OVERCOMING A NIGHTMARE IN REALITY
A 17 year old youth had been presented in the emergency department of RubyGeneral Hospital post a road traffic accident. He could not think rationally (altered sensorium) and had a head injury with laceration over right eye and forehead along with multiple abrasions over chest, left shoulder, both arms and knees. He had been admitted under the care of Dr. Tamajit Chakraborty (Consultant Neurosurgeon) and after evaluation and relevant investigations the young man had been diagnosed to have a compound depressed fracture (break in a bone with depression in toward the brain, loss of skin and splintering) of frontal bone and anterior skull base with avulsion (a forcible tearing off of skin) of forehead skin and large skin defect. After discussion with the family members and with proper informed consent the young man had been posted for surgery. Bifrontal Craniotomy was made with elevation of depressed skull fracture. The multiple small fragments in the anterior skull base were cleared with removal of frontal lobe contusion. The anterior cranial fossa floor (ACF) had been repaired followed by cranioplasty (Surgical repair of a bone defect in the skull) using titanium mesh and eight screws. Finally, reconstruction of the right upper eyelid and forehead degloving injury (An injury where the top layers of the skin and tissue are torn away from the underlying muscle, connective tissue or bone) had been done under the guidance of Dr. Deepanjan Dey (Reconstructive and Plastic Surgeon). The postoperative period had been uneventful and according to the consultants it is usually very rare that after such an extensive injury, a patient shows a speedy recovery in just five days post surgery.