An arteriovenous malformation (AV) malformation is a congenital disorder characterized by an abnormal connection between the arteries and veins in the brain or spine. An AVM is capable of disrupting the flow of oxygen-depleted blood in the vein, which is supplied back into the lungs and heart.

Monica from Ghana suffered from AV malformation. She decided to look for options for medical treatment when she started experiencing episodes of unconsciousness. After a long struggle of arranging funds and seeking help from the insurance company, Monica decided to take her chances and travel to India for state-of-the-art medical treatment.

Patient Introduction

Monica is a citizen of Ghana. She contacted her insurance agency for help with the medical treatment. The insurance agency happened to be Medigence’s strategic partner. They landed up referring this case to MediGence and shared Monica’s medical reports with them.

About Patient’s Medical Condition (Pre-treatment)

People with AV malformation may remain symptomless for years. However, dizziness, headache, and seizures are some of the symptoms that they may suffer from.

Monica did experience specific symptoms such as episodes of unconsciousness and seizures. She had three episodes of loss of consciousness. Fortunately, they all happened when she was home and therefore, there was no physical harm.

Travel Period

Quickly within two days, the team at MediGence analyzed the medical reports and shared it with the three best hospitals in the Delhi NCR region for an opinion. The team prepared a detailed treatment plan based on an opinion from the doctors.

Monica selected Artemis Hospital in Delhi NCR for her treatment as she and her family preferred CyberKnife treatment for her condition. Artemis Hospital is a globally renowned JCI-certified hospital and ranks among some of the best hospitals in the country. The hospital issued a visa invitation letter to her and she booked tickets to reach India on May 23, 2018.

As soon as she reached the county, the Patient Care team at MediGence went to the airport to pick her up and dropped her at the hotel, which was booked beforehand. Monica’s treatment got over on June 05, 2018. She had open tickets so her tickets were changed by MediGence team and she traveled back to Ghana on June 08, 2018.

Treatment Details

The same day of her arrival, Monica had an appointment with a neurosurgeon at Artemis Hospital. Investigations were carried out at the hospital, following which she went back to her hotel. The next day she was admitted to the hospital so that angiography of the brain could be conducted to see the extent of her aneurysm. After angiography, it was noticed that she had developed a second aneurysm in this span. Also, she was diagnosed with hepatitis B. At the same time, her planning for CyberKnife was conducted in the hospital.

A single or a couple of sessions of CyberKnife radiation is enough to treat brain AV malformation and it was the same case with Monica. Since the blood test indicated that Monica was Hepatitis B positive, she was given some medications. She was also asked to wait a few days before the CyberKnife treatment is initiated.

She also had a swelling in the back of her skull. Therefore, she was advised to wait for the swelling to subside before the treatment can be initiated.

Monica stayed with her little sister in a hotel for a period of two weeks. She was admitted to the hospital on June 04, 2018 for her CyberKnife radiation therapy planning sessions. The actual therapy took place on June 05, 2018.

Contrary to what was anticipated earlier, Monica only required one session of CyberKnife radiation for the treatment of AV malformation. The doctors advised her to return back after 6 months for a second sitting and follow-up.

Treatment Challenges

Since Monica was diagnosed to be hepatitis B positive, the doctors decided to wait for some time before the actual treatment was initiated. Therefore, Monica and her sister had to stay in the guest house for a couple of extra days.

As she had come with her younger sister, her local guardian was the MediGence team which was present with her during all investigations and treatment. The team kept visiting them at the guest house and also arranged things to make her stay as comfortable as possible.

Monica and her sister were more keen to prepare their own food in the kitchen. Therefore, the Patient Care team made sure that their room in the guest house was just opposite to the kitchen so that they can comfortably prepare their meals.

The MediGence team ensured a smooth coordination with the hospital and that all of Monica’s local traveling needs are met.

Patient’s Medical Condition (Post-treatment)

Monica tolerated the CyberKnife well and was discharged from the hospital in a stable condition. She was advised to follow up after six months.

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