A severe headache in a 23-year-old Abu Dhabi resident turned out to be massive intracerebral bleeding – a life-threatening complication of Evans Syndrome – an unusual autoimmune condition, making the medical case a rare phenomenon.
Instead of ignoring it as a lifestyle effect, he rushed to the hospital for medical attention. Doctors at Lifecare Hospital, Musaffah, identified massive intracerebral bleeding, an uncommon consequence of the Evans Syndrome, he was diagnosed with. The timely intervention and swift surgical intervention were instrumental in saving the youngster’s life.
‘No ordinary headache’
Before coming to the hospital, Ahmad struggled with an intense headache for a whole day. Doctors observed an altered sensorium – a change in brain function leading to confusion, loss of memory, etc. A CT scan revealed massive intracerebral bleeding turning the case into an exceptional medical emergency.
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Dr Ratnakar Vupputuri, consultant neurosurgeon, noted Ahmad’s condition was a high-risk scenario.
“The massive intracerebral bleed, along with impending brain herniation, required immediate surgical intervention to relieve pressure and fix the shifting of the brain’s centre,” Dr Vupputuri told Khaleej Times.
To understand the sudden onset of brain bleed, further investigations were done, which revealed an alarmingly low platelet and red blood cell count. He was diagnosed with Evans Syndrome, an uncommon autoimmune disorder in which the immune system attacks the body’s cells, including red and white blood cells, as well as platelets.
8-hour-long complex surgery
It was a high-risk surgery because of the low red blood cells and platelet count, and anaemia. Multiple blood transfusions of packed cells and platelets were required before doctors could proceed with surgery.
Shedding light on the challenges of the case, Dr Ravi Veera, a specialist neurosurgeon, said: “Evans Syndrome is a diagnosis of exclusion, ruling out other possibilities. Intracerebral bleeding in Evans syndrome is a rare phenomenon. Immediate measures, including intravenous immunoglobulins, steroids, and multiple blood transfusions, were administered before surgery.”
Apart from Dr Vupputuri and Dr Veera, the multidisciplinary team comprised Dr Sahithi Surapaneni, specialist pathology; Dr Biju George, specialist haematologist, Burjeel Medical City; Dr Kuldeep Shankar, specialist anaesthetist; and Dr Syed Mohamed Shimar, specialist anaesthesia.
During the 8-hour-long surgery, doctors stabilised Ahmad’s condition and addressed the massive intracerebral bleed.
Ahmad, on the road to recovery, expressed his gratitude to the medical team.
“I don’t remember the initial part of my hospital stay, but once I regained my consciousness levels, Dr Ratnakar Vupputuri and the team took care of me. I am thankful for the swift and expert care I received at Lifecare Hospital. The medical team’s quick response and expertise saved my life.”
Dr Vupputuri emphasised that Evan’s Syndrome is a complex condition that requires ongoing management.
“Regular check-ups and blood investigations are vital, especially considering the bleeding tendency associated with low platelets. We will continue to monitor Ahmad, ensuring his well-being through regular check-ups and appropriate interventions.”