NEW ORLEANS -- A New Orleans East man has a new chance of living a full life after he had brain surgery in New Orleans that was created in Japan.
And only a handful of doctors in the U.S. are experienced in performing this delicate surgical treatment.
It was just a couple of weeks ago that My Tran, 42, lay in the O.R. having brain surgery. Now he says he was never scared and feels fine.
"OK, OK, OK," he reassured his family and the doctor during his visit.
Tran and his family came to New Orleans East from Vietnam in the late 1970s. He and his wife have a 3-year-old daughter. His sister-in-law came along to his post-op check up to help translate. She says it was a few years ago when Tran was only in his late 30s, when his brother found him passed out.
"He came home and saw him just lie on the floor," said Kimberly Nguyen.
Tran suffered two strokes in the last five years. So why was a healthy, young man, in shape with no diabetes and no heart disease, suffering from strokes.
"Moyamoya disease is a Japanese name for a disease that was discovered in Japan and it's very common in Asian people, Korea, Japan, Vietnam, Indonesia. So it is genetically related," Melgar said.
Here's what happens in the brains of people with Moyamoya Syndrome. The blood vessels that bring oxygen-rich blood to the brain, get small and come to an end for unknown reasons at an early age. On a scan, you can see a space in the brain where there are little or no vessels. So the brain tries to compensate making new vessels, but those are small and inadequate.
"These vessels are fragile. They can rupture. They can bleed, so the patients can present with bleeding but most of the time they present with a stroke," said Dr. Melgar.
So a couple of weeks ago Tulane Neurological Surgeon, Dr. Miguel Melgar, brought Tran into a five hour surgery where he opened his skull and performed a brain bypass. It was created by Japanese doctors and something few surgeons in the U.S. are trained to do.
Here's how it works. Dr. Melgar finds the artery that runs in the skin of the scalp and marks in on the patient's head with a red pen. Then he isolates that artery out of the skin and opens the scalp and skull to expose the brain.
Then, using high power magnification, he connects that scalp vessel onto another vessel that goes into the brain. The vessels are tiny, less than one millimeter. He connects the two vessels using small sutures while the vessels are clamped off to temporarily stop the blood flow.
When he is done, extra blood that used to go to the scalp, now goes into the brain. The other blood vessels in the scalp already give it enough blood. Tran now has a good outlook for the future.
"His prognosis is actually really good because people who are functional at the time of surgery, when I am saying functional means they are recovered from the stroke and they are still moving around and they are walking around and talking, they are usually the best candidates to prevent future strokes," Melgar said.
When Tran is asked if he is happy with the outcome of the surgery he responds, "Yeah, yeah, happy."
Melgar says younger people should watch for signs of a stroke: speech problems, blurry vision, weakness on one side, numbness in the fingers. He even has a 12-year-old Louisiana girl scheduled for Moyamoya bypass surgery who is not Asian.
"Now here in America, it's being seen also in people from other backgrounds like Latinos and African Americans, so therefore we are getting to a better understanding. The disease perhaps it's environmental," Melgar said.
And the key is catching it early before a young person has a lifetime of disability from a stroke.
Doctors say there are other causes of young people having a stroke, but if they have symptoms, they should be checked for Moyamoya.