This is such a great story I have to share it with you. And do forgive me, but I also have to share the poignant image of the brain for emphasis.

The story

The baby is Liron Ohiani, a four-month old ‘fine boy’ who has hydrocephalus. We have spoken about this before, but I will reiterate the meaning of hydrocephalus.

Hydrocephalus

‘Hydro’ means water and ‘cephalo’ means brain. Hydrocephalus is ‘too much water on the brain.’ You see, the brain normally manufactures brain water (called cerebrospinal fluid). The brain water keeps it moist and allows the flow of nutrients to the nerves. The brain regulates the amount of the water by making and removing the water almost at the same rate. The water is made and removed daily like clockwork.

So, if there is any obstruction and the water cannot be removed, it builds up. This is because the brain is too stupid to know and just continues to manufacture the water. This causes the water to build up, and now, start damaging the brain because of the pressure. In babies, the bone of the skull is soft (not yet joined together) and so the early sign of hydrocephalus is enlargement of the head of the baby.

In adults, the skull has fused rigid and cannot enlarge, so the patient complains of severe headache. Hydrocephalus can cause confusion, headaches, deafness, blindness, paralysis, coma and severe brain damage, as well as death. It has to be treated, and very early too, before damage occurs.

When fathers saved a baby’s life

Mr. Ohiani came home from work and thought the baby looked different. There was just something about him that was unusual. He asked his wife, but she reassured him that nothing was the matter. A few days later, he thought that the head was bigger than he thought it was and he raised same concern. Again, his wife reassured him.

Then, his father-in-law came to visit and noticed not only the big head but also that the baby’s eyes were turned downwards (like the sun setting over the horizon)! So, the men made the diagnosis that something was, indeed, wrong with the baby and took him to hospital. This singular move was what saved the baby’s life. Note: They did not go to church, meander to a traditional healer or queue at the local chemist!

The eye doctor examined the baby and felt that this was a brain issue. The eyes were still seeing and were not the source of concern. However, that did not stop even the ophthalmologist from prescribing the ubiquitous ‘water’ for the eyes. Man must chop!

Regardless, he did refer the baby to a paediatrician who recognised the signs as due to hydrocephalus. The head of the baby was large at 52cm. Normal head circumference at four months of age is about 40-45cm. The paediatrician therefore referred the baby for urgent neurosurgical evaluation and operation. This is another important point.

Management of hydrocephalus

The management of acute hydrocephalus such as this is urgent and must be carried out without delay. There is no real value in medical treatment for this type of hydrocephalus and drugs such as Acetazolamide (Diamox) are a waste of time and a waste of brain. These drugs take time to work — time which the baby does not have! Operations for significant hydrocephalus should be performed as soon as possible and preferably within the same day the diagnosis was made. These babies must be seen by a neurosurgeon.

 

First things first, we requested for a brain scan to confirm the diagnosis. It showed the hydrocephalus was significant and severe. There was more water than brain inside the baby’s skull and it confirmed that the water was pushing the brain out of the way and so damaging it. This is why some babies end up blind, deaf, disabled and damaged such that they cannot function independently.

The baby had an operation called a ‘shunt’ immediately. The shunt diverts the brain fluid out of the skull, into the stomach and so reduces the pressure on the brain. This allows the brain to breathe a sigh of relief and start functioning again. The brain cells start working again and life can go on from that point.

The baby was discharged home from hospital in a few days and will be seen regularly by the neurosurgeon to make sure the shunt continues to work; doing its job as a pressure diffuser.

Fathers have it!

I was impressed that the fathers were the ones who noted that something was wrong and took prompt action. Mr. Ohiani works with the Federal Road Safety Corps (Toto Command) in Nasarawa State, and that may have something to do with the rapid reaction.

Kudos to Mr. Martins Ohiani for saving his son’s life!