Expressnews
Chennai, 14th July 2023: Rela Hospitalsperformed a complex and complicated lifesaving neurosurgery on a 23-year-old daily wage worker after he was admitted with a 2-inch nail embedded in the back of his head.
Mr. Bramha, a daily wage worker hailing from North India, experienced a sudden and intense pain at the back of his head while cleaning the floor at his workplace in a private firm in Navalur, Chennai. The pain was unbearable, and he felt blood flowing from the back of his head. The patient was unable to see or understand why there was pain and bleeding on his neck though. He was thankfully advised not to panic by the staff as he was informed a 2-inch nail from an industrial gun had accidentally struck his head. The nail was discharged by a coworker who was using the nail gun for a carpentry job.
He was immediately rushed to a nearby hospital, where an X-ray revealed a nail embedded in the back of his head. The doctors of that hospital referred him to Rela Hospitals for immediate surgery. Bramha arrived at the emergency room in a conscious and alert state. He exhibited no weakness in his hands or legs, and his blood pressure and pulse were normal. To prevent any movement of the nail, his neck was immobilized using a hard collar.
“After examining the X-ray, CT scan of the craniovertebral junction, along with a CT angiogram, was also scheduled. During the CT imaging, it was observed that the 2-inch nail was not a simple one, but rather had shanks and additional attachments designed to prevent easy removal once it is hammered into wood. The images revealed that the nail was positioned just above the left vertebral artery, indicating that damage to the vessel could be life-threatening. It was also found to be in close proximity to the occipital vein and the hypoglossal canal, through which the nerve to the tongue passes” said Dr M. Anbuselvam, Senior Consultant, Neurosurgery, Rela Hospital.
“We had to meticulously plan the whole surgery to remove the nail since leaving it in place could lead to infection, while any movement of the nail posed risks to the main artery and neural structures. Given these limited circumstances, the patient required anesthesia for the operation, which was performed with him lying face down. Unlike the usual procedure of inserting an endotracheal tube through the mouth, which involves bending the neck backward, an alternative method using a fiber optic approach was employed. It was then discovered that the nail had penetrated the occipital bone and was lodged firmly. With caution, a diamond burr was used to gently drill around the nail and create space. The shanks of the nail were exposed, and further delicate drilling allowed for the nail’s gentle extraction. There was no bleeding, and the wound was closed successfully” added Dr M. Anbuselvam.
This was an extremely complex and a very complicated surgery which involved a team of experts who had to perform the surgery in a matter of hours to ensure there were no further damage to the spinal cord and other nerves. Shortly after the surgery, the patient regained consciousness, he remained alert, and was able to move his hands and legs without any difficulty. The very next day, he could move around and was discharged on the 2nd day. He is now perfectly normal and is back for work.
“We are proud of our team of Doctors at Rela for performing this extremely complex, complicated, and life-saving surgery in record time ensuring the patient is back to work on the 2nd day itself. Rela Hospital is known for its efficient and experienced doctors and world class infrastructure proving time and again that we are one of the best in the world,” quoted Dr Ilankumaran Kaliamoorthy, CEO, Rela Hospitals.
