Mathari miracle baby gets new skull in breakthrough surgery

Baby Brian shocked everyone present during his birth on December 18, 2013 at Kinunga Health Centre in Nyeri County.

Born with multiple facial abnormalities with some parts of the brain outside the skull, a cleft lip and bilateral palate, nurses at the health facility promptly referred him for specialised medical attention at the Consolata Hospital Mathari where his there arrival continued to shock everyone who saw him. Doctors gave him six days to live.

“I was shocked when I saw the baby soon after we admitted him, I even asked a doctor how we will we deal with the case, I almost lost hope on the infant survival chances,” said the hospital’s director Boniface Mwangi, a Catholic priest.

According to the medics, the baby was diagnosed with encephalocele, also referred to by its Latin name cranium bifidum, a defect characterised by sac-like protrusion of the brain through the skull. The new-born's cleft lip and palate compounded the situation as it made it difficult for him to suckle, forcing the doctors to insert feeding tubes through through his little body.

His rude welcome into the world was complete a week later when his terrified mother lost all hope and abandoned him to his fate and escaped from the hospital.

The Hospital’s Chief Executive Officer Bernard Muriithi said the hospital’s management empathised with the young mother as they tried to save the baby. “The situation she found herself in was too traumatising and one can understand why she acted the way she did.”

Now aged 21 months, Baby Brian has earned a new moniker, that of Mathari’s Miracle Baby. He is alive, and repairing well after undergoing a number of life saving surgeries when his skull was broken apart and pieced back together. The latest was a five-hour neuro-surgery operation, the first ever attempted at the Consolata Hospital Mathari, Nyeri in July.

SERIES OF SURGERIES

A team of six specialists comprising of three neuro-surgeons, a maxillofacial, a plastic surgeons and an anaesthetist took part in the first surgery. They however revealed that, the baby had only undergone stage one of the operation that included the soft tissue components for both neuro-surgical part and the plastic surgery part.

According to the team leader Dr Peter Wanyoike, a neuro-surgeon, he said depending on how the baby progressed, there would be re-evaluation of what else they could do as a team.

“We shall be able to evaluate and do what is safe to baby Brian,” said Dr Wanyoike.

He described the operation as a multiple surgical procedures.

Consultant neurosurgeon at Aga Khan University Hospital Mahmood Qureshi who was part of the team said they carried out a procedure on the condition that he referred as neuro-tube defect, the defect in the cranium which causes a deformed part of the brain to protrude from the skull in form of a large growth causing significant deformity that made it impossible to feed.

“What we did is to successfully size/remove that growth and the part of the brain that was not functional because of where it was. The deformity was successfully corrected and this will enable the baby to hopefully be nursed and looked after more comfortably,” he said.

The neuro-surgeons said their work did not involve pushing anything inside the brain but instead created a cover for the exposed part of the brain.

“Baby Brian had a congenital abnormality where part of the brain had grown outside. That part of the brain which had grown outside the skull was not useful, and the baby was not using that part of the brain. The exposed part of the brain was destroyed at that time when the un-normality happened. We did not push anything back, but what we did is part of reconstructive surgery both for the anencephaly and maxillofacial defects,” said Dr Wanyoike.

Anencephaly is the absence of a major portion of the brain, skull and scalp that occurs during embryonic development. This is a disorder that results from a neural tube defect that occurs when the head end of the neural tube fails to close, usually between the 23rd and 26th day following conception.

Oral and Maxillofacial surgery is treating injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral (mouth) and maxillofacial (jaws and face) region.

SURVIVAL CHANCES

Dr Emily Nyamu and Dr Shaban Saidi both from Nyeri County Referral Hospital conducted maxillofacial and plastic surgery respectively.

Dr Nyamu also a consultant oral and maxillofacial surgeon at the county referral hospital said the defect on the face was actually a bony and soft tissue defect.

“The baby had a facial cleft, not only a simple cleft lip and palate that we normally know; this one went across the face towards the cranium,” she said.

She said the surgery was stage one operation where they put together the soft tissues, and they did not correct the defect in the bone.

“We first did the soft tissue so that it could mould the bony pieces together and we are going to come back together again with the neuro-surgical team to address the bony defect later along, when baby Brian is a little bit older,” said Dr Nyamu. The baby also had a cleft palate and we shall repair it in three to six months from July depending on how the baby heals from the initial operation. This will help the baby eat with his mouth.”

Currently, the baby is feeding from the tube that passes through the nose and is now scheduled for the second surgery in the same hospital aimed at reconstructing his face.

His mother is also back and Brian continues to shock at the tremendous progress he has made since.

In an interview with the Nation, his mother Ms Elizabeth Nyambura said she was only 19 when she gave birth to him and was heartbroken at the sight of him. “I left him at the hospital after doctors said that he would not live for more than six days. I however visited him at least twice a week,” she said.

For the single mother who ekes out a living as a casual labourer, visiting him was an expensive, stressful exercise as she could only afford bus fare to the hospital and his diapers.

“I got so emotional every timeI saw my baby, but seeing him now, i am happy  with the treatment he is receiving and I feel there is hope my son will survive.”