Life Changing Surgery in Brisbane for Vanuatu girl
March 6, 2011
When doctors first saw three-year-old Gayreen Langa from Vanuatu, her head was so filled with fluid that it was bigger than her body.
Bola Langa with her daughter, Gayreen, 3 years old
The young islander had been suffering from an extreme case of hydrocephalus an accumulation of cerebrospinal fluid in the cavities of the brain.
Gayreen had never held her head up or crawled, rolled over or walked because of the weight of her skull.
She had little hope of surviving beyond the next few years.
But the charity of Queensland doctors and Rotarians has given her a chance.
"We don't normally see cases as bad as Gayreen's in Australia because it is picked up and treated in the early stages," pediatric neurosurgeon Dr Martin Wood said.
"It happens because babies, unlike adults, have a very expandable skull as the skull bones haven't fused yet.
"There is a build-up of fluid inside the brain giving them a progressively expanding head.
"That is why doctors or nurses in Australia measure a baby's head for the first few months to monitor and watch for the condition.
"In Gayreen's case it started at birth and her skull has never had the opportunity to fuse."
At its biggest, the circumference of Gayreen's skull was 65cm, whereas a child her age would normally have a skull circumference of 40cm.
Gayreen was brought to Brisbane for medical assistance by ROMAC.
"It is the largest case we have ever seen," said Dr Wood, who performed the lifesaving surgery pro bono at Brisbane's Royal Children's Hospital a fortnight ago.
Dr Wood and RCH neurosurgery fellow Dr Juliet Clayton used an endoscope to access Gayreen's brain from the top of her head.
"The reason she had hydrocephulus is the narrow channel at the back of her brain, called the aqueduct, was blocked from birth. We had to make a bypass for the blockage so we effectively made a hole in the third ventricle of the brain to allow the fluid to escape and get reabsorbed into the bloodstream," Dr Wood said.
The surgical team were "hamstrung" with their options because it would usually be treated by inserting a shunt.
"But a shunt could block, break, or become infected and with no one to care for her in Vanuatu, to send her home with a shunt is effectively giving her a death sentence.
"Our only shot was to do this surgery and hope we were successful."
"In cases with hydrocephalus as bad as her's there is a far greater risk of it not working because there is not enough pressure in the brain itself to drain the fluid.
"If it didn't work that would have been it for her."
The operation was a success and the fluid started draining straight away. In the past two weeks Gayreen's skull has already decreased by 4cm.
Rotarian Bill Benham said the little girl was instantly brighter and more alert after the operation.
"Her mother Bola, who is here with her, is so relieved for her only child," he said.
"She will not only survive but may one day walk and live like other little girls in her village."
It cost about $8000 for the treatment, airfares and accommodation to help Gayreen.
Mr Benham said ROMAC raised about $800,000 a year to provide medical assistance to overseas children.
"We think we get around $5 million in value from that fundraising because the doctors and some hospitals provide the services free of charge," he said.
"It is great experience for the doctors who would otherwise never see or treat cases such as this."
