Pune, 27 August 2024: 1Nine-month-old Anushree was admitted to Manipal Hospital in Kharadi after she fell from the second floor of her house. The heavy fall left her with severe head and thigh injuries and she lost consciousness.

She was exhibiting a number of critical symptoms including seizures, drowsiness and unequal pupils, indicating a potentially life-threatening brain injury. The medical team led by Dr. Parth Dalal, Pediatric Intensivist, suspected brain hernia and internal bleeding and immediately started emergency measures to reduce the intracranial pressure (ICP) in her skull and stabilize her condition. A rapid CT scan was conducted, which confirmed the presence of left-sided subdural hemorrhage (SDH) and signs of brain hernia.

After diagnosing her condition, doctors performed a craniectomy (brain surgery) to reduce pressure and prevent future brain damage. During the procedure, a large blood clot was removed and part of the skull was temporarily removed to allow the brain to grow safely without increasing intracranial pressure. After ensuring the stability of her intracranial pressure, she underwent orthopedic surgery for a femoral fracture. A flexible rod was inserted to stabilize the fracture, which will be removed during follow-up surgery.

Anushree was taken to the intensive care unit where she continued to receive intensive medical care, including physiotherapy and nutrition. Her condition gradually improved, she regained consciousness, was able to follow commands and her motor skills improved. She was able to open her eyes, recognize her parents and respond appropriately.

Dr. Parth Dalal, specialist in pediatric intensive care, spoke about the case. Manipal Hospital in Kharadi, Pune, said: “The violent impact with the ground caused a brain hernia and subdural hemorrhage on the left side of the brain. In such cases, pressure builds up inside the skull, pressing on the brain tissue and can lead to paralysis, reduced breathing and even death. During the craniectomy, we removed a large blood clot to reduce the intracranial pressure. Despite her frequent seizures and hemodynamic instability, her condition eventually stabilized with constant observation in the intensive care unit, medication and therapy, including electrolyte monitoring and respiratory support. She was discharged after a 9-day hospital stay. As her condition improves, we are monitoring her closely to ensure her steady recovery.”

An interdisciplinary team of pediatric intensive care physicians, neurosurgeons, orthopedists, anesthesiologists, nurses and physiotherapists responded quickly, saving Anushree’s life and enabling her miraculous recovery.

Patient admission date: June 9, 2024

Patient discharge date: 17 June 2024