Doctors immediately intubated the child and put him on ventilator support. “We had to start multiple medicines to stabilise his blood pressure, reduce pressure inside the brain and control seizures,” Dr Lad said. A CT scan revealed fractures in the parietal and temporal bones of the skull along with bleeding in the brain.The child was managed conservatively in the ICU after being reviewed by senior neurosurgeon Dr Sachin Mahajan. However, his condition worsened further. “He developed severe seizures and his blood pressure dropped significantly, requiring two to three medications to support circulation,” Dr Prateek Kataria, senior pediatrician at the hospital said.An EEG test revealed ongoing seizure activity despite the absence of visible convulsions — a condition known as non-convulsive status epilepticus. “This is a life-threatening neurological emergency because seizures continue inside the brain and can sharply increase brain pressure,” Dr Lad explained. The child was placed on continuous EEG monitoring for 24 hours and treated with multiple anti-seizure medications.Once stabilised, an MRI scan showed diffuse axonal injury — a severe form of traumatic brain injury – caused by widespread damage to nerve fibres.Complicating matters further, the child was also found to have bilateral pneumothorax — air leakage around both lungs — due to rib fractures in the fall, for which intercostal drains were inserted.Though doctors attempted to gradually reduce ventilator support, the child showed very weak spontaneous breathing. On the 15th day, a tracheostomy was performed to allow prolonged ventilation. “Around 18 to 20 days after admission, we began to see signs of neurological improvement — eye opening and limb movements,” Dr Lad said, adding that weakness in the lower limbs gradually improved.After nearly a month in intensive care, the child was weaned off ventilator and oxygen support and discharged. At the time of discharge, he was responsive, moving his limbs and beginning to sit up. Initial tests showed normal hearing, while vision was kept under observation.“During follow-up after three months, we found that his vision and hearing were completely normal. He had started walking and his speech development was age-appropriate,” Dr Lad said, describing the outcome as exceptional given the severity of the brain injury.
