The viral fever that left 32-year-old Mumbai man in coma

In December when 32yearold banker Keegan Vaz developed a fever along with a cough and cold he did what any of us would do He went to a local chemist got some overthecounter medicines and popped the pills maintaining the weeklong course He even recovered Until late November when he started getting headachesBy December first week his condition started deteriorating and Vaz started having a severe headache A banker he took a break from work and stayed at this Malad home with his uncle But resting and more overthecounter medicines didnt help When he became increasingly weak his friends then took to a primary health care centreDr Vivek Agrawal consultant brain spine and interventional neurosurgeon at Sir HN Reliance Foundation Hospital explains the procedureThe doctors there on a quick checkup asked his friends mdash by now Vaz had fainted mdash to take him to a multispecialty hospital At Girgaums Sir HN Reliance Foundation Hospital the doctors conducted an MRI on him mdash by now they had deduced that Vaz had slipped into coma mdash and diagnosed that he was suffering from Acute Disseminated Encephalomyelitis ADEM mdash an autoimmune disorder in which the bodys immune system attacks its own brain tissueDr Vivek Agrawal consultant brain spine and interventional neurosurgeon at the department of neurosurgery at the hospital says While the immune system is meant to fight infections in Vazs case the antibodies start working against him This affects the nervous system and brain which sends patients into comaAlso ReadTragic Mumbai traffic constable in coma for eleven months dies in WorliKeegan Vaz with his brother Kevin in May Doctors say it took two months post the cutting of the skull for the brain to return to its normal sizeThe infection led to Vazs brain swelling up compressing the skull from inside A rare case in medicine The doctors had to cut out sections of the skull to accommodate the brain In fact his doctors have now sent his case and the treatment as a study to an American journal They are still awaiting a response from themAlso ReadMumbai Rat bites coma patient in right eye in ICU hospital alleges conspiracyLine of treatmentDischarged in May Vaz is now back to normal But at the peak of his illness his brain was functioning at a mere 5 percent of its total capacity say doctors He now says I had a severe headache which turned more severe with every passing day I just remember when I was taken to the hospital and the next thing I remembered was when I saw my brother sitting beside me but I couldnt respond to him Even though I tried to talk I couldnt which scared me off and the feeling was indescribableWhile his parents who live in Goa rushed to Mumbai the same day his brother Kevin had to fly in from Dubai The sight at the hospital left him with little hope His body shutting down gradually After the doctor saw the MRI we felt there was no hope left We were all in shock We never thought he would come back home safely one day says the brotherIn such cases there are usually two options Plasmapheresis is a process that filters the blood and removes harmful antibodies much like dialysis The other option would have been to introduce steroids in Vazs system which would compress the antibodies But Vaz say doctors didnt respond to either of the procedures This is when they decided to perform a decompressive craniotomy see box in which a piece of the skull bone is removedHis brain had swollen so much that it was causing the pressure inside the skull to increase Thus we decided to cut off two parts of the skull to help the brain expand It was only after two months that the swollen brain started shrinking says Dr Arun B Shah a consultant neurologist and mentor at the department of neurosciences at the hospitalBy now a onecentimeter layer of skin had formed in the area of the missing skull Later when Vazs condition improved in May the doctors replaced the skull pieces with hocks and screws A surgery thats done in cases of head injury or strokes helped Vaz beat death Yet there are less than 10 case reports available in English medical literature across the world were this surgery was done in the case of ADEM says Dr AgrawalIn April the doctors won an award at the Emirates Critical Care Conference for the best Critical Care of Patients People should be careful if suffering from weakness or dizziness during or after viral fever They have a tendency to pop pills without consultation which can be life threatening says Dr Darshana Rathod consultant critical care medicine from the hospitalThe surgery Vaz underwentDecompressive craniectomy is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed It is performed on victims of traumatic brain injury stroke or other conditions associated with raised intracranial pressure Studies show that the procedure lowers intracranial pressure ICP the pressure within the skull Raised intracranial pressure is very often debilitating or fatal as it causes compression of the brain and restricts cerebral blood flowAlso ReadSunshine story Mumbai girl whos head was smashed by falling frying pan recoversCatch up on all the latest Crime National International and Hatke news here Also download the new midday Android and iOS apps to get latest updates