A Dire Situation

A 76 year old patient Dr. Meena was being treated for COVID-19 at Sagar Hospitals, Jayanagar. She was recovering well and was about to be discharged. However, on the day of her discharge, she had sudden massive intracranial bleed and became deeply comatose.

Although the survival chances were less, her sons agreed for her surgery. Dr Manmeet Singh Chhabra, Consultant Neurosurgeon at Sagar Hospitals didn’t delay further & performed her surgery.

To quote Dr Manmeet- “Apart from other factors like age and coagulation parameters, the prognosis and survival chances in intracranial hemorrhage depends mainly on the level of consciousness , also known as the Glasgow Coma Score (GCS) before surgery. In Dr Meena’s case, she rapidly slipped into a deep comatose state with a GCS of 4/15 and non-reacting pupils. This condition is known as descending transtentorial herniation which, in general, has a poor prognosis. It requires early diagnosis and prompt surgical intervention to prevent respiratory arrest and death”.

COVID-19 & Neurological Disorders

According to Dr Shobha Naidu, Consultant Physician at Sagar Hospitals, - “COVID-19 can cause a myriad of neurologic sequelae. According to a study, the incidence of intracranial hemorrhage (ICH) was found to be 0.7%. Although relatively uncommon among COVID-19 patients, ICH is associated with a high mortality rate.”

The Miraculous Recovery

Despite her age and one-sided bleeding, she showed remarkable recovery with preserved speech and intact limb movements. With physiotherapy and rehabilitation, she was on her feet soon. It was only with immediate and timely neurosurgical intervention; she recovered completely and was discharged from the hospital.

Dr Santosh Kumar, Consultant Neurologist, Sagar Hospital further explains, “COVID-19 induces inflammation of blood vessels (vasculitis) which is responsible for most of the complications including acute ischemic stroke and rarely, brain hemorrhage. During the course of her treatment, apart from ICH, she also developed a condition known as ‘Cerebral Vasospasm’ which is very rare but fortunately recovered with medications.”

A Heartfelt Message to the People

Dr. Manmeet Singh’s message to the people is, “Doctors across the world are doing their best and risking their own lives trying to save patients with COVID-19. Despite taking necessary precautions, the risk of transmission of infection while operating on a COVID positive patient is very high especially during use of high-speed drills for cranial surgery. However, doctors and hospital staff across the country are selflessly providing their services despite the risks. It is indeed satisfying and heartening to see someone in deep coma recovering so well after surgery. On the flip side, it is equally painful to see incidences of attacks on doctors and hospital staff when some patient expires despite all efforts.” Let us thank the brave doctors for selflessly providing their services and who face risks during the COVID-19 pandemic.