Head Injury
14 years old male brought to hospital with h/o glancing blow to the head by a passing cyclist.
No h/o un-conscious/ vomiting/ ENT bleeding on presentation.
No external injuries.
O/E: clinically normal
X-Ray Skull: revealed a small linear fracture over Rt. Temporal region.
An urgent CT Scan was advised and revealed large extra dural haematoma over Rt. Parietal region.
While patient was being wheeled out of CT Scan, he had first episode of vomiting which was projectile in nature.
Patient was immediately posted for decompression. He underwent craniotomy with evacuation of extra dural haematoma with ligation of Rt. Temporal artery.
Patient recovered uneventfully.
KEY TAKEAWAYS:
- High index of suspicion even when patient was clinically normal.
- Rapid mobilisation for surgery leading to prompt recovery.
Scoliosis
A 20 years old male patient with progressive deformity of spine, since adolescence.
No treatment taken as patient was economically weak.
At age of 20 years patient first presented in OPD with deformity of spine. He was diagnosed as idiopathic scoliosis with double major curve in dorsal/ lumbar spines. He had no neurological deficit..
Patient was very keen for surgical correction of deformity due to cosmetic reason.
Patient underwent a supra major procedure lasting over 12 hours, in which his deformity was corrected.
Patient was well satisfied with the correction. Correction has been maintained 2 years post operatively and patient has got married.
KEY TAKEAWAYS:
- Procedure was extremely long with major risks of infection. The quality of the operation theatre permitted the undertaking of such an extensive procedure with minimal risks.
- The procedure was done at a fraction of the cost that would have cost the patient in any hospital including government hospital. A large part of his expenses was borne by his employer. The hospital and doctors charged a fraction of their charges.