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A Delicate Touch to Ensure Successful Surgeries

Complex University Surgery: A Linz professor removes an angioma during a 24-hour procedure.

Andreas Gruber
Andreas Gruber

There’s no rush: When Linz neurosurgeon Andreas Gruber plans a complex procedure, it is less about a race against the clock. The university professor for neurosurgery at the Johannes Kepler University (JKU) remarked: "When we operated on this particular patient, we were in the OR for over 24 hours. I myself began at noon and operated until 9:00 AM the next day until I was relieved by a colleague." The operation involved a so-called angioma located in an almost inaccessible area in the patient’s brain. No other surgeon dared to perform the operation.

Epilepsy and Cerebral Hemorrhage
The stakes were high for the patient, Josef Müller (name changed), who began having epileptic seizures at the age of 16. However, the altered blood vessel causing the seizures was located in an almost in accessible area in the brain and specialists considered an operation to be too risky. Müller recalled: "I had my first embolization in Switzerland when I was 18." This was an attempt to close the defective vessel using an active substance. A second procedure followed, but did not help. The years went on – he got married and had children - and he learned to live with the condition. After suffering a brain hemorrhage in 2017, something needed to be done. Swiss doctors told him about Professor Gruber's expertise and they contacted him. Müller remarked: "Since the operation in 2020, I can now lead a completely normal life.", expressing so much of what the now 47-year-old patient has suffered since he was a teenager. It was not only the epileptic seizures and how the insufficient blood flow impacted his life. Müller added: "I lived in constant fear that something was going to happen. Today I feel freer." He added that the fact that he was so welcomed and well-treated in Linz added to the JKU and KUK team’s tremendous accomplishment. The patient is grateful that thanks to innovative high-end technology, the procedure could be performed by experts at the Department for Neurosurgery: "The fact that Professor Gruber had the courage to do the surgery is amazing."

The Angioma, a Parasite
The neurosurgeon explained what made the procedure particularly difficult: "An angioma of this kind is like a parasite that draws away all of the blood. Veins and arteries look similar. First, you have to close the supplying, deeper vessels, then the draining vessel. Damaging the wrong vein results in too much bleeding and during an operation like this, patience and taking one’s time is critical. One small mistake can have immediate, fatal consequences."  Does he have any caffeinated beverages when operating for this length of time? "Absolutely not. Stimulants affect one’s fine motor skills. When you have to focus and concentrate for this long, physical needs tend to take a back seat, even over the course of many hours."