Hi,
my father aged 67 years had a road traffic
accident
last march 2005. He had left temporal
cerebral
contusion & intracerebral
hemorrhage.
Surgery was conducted under general
anesthesia,
through a left frontotemporal incision a
free left
temporal craniotomy bone flap was raised.
Additional
craniectomy of the temporal squama was
done to expose
the posterior and inferior parts of the
temporal lobe.
The dura was tense. It was opened as a
flap based
posteriorferiorly. The localized subdural
hematoma was
suctioned out and washed off.There were
surface
contusions over the middle and inferior
temporal gyri
.Through the traumatic tears in the
arachnoid and pia.
The contusion hematoma and the necrotic
brain matter
came out and were removed by suction. All
the contused
parts of the posterior parts of the
inferior half of
the temporal lobe were removed under the
operating
microscope. Hemostasis was achieved.
Care was taken to
preserve the vein of the labbe and the
sylvian
vessels. The brain became lax and sank
well below the
dural surface. Surigical and adgel were
placed over
the raw area of the brain left behind
after excising
the confusion.
The dural flap was close primarily. The
bone flap was
replaced and held in place with
polypropylene sutures
passed through drill holed in the edges
after hitching
the dura. The scalp was closed in three
layers over a
closed subtemporails suction drain.
Surgery was done
under the cover of cefpirome &
amikacin.
Follow up ct scan showed total excision of
the
contusion hematomas and no infarctions.
The edema and the mass effect had come
down.
After the surgery there was a drastic
improvement for
the next ten months. He was regularly
going for
walking in the morning and evening and was
capable of
doing all his daily activities on his own.
He was
perfectly alright and nobody knew he had
undergone a
surgery.
During the last two months his health
condition is
detiorating slowly, he has got giddiness
and there is
also increase in his memory loss, he gets
irritated
for simple reasons and is scared to do his
regular
exercise.
I kindly request you to let me know, what
will be the
problem and what rehabilitation steps I
have to take.
