Hyderabad, June 26: Yashoda Group of Hospitals, Hyderabad has once again displayed its competence and expertise in advanced neuro trauma care by successfully managing a complicated case of severe traumatic brain injury (TBI) due to a road accident. The multidisciplinary team at the hospital managed to stabilise the patient and successfully guide him through a very challenging recovery phase with rapid diagnosis, urgent neurosurgical intervention and meticulous intensive care.
Severe TBI continues to be one of the most prevalent public health problems in India, particularly in young and economically productive age groups. These injuries often occur without warning, and can progress from seeming stability to irreversible neurological damage in minutes or hours. Outcomes can be permanent disability, vegetative state or death. Immediate neuroimaging, surgical decompression and intensive care support are paramount.
In high-speed accidents brain injuries are rarely confined to one bleed or fracture. They are usually a combination of hemorrhagic contusions, extradural and subdural haematomas, diffuse cerebral oedema and secondary ischaemic insults. As the pressure within the skull increases, it can quickly become a threat to cerebral perfusion. The time frame for life saving intervention is very narrow.
In a recent case, Mr. Naresh M, a 30-year-old resident of Nagarkurnool district of Hyderabad, was brought to Yashoda Group of Hospitals, Malakpet Branch, after a two-wheeler accident. He had lost consciousness, repeated vomiting, epistaxis and bleeding from the ear. Initial inspection shows that the patient had a low Glasgow Coma Scale (GCS) score indicating the possibility of severe TBI. Emergency neuroimaging further revealed bilateral temporal hemorrhagic contusions, extradural and subdural haematomas, diffuse cerebral oedema, skull base fractures, and features of diffuse axonal injury.
The patient was operated under general anaesthesia and an emergency left fronto temporo parietal decompressive craniectomy with haematoma evacuation, duraplasty and external ventricular drainage was done. Following surgery, he was managed in the neuro ICU with mechanical ventilation, ICP monitoring, antiepileptics, antibiotics and full supportive care. Due to the need of prolonged ventilation, a tracheostomy was done. Serial imaging revealed a resolution of large intracranial haemorrhages and stabilisation of cerebral oedema.
“A severe Traumatic brain injury after road traffic accidents is one of the most serious neurosurgical emergencies . Delay in surgical decompression or critical care support can lead to irreversible brain damage or death. Early neuroimaging, early decompressive intervention and continuous neuro critical monitoring assisted in controlling secondary brain injury and stabilising the patient here. Such results can be achieved only with advanced neurosurgical infrastructure and dedicated multidisciplinary ICU team,” said Dr. Sayuj Krishnan S, Chief Consultant – Neurosurgery, Yashoda Group of Hospitals, Hyderabad.
The patient started showing neurological recovery with stable vital signs and controlled intracranial pathology. He was discharged in stable condition with advice for continued neurorehabilitation and follow up.
This case showcases the advanced capabilities of Yashoda Hospitals in handling complex neuro trauma emergencies. Yashoda Hospitals continue to set benchmarks in emergency neurosurgical and trauma care with rapid emergency response, state of the art neuro imaging, round the clock neurosurgical availability and comprehensive neuro critical care. All branches of Yashoda Hospitals are well equipped with advanced neuro trauma infrastructure, expert neurosurgical teams and 24/7 intensive care facilities to provide timely intervention during the critical golden hours.