PATIENT CONDITION A 55 year old housewife found unconscious at home by neighbors. She was taken to nearest Hospital in Bulandshahar and CT scan was done at after 2 hours which showed brain hemorrhage. She was referred to Fortis Hospital, Noida for brain angiography, Patient was admitted in Fortis Hospital in unconscious condition. She had difficulty in breathing.
INVESTIGATION She required ICU care and ventilator for breathing. Her heart was not working properly. She was resuscitated in ICU and brain angiography was done after 2 day. There was an aneurysm which has caused brain haemorrhage and she needed surgery to prevent rebleeding. But she was not fit for any anaesthesia. After one day, her condition was further deteriorated and blood pressure falled to minimum level. Her pupils dilated and doctors thought she will not able to survive for more than two or
SURGERY With efforts by critical care and neurosurgery team her condition improved. She was then operated upon after 36 hours. surgery was successfully performed at Fortis Hospital, Noida. Sugeons has to perfomed craniotomy and clipping on the patient. surgeons had to open the skull because there was a large blood clot also which was to be evacuated.
Chief Surgeon Dr. Rahul Gupta, Senior Consultant Neurosurgeon, Fortis hospital, Noida. Team Members : Dr Anil Dhar Dr A P Singh Dr Manish Marda& AFTER SURGERY After surgery she had severe pneumonia and she stayed in ICU and she kept on ventilator for 10 days. Then she became conscious and shifted to ward.Now after oen month she has regained all her brain function. There is some left side weakness, but her condition is improving fastly. ABOUT COILING/CLIPPING Coiling or Clipping of aneurysm are methods to prevent re-rupture of ananeurysm. Coiling is done in Neurocathlab, where without opening the skull, the aneurysm is packed with coils. It is a relatively new method with excellent results. In clipping, the skull is opened, aneurysm
is exposed and a clip is placed across its neck. This is a time tested method and provides permanent cure. Spontaneous brain haemorrhage is very common and almost 50% patients expire before they can be shifted to a tertiary care hospital. Patients who are unconscious before surgical treatment take months to recover. Unfortunately, there are few centres for rehabilitation in India and patient has to be shifted home after definitive treatment. Hence, role of prevention and timely intervention cannot be
overemphasised. Brain haemorrhage is bleeding into the brain tissue or its surface due to rupture of blood vessel. It can be spontaneous or due to head injury. Spontaneous Brain haemorrhage is usually associated with high blood pressure (BP). Different types of brain haemorrhage may have different reasons.
SURGEONS ADVICE For preventing brain haemorrhage frequent monitoring and control of blood pressure with medication and lifestyle modification are most important. Brain haemorrhages are more frequent in early morning especially in winters. Drinking lot of water and timely consumption of medicines is essential. Minor headaches should not be neglected and Neurosurgeon/Neurologist should be consulted.