Sunday, February 3, 2013

'Skull in a suitcase' after fall

30 January 2013 Last updated at 08:25 GMT By Smitha Mundasad BBC News picture of Lee Charie Lee Charie had part of his skull removed after a fall from a balcony Lee Charie does not remember falling off a balcony in Thailand.

But when he woke up, part of his skull had been removed.

Doctors in Thailand had cut out a portion to relieve the pressure building on his brain.

And Lee carried this piece of skull home in a polystyrene box, hoping surgeons in the UK would be able to use it to help reconstruct his head.

Lee, 32, from Hertfordshire, was on holiday on the island of Koh Tao when the injury happened.

His memories of the event are hazy, but his father flew out soon after the accident took place in December.

Peter Charie was told his son had fallen from a height of 25ft (7.6m) and was unconscious when found.

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Sometimes you literally need a kick in the head to sort yourself out and start doing what you really want to do”

End Quote Mr Lee Charie And Lee spent a month recovering in hospitals in Thailand before a flight home to the UK accompanied by medics.

His father carried the section of skull the doctors had removed.

He had had no trouble getting it past customs and security, he said.

Under pressure

Lee is currently recovering in hospital in the UK, where he is undergoing physiotherapy, medical tests and help for his pain.

When he realised he had had some of his skull taken away, he says he didn't stop crying for two weeks.

But he says he has been overwhelmed by the support of family and friends, some of whom are organising fundraising events to help him and others in similar situations.

Consultant neurosurgeon Colin Shieff says when the he brain is injured, swelling can push it against the protective bony casing of the skull.

"The brain doesn't work well under pressure. It is safer and can guarantee a better recovery if pressure is not allowed to build up," he says.

"It's a bit like if you sprain your ankle, you undo your shoe. It might look worse but it helps."

Sometimes the swelling is mild enough to subside on its own. In other cases, medication can be given to help reduce and control it, Mr Shieff says.

But in some situations unless a part of the skull is removed, the pressure can start to damage the brain.

Mr Shieff, a trustee of Headway, the Brain Injury Association charity, says in terms of everyday function the whole skull isn't essential - there are a lot of people with skull defects who carry on with their everyday lives.

Some are advised to wear a protective helmet to shield against further brain injury, which can be the greatest risk to people with such bony defects.

In fact surgeons have been operating on the skull for many years.

There have been cases from as far back as the Incas, Aztecs and ancient Egyptians of people who have clearly survived for some time with holes deliberately made in their skulls, Mr Shieff says.

Metal template

Many of Mr Shieff's current patients choose to have their skulls reconstructed.

At times the section that has been removed can be put back in place.

Another option is to construct a metal template using scans and computer models, which follows exactly the contour of the natural skull.

Lee says his surgeons are considering using the piece of skull he brought back to help shape a titanium mould for reconstruction.

He is recovering well, apart from a little pain when he uses his facial expressions too much.

And judging distances when walking up and down stairs can be difficult, he says.

Mr Shieff says: "Any fall from more than one's own body height can be very dangerous.

"Some people die following a fall from that height. To survive and survive unscathed from such a fall is an extremely good thing."

Luke Griggs, spokesman for Headway, says: "The effects of brain injury can be devastating. No two brain injuries are the same, so it is impossible to predict what the long-term effects will be when someone sustains a severe brain injury.

"But public perception needs to change. People with brain injuries are already battling with everyday life and yet sadly they are often unfairly judged and treated unkindly.

"With the right care, support and understanding, many people with brain injuries can lead happy and fulfilling lives."

Lee says: "It has made me re-think a lot of things about my life.

"Sometimes you literally need a kick in the head to sort yourself out and to start doing what you really want to do."


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