A subdural hematoma is a collection of blood between the brain and its outer covering, usually caused by bleeding from small veins after a head injury or even a minor, unnoticed fall, especially in older adults. As the blood accumulates, it increases pressure on the brain. It can cause symptoms such as weakness, imbalance, confusion, headache, and altered consciousness. If left untreated, it can lead to permanent brain damage, paralysis, seizures, coma, and even death, making it a life-threatening neurological emergency that requires prompt medical attention.”
Dr. Kushal Bhatia, consultant Neurosurgery & Neuro-vascular intervention, said, “Such findings usually require emergency open surgery. Traditionally, patients with such a large hematoma require open brain surgery, where burr holes or a craniotomy are performed to remove the blood clot. In this patient’s case, the large size of the bleed clearly met the criteria for conventional surgery. Because the patient was on blood thinners for his heart disease, stopping the medication for surgery would have been risky. After detailed evaluation and discussion, we decided to perform Middle Meningeal Artery (MMA) Embolisation on March 26, offering a safer alternative while avoiding major surgery and avoiding stopping his blood thinners. Middle Meningeal Artery (MMA) embolization is an advanced minimally invasive procedure. During this treatment, a thin catheter is inserted through a small blood vessel, usually from the wrist or groin, and guided to the artery supplying the bleeding membrane around the brain. Tiny particles are then released to block the abnormal blood supply, preventing further bleeding and allowing the body to gradually absorb the existing blood collection naturally. The procedure does not require opening the skull, causes less discomfort, and allows faster recovery. The procedure lasted for half an hour.”
Dr. Mayur Gharat, Consultant Neurosurgery & Neurointervention, said, “The patient’s progress was remarkable. He clinically improved the next day. The hematoma thickness slowly reduced from 22 mm to 6mm over a month. And completely disappeared after six weeks. Today, he has completely recovered and returned home walking independently. The patient has resumed his daily routine without any difficulty. Also, MMA Embolisation reduces the risk of recurrence from 15 per cent to less than 1 per cent even on blood thinners as per recent randomised controlled trials.
The man said, “When I started experiencing weakness, imbalance, and confusion, I knew something was seriously wrong. Being a doctor myself, I understood the seriousness of the diagnosis but was concerned about undergoing open brain surgery, especially because I was taking blood thinners for my heart condition. After consulting Dr. Kushal Bhatia, I was given a detailed explanation of this minimally invasive treatment and felt confident. The procedure went smoothly, my recovery was much faster than I expected, and today I am truly grateful to the entire team for giving me a safe and effective treatment.”
Dr. Bipin Chevale, CEO of the city hospital concluded, “This case highlights how advanced minimally invasive neurovascular procedures are transforming the treatment of complex brain conditions. Patients who previously had limited options or faced high-risk open surgery can now benefit from newer techniques that offer faster recovery, reduced complications, and excellent outcomes.”