summary so far

Bill had what we thought would be a routine sinus surgery on Monday 7/20 at Metro Health Hospital. He went home the same day and was a bit confused there, but appeared to be doing well. On Thursday 7/24 he was having a bad headache, vomiting, and clear fluid draining from his nose, so Nancy took Bill to the emergency department.

There, they did a CT scan and saw that there was air around his brain as well as a contusion (a bruise) of the brain. This air was from a defect in the sinus wall that had been created as a complication in surgery. The air got around the brain by coming through the nose and then up through this hole into the skull, and the clear fluid draining from his nose was cerebral spinal fluid (CSF) that was leaking out from the defect.

They did a surgery on 7/25 to try to repair the hole with a patch and glue. There is less CSF drainage from his nose currently, but still some leakage. With treatment by breathing 100% oxygen, the air around his brain has decreased significantly, as shown on subsequent CT scans.

Another complication from having a defect in the sinus wall is that in addition to the air entering the skull, bacteria can also enter and cause meningitis. So, Bill is currently on IV antibiotics to prevent meningitis.

He is somewhat confused. Most of the time he knows who he is, but doesn't know where he is and when it is.

ENT (ear nose and throat), neurosurgery, neurology and infectious disease are all keeping a close watch on Bill and making recommendations.

Another ENT doctor is coming by later today to evaluate him and possibly plan for another surgery for another patch of the hole.