Groundbreaking Surgeon from Rijeka Successfully Completes Complex Brain Surgery

By 28 August 2017

Dinko Štimac M.D., the head of the Neurosurgery Department at the Clinical Hospital Center in Rijeka (KBC), is blazing a trail in Croatian medicine.

Dr. Štimac was the first in Croatia – and in the world – to carry out a procedure which had him implant a 3D-printed artificial vertebra. The implant was used to replace a metastasized 7th cervical vertebra of an 77-year-old patient who was suffering from a malignant disease. He is also known for removing a tumor through an incision at a patient's eyebrow; he went on to set yet another world precedent by successfully completing a procedure where he installed two bypasses at the blood vessels of the brain.

After all the groundbreaking procedures, Štimac faced the most complex surgery of his career so far, reported Index on August 27, 2017. A 70-year-old came in with an extremely rare type of malformation of cerebral blood vessels.

"It looks like an aneurysm, but the pattern of blood circulation resembled one of an arterio-venous malformation. The patient's artery was passing under the bone, below the skull roof of the eye socket, piercing the said roof and entering the skull cavity, resulting in an instant malformation. We had to remove the skull roof of the eye socket to get access to the arterial vessel. In such cases, it's of extreme importance to do a quality vascular screening, which was done at the Radiology Department at the KBC Rijeka and at the Faculty of Medicine in Rijeka", said Dr. Štimac, adding this was the first time he faced such a malformation in 21 years of surgical practice.

The patient's medical issue was diagnosed at the Neurology Department at KBC Rijeka. The removed malformation will be analysed at the Pathology Deparment, and according to Štimac, the most important part of this successful outcome is the fact that the patient is recovering well despite his old age.

"The malformation started to bleed recently, and the patient was lucky enough to have the bleeding stop spontaneously. It wouldn't have lasted long, though. It would have burst again, but with a much worse outcome. If he didn't have surgery, there would have been a great chance of the malformation bursting again, but he would have had little chance for the bleeding to stop on its own again; the bleeding would have probably lead to the patient's death or serious neurological damage. That's why such malformations need to be removed instantly, in order to prevent repeated bleeding and the catastrophic consequences for the patient's life and health. This was the most complex malformation I have ever seen, but we managed to remove it", concluded Dr Štimac.

He also said such procedures are opening new horizons in Croatian medicine. The surgery was observed by medical students from Spain and Portugal.