16-year-old Great Ebhodaghe, who almost lost his life to Subdural Empyema, more popularly known as abscess or collection of pus between the frontal region of the skull and the brain, due to late presentation and lack of money, but was saved from death by a philanthropic initiative.
All it took was one bad fall, and life turned sour for 16-year-old Great Ebhodaghe. He had slipped while playing and hit his forehead on the ground. The immediate result was an intense pain that he wished away. He had dismissed the pain with the misconception that he would be fine in a few hours. How wrong his personal diagnosis turned out to be. The pain only intensified as the days went by and soon got worse.
It all began with a severe headache in his right eye accompanied by bouts of fever. Its persistent reoccurrence made his parents to take him to a nurse for evaluation. But like a number of Nigerian healthcare personnel, the nurse diagnosed the problem as typhoid and malaria; an ailment they treated, until the dosages were exhausted without improvement.
His parents, Godwin and Margaret Ebhodaghe, then took him to one of the hospitals in Okoko area of Lagos, for what they had thought would be for a ‘proper treatment’, but again, they were wrong. The teenager was admitted for five days and treated for same malaria and typhoid. At that point his health began to deteriorate.
His father said: “It was at this point we realised he was developing a swelling on his forehead with increased running of the nose, moments of unconsciousness, high fever and other severe illnesses. We were advised by friends to take him to Badagry General Hospital but the hospital and other government healthcare facilities in Lagos State were on strike at the time.
“We then took him to a laboratory where a Computer Tomography (CT) scan showed the issue was beyond just typhoid and malaria. They immediately asked us to go to one of the military hospitals here in Lagos, and there, they told us the case was beyond them.”
At this point, Great, who was the second brightest student in his class, stopped attending school. Writing his promotional examination was the last thing on the menu for the young Ebhodaghe. His life was daily growing dim. There was no guarantee he would make it alive, not to mention completing his examinations. It was a case of life and death.
Journey to Lagoon Hospital
But as a family determined to make lemonades from the lemons they were been served by life, the family was asked to go to Lagoon Hospital since they have the specialists and facilities to tackle issues like this there.
According to Ebhodaghe, “The next day, I and my wife rushed Great to Lagoon Hospital, Apapa. At this point we didn’t know what was actually going wrong with him, all we knew was that this was beyond typhoid and malaria, and he had lost all the elements of his former self. All what we were carrying about was a caricature of my son.
“Immediately we got to Lagoon, they examined him, checked the CT scan result we brought and then they concluded it was an emergency case that required urgent attention.”
Moments after examining him, the hospital told his parents their son was suffering from bi-frontal subdural empyema, which means there was a collection of pus between the frontal region of his skull and the brain.
“At first I and my wife were happy that finally the problem with my son has been diagnosed, which means the solution will be a walk over,” Ebhodaghe said.
But that was the beginning of another major issue. The surgical intervention was going to cost millions of naira, an amount Ebhodaghe said he has never held in his entire life. The initial deposit for the surgery would cost about N3.5 million, but all Ebhodaghe had on him was N14,000.
He recalled: “At that point my wife burst into tears. We thought there was no way our son would come out of this crisis alive. I knew there was no way I would be able to raise that kind of money.” Little did they know favour had singled them out.
However, succour came from an unexpected source; Lagoon Hospital. The hospital, despite the huge cost, decided to foot the bill of the entire surgery, even though they were seeing the Ebhodaghe’s for the very first time.
According to the patriarch of the family, “My wife was still on the floor in the hospital crying when a senior member of the management team of the healthcare facility was passing through. He called us and enquired what happened. He then went to the emergency room to see our son. It was at that point he concluded that if nothing drastic was done, our son may not survive the condition. At that point, I just told myself we would take Great home, continue the drugs he was taking at the moment, until God eventually takes his life.
“Recall that was the very first day we were setting our feet into Lagoon Hospital. To my surprise, they wheeled Great into the theatre, and by the next morning, the surgery was conducted on his skull and brain area. It was a miracle to us. I have never seen such act of gesture in my life.”
Process of Healing
Ebhodaghe, who is an unemployed father of four, also noted that because of the complexity of the surgery, and considering they came very late for the operation, he still wasn’t sure Great was going to make it out alive from the theatre, because he had heard how delicate such surgeries were.
“I based the successful outcome on a 50/50 probability since it is a surgery requiring fixing parts of the skull.
But days passed after the surgery and I noticed my son was beginning to recover”, he said, adding that to their utmost joy, albeit pleasant surprise, by the time they were discharged on the third week after surgery, their son was full of life.
He stated, “He can now do everything he couldn’t do before. He has even added weight, can walk on his own, play around and is now living a very normal. My son has been rescued from death and given a second chance to live.” He added that if he had sought for treatment in time, it wouldn’t have gotten to the point of surgery, as drugs are available for early treatment after diagnosis.
About Subdural Empyema
Consultant Neurosurgeon, Lagoon Hospital Group, Dr. Chiazor Onyia, who headed the surgical team that operated on Great, said the CT scan showed the teenager had a hypodense collection in the front region of the space between the skull and the brain with a collection of gas above it. This is called subdural empyema.
He said based on the clinical features and radiologic findings, the diagnosis showed both sides of the heads front skull/brain had the issue, adding that during the surgery, a collection of foul smell pus was evacuated from both sides of the frontal part of the head.
“With the presentations, we looked at the different treatment options available. One requires making a borehole on his skull to drain the pus, but we felt opening the skull would be more effective because the pus had gone beyond just what just drainage could do. So we went to work, along with my team, and operated on him. We subsequently placed him on antibiotics after the surgery, and we are glad he has recovered fully well,” Onyia said.
Onyia also cleared some misconceptions. He said even though the Ebhodaghes believe the health condition was caused by the bad fall, medical books suggest it was caused by viral infection, which resulted in recurrent catarrh.
“A normal catarrh would usually go within days or weeks, but in this case, it becomes recurrent. Overtime this leads to pus in the space between the skull and the brain,” he said. He noted that the condition could have been easily tackled if Great had been treated on time. He added that the sickness it is common in children because their bones are still soft, adding that it comes with a number of signs and symptoms, which parents especially, must watch out for.
He listed the symptoms as “recurrent headache-which tends to occur in young people, recurrent sinusitis, fever, cold, catarrh, smelly and thick mucus from the nose, among others. If all symptoms are ignored at this stage the patient may start to experience recurrent seizures, impaired level of consciousness (from abnormal speech to being confused to deep coma). It may even lead to functional deficit of the brain, and of course death.”
Dearth of Neurosurgeons
Medical Director, Lagoon Hospital Apapa, Dr. Mowa Falase, who was visibly happy that the teenager is now full of life, courtesy the free treatment paid for by all staff of the hospital group, said the family was lucky that Lagoon has state-of-the-art facilities to tackle the condition, and a neurosurgeon despite the scarcity of the specialty in Nigeria.
“For over 180 million Nigerians, we have only about 100,000 medical doctors in the country, and out of which only 81 are neurosurgeons. This shows the country is in dire need of this specialty. On the average we know it takes about 15 years to become a specialist, but our young doctors need to focus on this area as well because of its vital importance to the society. Many neurosurgeons work in teaching hospitals, we are lucky to have Onyia with us,” she said.
She said to prevent the condition parents should take special interest in the health of their children, adding that any child that has cold beyond two weeks or recurrent catarrh should be taken to their family physician.