When Complex Means Simple

A 21 year old young woman had been presented in the Emergency Department of Ruby General Hospital in the wee hours of the morning with complaints of headache, fever associated wth dysuria (Difficult urination), nausea, vomiting followed by altered sensorium along with weakness of left upper and lower limb. After a thorough evaluation and relevant investigations, she was put under the care of Dr. Biswajit Sengupta (Consultant Neuro Surgeon). Simultaneously, the lady was 35 weeks pregnant with a premature live foetus and had been initially treated at a nursing home in Burwdwan where she had been diagnosed with right subdural empyema which is a collection of fluid material inside the brain and causing headache and left sided weakness. (Prof) Dr. Sudhir Adhikary (Consultant Obstetrics and Gynaecology) with his expertise had taken care of the Gynaecological issue along with the Paediatric team. The brain condition required immediate surgery to relieve the brain pressure at the same time to take care of the infection as well.

After discussion at length with the family members and explaining them about the risk involved, benefits and nature of procedure to be done under general anaesthesia. After obtaining written and informed consent from the family members, the lady had been posted for immediate surgery. First, the baby had been delivered by Caesarean section under the supervision of (Prof) Dr. Sudhir Adhikary (Consultant Obstetrics & Gynaecology) followed by the brain surgery under the supervision of Dr. Biswajit Sengupta (Consultant Neuro Surgeon). A portion of the skull on the right side was removed, a layer of dura mater was slit and all pleural matter was drained out and irrigated thoroughly with antibiotic solution. Postoperatively, the lady was managed in ICU with ventilator support and after two days she had been successfully extubated. The lady had a speedy recovery and was discharged on the seventh post operative day. According to both the treating consultants such cases are very rare and a positive outcome is a little short of a miracle. The multi disciplinary effort of the various departments played a very important role in helping the lady enjoy motherhood as well as the family with the bundle of joy.