Doctors from Istanbul refer patients to “Heart and Brain” Pleven

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The unique equipment is part of the Complex Oncological and Radiosurgery Center in the high-tech Heart and Brain, Pleven, which is unparalleled in the country and the Balkans.

In 2012 Eugenia was only 17 years old when she was diagnosed with multiple benign intracerebral tumours, mainly on the periphery of the brain and the meninges. The largest was located in the left hemisphere, near the brainstem (the part of the brain where the centre of respiration and heart activity are located). A similar benign tumor, but smaller in size, is located mirrored and on the right side of the head. The patient has other tumors, but of sizes and locations that do not threaten her health at this time. Due to the proximity of the tumors, neurosurgical intervention was not possible and the patient was referred for radiosurgery in Istanbul (at that time there was no radiosurgery equipment in Bulgaria).

The radiosurgical procedure done abroad is ionizing radiation and covers both areas of the brain that are irradiated with a dose of 25 Gy (Gray), with 3 irradiations in the left and 2 irradiations in the right hemisphere, respectively. The complexity with Eugenia is that the two irradiated areas are in close proximity – on either side of the most important brain structure.  The intervention cumulatively exposed the patient to a dose of radiation close to the critical dose, but the development of the tumor process was halted for 8 years.  In 2020 – 2021, a new growth was observed that squeezed and deformed the brain stem. Due to the proximity of the tumours to the respiratory and cardiac centres, the fear of complications is serious and repeat radiosurgery in Turkey is delayed. This results in irreversible damage to the auditory nerves and complete hearing loss. Eugenia and her family sought help from specialists at home and abroad, but everywhere they were denied both surgery and radiosurgery.

In June last year Jenny was consulted again in Istanbul, where she was recommended radiosurgery treatment at Heart and Brain Pleven. There is the most advanced in the Balkans and the only Gamma Knife in Bulgaria. Collegially, the Turkish doctors sent the documents with the initial treatment. A multidisciplinary team of radiosurgeons – Dr. Rumen Lazarov, Dr. Nikola Bildirev, the leading neurosurgeon Assoc. Prof. Dimitar Haritonov and doctors from several other specialties. They decided to carry out treatment by irradiation. The treatment dose was carefully tailored to the radiation already accumulated in Eugenia’s body, as well as to the time that had passed between the first treatment and the current one in Pleven.

The repeated need for a patient to undergo radiotherapy is a real challenge in medicine. The doctors again administered a dose of 25 Gy, divided into 5 fractions, and included decongestive (anti-swelling) therapy – before, during and 2 weeks after the treatment, with a gradual reduction in dose. Precision in defining the boundaries of the treated area in the brain, constant monitoring of the patient’s position (any twitching in the body leads to automatic cessation of radiation) and direct connection to the MRI, ensuring accurate imaging, are additional prerequisites for the success of the treatment. The patient feels well and has no side complaints.  Along with the knowledge of the doctors and the capabilities of the modern equipment, the key is the trust gained in the team and the return of hope in the young woman.

Today, Eugenia is 27 years old and the Heart and Brain doctors continue to monitor her condition and keep in touch with the family. “I am grateful to the Heart and Brain doctors in Pleven because they saved my life,” she says.  She feels well, enjoys the support of her husband and family and is making plans for the future. “By telling the story of my treatment, I want and strongly hope to help other patients like me get the help they need. The doctors and equipment in Pleven helped me and my family after months of wandering around clinics abroad,” says Eugenia.

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