Experts at a private neurological hospital in Kolkata have rescued a 50-year-old man who had a needle placed inside his nasal cavity closer to the brain, performing a surgery by opening a portion of the skull.
A senior expert of the Institute of Neurosciences Kolkata (INK) said that they practiced craniotomy, a process generally used to eliminate a brain tumour or abnormal brain tissue, on the man recently.
“The man reached us with one day’s history of bleeding from the nose following which he was admitted. When he approached us he was drunk and we had no clue if he had an injury or somebody had hit him. So we decided to conduct a CT scan of his skull which displayed that a needle extended from his nose till his brain,” the doctor said. In spite of carrying the metal object inside the nasal cavity, the man was otherwise clinically ok and fully conscious.
“He was speaking normally, moving upper and lower limbs as usual and able to walk, eat and drink like a normal human. We had to do an angiogram to map out the exact root where the needle was traversing from the nose to the brain. We are determined to go in for skull base surgery,” he said. The patient’s skull had to be opened primarily and then the needle was plucked from the nose, said the doctor who was part of the team which performed the surgery.
“It is crucial to do the craniotomy opening of the skull first, so that the needle is plucked from the nose and we can tackle any tearing injury that can happen to the major blood vessels inside the brain,” he said. The patient improved well after the surgery as he had only minor problems like local nasal bleeding which was managed using simple ice packs and he was released after three days. Anyhow, it is unclear how the needle entered his nasal cavity.
“The main point to be noted in this issue is that this is a foreign object and it is going through a relatively dirty area (the nose) and infecting a very clean area, the cranial cavity (which contains the brain and all the major blood vessels),” he explained. According to the experts, the surgery needed to be done on a priority basis “or otherwise the disease could have spread through the needle from the nose into the brain”.
Doctors then closed the tiny hole left after withdrawing the needle from the nose to prohibit any leak of cerebrospinal fluid from the cranial cavity or else it could have caused the disease to spread from the nose to the brain. “The patient is stable now but he requires long term follow-up in the form of a CT scan to exclude any brain abscess (a condition of a painful collection of pus, usually caused by a bacterial infection) and an angiogram to exclude any delayed development of aneurysm (bulge in a blood vessel),” he said.
