Mumbai docs save life of 4-year-old child with severe traumatic brain injuries

In a remarkable case doctors at a Mumbai hospital have saved the life of a critically injured fouryearold Vaibhav MishraThe child was brought to the Emergency department at Jaslok Hospital after sustaining a highimpact pedestrian injury The patient was found unconscious and alone by police personnel having been struck by a fourwheeler while attempting to cross the roadUpon arrival Vaibhav exhibited a severely depressed level of consciousness Glasgow Coma Scale score of E1V1M1 which means unconscious and no response to deep pain signs of head trauma and multiple external bruises The Accident amp Emergency team including Dr Sachna Shetty and Dr Sunil Jain at Jaslok Hospital promptly initiated the paediatric trauma protocol with spinal stabilisation airway management through endotracheal intubation and fluid resuscitation to stabilise the patientEarly imaging and diagnosis emergency imaging revealed critical injuries including intracranial haemorrhage and diffuse cerebral edema with multiple contusions in both lungs Additional injuries included fractures to the clavicle mandible and first rib along with a rightsided pneumothorax all of which were identified through CT scans of the brain spine thorax and abdomen It was suspected to be a Diffused Axonal Injury and was later confirmed by MRI brain reportsA comprehensive management plan was initiated with the involvement of the paediatric trauma care neurology and neurosurgery orthopaedic and intensive care teams for children The child was started on IV fluids IV antibiotics anticonvulsants hypertonic saline for intracranial pressure management and sedative analgesia MRI findings later confirmed the diagnosis of Grade 3 DAI Surgical Intervention amp Recovery Orthopaedic intervention was required for the fractured clavicle which was surgically repaired without complicationsOver the next few days Vaibhav showed encouraging signs of neurological improvement including spontaneous eye opening and limb movement He was successfully extubated and weaned off oxygen supportDr Shetty consultant Accident amp Emergency at the hospital said ldquoVaibhav was brought in a deeply unconscious state with signs suggesting potential airway compromise Our priority was to secure the airway and stabilise the patient hemodynamically Early diagnosis through trauma imaging played a pivotal role in guiding further interventions and preventing secondary complicationsrdquoDr Shehla Kazi consultant ndash Paediatrics ldquoVaibhavrsquos condition was critical He was immediately started on IV fluids IV antibiotics anticonvulsants medication for intracranial pressure management and sedative analgesia MRI findings later confirmed the diagnosis of Grade 3 DAI hence timely Paediatric trauma care Neuroprotective interventions and supportive care helped stabilise neurological functions Holistic approach in the form of physiotherapy speech therapy and Ooccupational therapy by expert Dr Shehnaz Shaikh was started early on and continued neurorehabilitation under the expert care of Dr Anaita Udwadia Hegde Paediatric Neurologist and close paediatric monitoring were key to the recovery journeyrdquoDr Abhijeet Savadekar consultant ndash Orthopaedics and Shoulder Surgeon at Jaslok Hospital amp Research Centre added ldquoVaibhav had a severely displaced clavicle fracture with suspected brachial plexus injury due to high velocity trauma Fractured Clavicle end was exposed through the skin with possible ligament and Brachial plexus injury Surgery was carefully performed by Dr Kiran Ladkat Consultant Orthopaedics and Hand and Brachial plexus surgeon and myself with the guidance of Dr Rujuta Mehta Paediatric Orthopaedic Surgeon at Jaslok Hospital Given the polytrauma context it was important to ensure timely intervention while coordinating with the Neurology and Paediatric teams to prevent any delays in recovery and to get the best possible functional outcome The surgery was supported by the Dr Anuraj Jain Consultant Anaesthesiology at Jaslok HospitalrdquoRuby Mishra Vaibhavrsquos mother expressed her heartfelt gratitude for saving her child and said ldquoI couldnrsquot believe in any other hospital and doctors after seeing the way my child was managed when he was brought in critical condition with no hope of survivalrdquoThe patient was discharged in a hemodynamically stable state showing gradual but promising neurological recovery The family was provided detailed education on feeding medication home care and warning signs requiring medical attention Ongoing physiotherapy and speech therapy have been advised to ensure longterm rehabilitation