Emergency brain surgery saves woman: Paras Health
Srinagar, Jul 18: In a time-sensitive medical crisis, Paras Health Srinagar performed a life-saving neurosurgical procedure on a 40-year-old woman diagnosed with chronic subdural hematoma (CSDH), a condition typically seen in older adults and rarely encountered in this age group.
A statement of the Paras Health Srinagar issued here said that the patient, a homemaker and mother of a 10-year-old, had experienced ongoing headaches and dizziness for nearly two weeks.
After multiple consultations, her symptoms were attributed to a vascular headache. Her condition deteriorated suddenly when she collapsed at home, leading to her emergency admission.
By the time the patient arrived at the hospital, she was unconscious and exhibiting signs of critical neurological compromise.
An urgent clinical evaluation followed by neuroimaging revealed a large sub-acute subdural hematoma on the left cerebral hemisphere, along with medial temporal lobe herniation and early brainstem compression - a neurosurgical emergency with a narrow window for life-saving intervention.
Vice Chairman, Neurosurgery, Paras Health Srinagar, Dr Altaf Umar Ramzan, said, “What made this case particularly challenging was how easily the condition could have been missed and nearly was. Subdural hematomas are rarely considered in younger adults, which is why persistent headaches in this age group are often dismissed as migraines or stress-related. By the time she reached us, her neurological condition had already begun to decline rapidly. This wasn’t just about performing a surgery; it was about recognising a silent emergency before it became irreversible.”
The neurosurgical team, including Senior Consultant, Dr Irfan Hussain Bhat, and Consultant, Dr Rahil Rafiq, immediately initiated airway protection and transferred the patient to the operating theatre. Within five minutes of arrival, a burr hole evacuation was performed to decompress the brain and remove the hematoma.
Senior Consultant, Neurosurgery, Dr Irfan Hussain Bhat, said, “When the patient arrived, her clinical signs were deeply concerning - bradycardia, hypertension, and a dilated, non-reactive pupil on the left - all pointing towards brainstem herniation. At that point, it wasn’t just about acting quickly; it was about absolute coordination. From airway management to anaesthesia to surgical intervention, every step had to happen in perfect sequence. In situations like these, the difference between life and death is often measured in minutes or even seconds.”
Consultant, Neurosurgery, Dr Rahil Rafiq, said, “Chronic subdural hematoma is so uncommon in younger adults that it rarely features in the initial differential diagnosis. The symptoms – persistent headaches, mild dizziness - often mimic far more benign conditions like migraines, which leads to delays in appropriate investigation. This case is a reminder that when headaches are new in onset and progressively worsening, especially without a clear trigger, we need to consider less obvious but serious possibilities. Early imaging and timely referral can be the difference between full recovery and irreversible damage.”
Postoperatively, the patient regained full consciousness within hours.
She demonstrated no residual neurological deficits and was subsequently discharged in stable condition. The successful outcome highlights the critical importance of early neurosurgical intervention in patients presenting with rapidly progressive intracranial pressure syndromes.
This case serves as an important clinical reminder that CSDH, though uncommon in younger individuals, can present with nonspecific symptoms and must be considered in the differential diagnosis. Rapid access to neuro-imaging and specialist care is a key to preventing devastating consequences in such high-risk cases.
The incident underscores Paras Health Srinagar’s emphasis on evidence-based clinical decision-making, rapid response systems, and multidisciplinary coordination in managing complex neurological emergencies.
It also reflects its ongoing commitment to strengthening systems that enable urgent access to specialised interventions in resource-constrained settings.
