KIMSHEALTH: Traumatic head injury patient recovers after neurosurgery

ON  14 Sep, 2020

Shattered skull pieces removed from the brain in five-hour procedure

Death looked a near-certainty when a 57-year-old fisherman shattered his skull into pieces in a freak fishing accident, but an incredible surgery and effective aftercare at KIMSHEALTH, a world-class multispecialty hospital here, pulled him back from the brink to a new lease of life.

In the surgery that lasted about five hours, Dr M D Sreejith, Neurosurgeon at KIMSHEALTH, undertook the high-risk procedure of extricating the broken pieces of the skull from the patient’s partly damaged brain and emerged successful, despite the survival rate in such cases being only razor-thin and almost negligible.

Although the odds were heavily stacked against the patient – the critical nature of the wound, the collateral injuries he suffered on the chest and his age – we are happy the patient could leave the hospital cured in over 10 days’ time, said a beaming Dr. Sreejith.

It was on August 14 that the cable of the hydraulic fishing net hauler snapped and pierced through the patient’s skull when he was on the high seas, fishing on board a trawler off the coast of Neendakara Fishing Harbour with a few of his colleagues.

Not only did the incident cause him serious head injury, its impact tossed him off the boat. To make matters worse, his chest violently hit the side of the trawler as he hurtled into the water. His colleagues immediately stopped the boat and two of them rescued him and brought him back to the trawler even as he was losing consciousness. An ambulance was ready on the coast to take him to the nearest hospital.

By the time he reached the hospital the patient was finding it difficult to breathe. He was immediately intubated, a process in which a tube is inserted into a person’s trachea for ventilation. Seeing the nature of the injuries, the hospital advised his colleagues to take him to another hospital which had a neurosurgery department.

When the patient reached KIMSHEALTH, much time had been lost; moreover, he urgently needed ventilator support.

Doctors attending on the patient pointed out to his colleagues that the surgery was fraught with utter risks, but then there was no alternative to it. On getting the consent and based on advice from Dr Khalil Issac, the surgery was taken up and Dr Sreejith which took five long hours to remove all the bone splinters in the patient’s head.

The wound resembled a bullet injury, in which the skull gets shattered into several pieces on slug impact. Each bit had to be carefully extricated from the brain. The patient survived the operation. While we waited fingers-crossed, he moved his fingers on the second day which gave us hope, said the surgeon.

The patient had an ICD (Intercostal Drainage in both chest) apart from an ET tube (Endotracheal tube). On the third day, he was slowly weaned away from the ventilator. However, there was a setback on the fifth day as Henry showed signs of pneumonia, largely due to the blow he suffered on the chest and the sea water he ingested.

A tracheostomy was performed and the patient was given support to breathe. Moreover, phlegm from his chest was removed using the tubes and by the seventh day he recovered to a great extent.The patient condition improved thereon and he was discharged on the 11th day.

The 57-year-old will have to return to KIMSHEALTH after a couple of months to attach a titanium cap to the part of the skull that was traumatized,Dr. Sreejith said, adding: The worst is over for him, and he can look forward to a new lease of life.

The patient care team included Dr Bhadrinath N (Anesthetist), Dr Khalil Issac (Neurosurgeon), Dr Sudin Koshy (Respiratory Medicine), Dr Ragitha B (ENT), Dr Sujith V (Cardiac Surgeon) and Dr Shafy Ali (General Surgery).

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