Complex surgery saves boy having brain haemorrhage, coma

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Dr Ashwin Borkar

 Rohit Shishodia
Doctors at Wockhardt Hospital, Mumbai, have given a new lease of life to a 6-year-old boy who suffered brain haemorrhage, by performing decompressive craniectomy, a complex brain surgery. The boy is improving and doing well.

The boy, Shahid, had also undergone bone marrow transplantation as he suffers from Sideroblastic anemia, a group of bone marrow disorders characterized by increased accumulation of iron in the red blood forming precursor cells.

Life was beautiful until the parents of 6-year-old Shahid, a resident of Ahmednagar (currently staying at Borivali) noticed that he had vomited and was unresponsive in the middle of the night. He recently came to the emergency in the early morning.

Dr. Ankit Gupta, Lead Paediatric Intensivist, Wockhardt Hospitals, said: “In the emergency he was unresponsive, actively convulsing and showed life-threatening signs of brain herniation. CT scan of the brain suggested he had a severe form of brain hemorrhage, which, if not treated urgently, would lead to death in a couple of hours.

Dr. Ashwin Borkar, Consultant Neurosurgeon, who performed Shahid’s brain surgery, said: “An extra Dural Hematoma is a common occurrence following traumatic head injuries and accidents but spontaneous epidural hematoma (EDH), which happened in Shahid’s case, is very rare. It could be due to platelet dysfunction, altered blood coagulation parameters, and ineffective bone marrow."

"Hematoma causes progressive compressive effects on the brain causing unconsciousness, coma and may be fatal if not evacuated timely. As the child was brought in a comatose condition, he was immediately put on a ventilator and taken up for an emergency surgery craniotomy and Hematoma evacuation after a CT scan of the brain showed a massive Hematoma," explained the doctor.

Dr Borkar further said that this surgery involves creating a window in a skull bone overlying the Hematoma and the use of suction to remove the clot and is a life-saving surgery. Control of bleeding during such surgery is challenging due to altered blood parameters, hypertension and massive clot size.

Dr. Ankit Gupta added: “He had a stormy post operation course, where he developed HLH (Haemophagocytic Lymphohistiocytosis) which is a potentially fatal condition wherein the immune system gets excessively activated and destroys the normal cells of the body. The boy has resumed his daily activities and is fine now.”


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