Today, during a follow up in OPD, came across a child of head injury which he had suffered due to fall from stairs 1 month back. This was the first time that I was seeing a smile on his mothers face ever since he suffered from this fatal injury. The child had improved significantly and had started talking with mild left upper and lower limb weakness.
The mother said to me, “ Abhi ladka kafi achcha hua hein, Baat bhi acchi kar leta hai. Usko sab yaad hain... woh khud mujhe batata hai ki woh sidiyon se kaise gira... Sirf abhi baen (Left) haath mein thodi kamjori hain... aur ek dikkat ye hai ki ab ye khaana jaada khata hain ... aur meetha toh kuch jyaadaa hi pasand karta hai...”
I just remembered the day when this 2 years old boy was presented in emergency in poor neurological status with labored breathing at around 12 pm. He was not responding to any painful stimuli, was not opening eyes and was not moving left upper and lower limb. On evaluation, we diagnosed him as having acute hematoma in brain (Acute subdural hematoma).We immediately shifted him to ICU and kept on ventilator after resuscitation. He was started on drugs to lower the pressure inside brain.
Thanks to Almighty, repeat CT scan showed resolution hematoma. But there was no improvement in his neurological condition. Two days later he developed severe respiratory infection with increased respiratory rate. We started on higher antibiotic to which he responded. One week later he was gradually weaned off from ventilator.
On discharge, he was opening eyes spontaneously, not talking and had left side paralysis. But with his parent’s intensive efforts, frequent interaction with the child and regular physiotherapy he improved over time and got through this fatal head injury.
In severe head injury, patients relative play a more important role than any other member of the treating doctors. Its active participation of family member in his rehabilitation help him improves rapidly.
Image source: australiawidefirstaid.com.au