Thursday, April 29, 2010

Docs pull splinter from brain -New Delhi-India

Docs pull splinter from brain

Foreign Object Was Lodged In 11-Year-Old’s Head For 2 Years


New Delhi: (India) The doctors were shocked when 11-year-old Rahul walked into the neurosurgery OPD at AIIMS a few days ago. Rahul had been walking about with an 8cm-long wooden splinter in his brain — it had pierced his left eye — for the past two years. On Wednesday, doctors at AIIMS extricated, in a five-hour-long surgery, the splinter from Rahul’s brain. The doctors were very surprised that Rahul hadn’t developed a neurological or other complication over the past two years.
‘‘It’s unbelievable. Despite having a foreign body in his brain, he didn’t develop a medical complication. He was absolutely fine when he came to us,’’ said Dr P Sarat Chandra, associate professor, AIIMS, who operated on Rahul.
According to Rahul’s family, he was playing when he fell on a wooden stick, a splinter from which pierced his left eye and entered his brain. ‘‘The stick broke when he tried to get up. We took him to a local hospital where doctors said they couldn’t remove it,’’ said Ratna Devi, Rahul’s mother, who took him to several hospitals before bringing him to AIIMS. Because of the accident, Rahul lost his vision in the left eye but that didn’t stop him from going to school and going about his everyday activities. “He had no difficultly at all. We consulted several doctors but all of them refused to operate him. Then someone suggested us that we should take him to AIIMS.’’
Apart from the left eye orbit, the splinter pierced the temporal lobe (responsible for memory), cavernous sinus (a collection of thin-walled veins at the base of the brain), the cerebellum (responsible for motor function), and was exerting pressure on the brain stem. ‘‘The splinter missed the internal carotid artery, which is very close to the cavernous sinus, by less than a millimetre. Since the splinter had been lodged in the brain for two years, there was some inflammation around it and there were significant changes near the cerebellum. Had the splinter been pushed farther inside, it could have been fatal,’’ said Chandra. Doctors say Rahul’s case is nothing short of a miracle. ‘‘All the major areas in the brain were affected by the splinter, but there were no complications. It is surprising that he didn’t develop an infection over the past two years. And he is very lucky there was no major damage to the brain,’’ said Dr AK Mahapatra, head of the department of neurosurgery, AIIMS.
During the surgery, doctors had to be very careful while pulling the splinter out. Even a minor error might have proved fatal. ‘‘We cut open the
front of the left skull and the roof of the eye orbit. We retracted the brain so that we could see the splinter and then, slowly, pulled it out. The splinter had become soggy and it was difficult to pull it out in one piece. We then washed the affected areas of the brain with antibiotic solution,’’ said Dr Chandra. Rahul has lost vision in his left eye due to the injury but doctors were able to preserve the globe of the eye. “He wouldn’t be able to see but cosmetically it will not look bad,’’ said Dr Chandra.
Doctors say that it will take Rahul a month or two to recover completely. ‘‘The risk of him catching an infection is high. He can still get meningitis so we have to be very careful,’’ said Dr Mahapatra.

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