A craniotomy – ‘the last resort’

On 23rd December 2020, Phil was crossing the road and was hit head-on by a pizza delivery driver. He sustained a significant frontal brain injury and went on to have revolutionary cranio-reconstruction surgery.

The accident

After the accident, Phil was taken to the local A&E by ambulance. His injuries were so severe that he was immediately redirected to the regional A&E. The team spent three hours stabilising him and discovered Phil had suffered a massive brain haemorrhage and had multiple areas of damage to the brain. Doctors told his wife, Rachel, that he was “unlikely to survive”. Rachel said:

When I finally got to see Phil that night, he looked absolutely perfect: No scratches, no cuts, and no grazes. He looked so perfect, yet he was covered in tubes and machines keeping him alive. It was very surreal.

A craniotomy – ‘the last resort’

Phil was transferred to Walton Neurological Centre, where he continued to deteriorate over the next few days.

The swelling in his brain was so much that it caused significant pressure on his skull. Four days after the accident, Phil had a bi-frontal decompressive craniotomy to relieve this pressure and prevent his skull from doing more damage to his brain.

This was a last resort but turned out to be the best course of action because his brain had room to swell after the operation, and he started to stabilise. He remained in a coma for three weeks before he very slowly began to emerge.

Phil’s vulnerable brain

After emerging from the coma, Phil was in a stage of recovery called “post-traumatic amnesia,” and he was extremely angry, agitated and confused.

The pressure in Phil’s brain eventually returned to normal, and so his head was “scooped” in with there being no frontal skull in place. Phil needed to wear a safety helmet as this left his brain very vulnerable.

Cranio reconstruction

Fast forward 18 months, Phil faced the long and complex process of cranio reconstruction. Because it was a large area of skull that was missing and because his skin had shrunk, Phil needed a “complex cranioplasty” involving both plastic surgeons and neurosurgeons. This came as quite a shock to the family, who had expected this stage to be relatively straightforward.

It sounded like another huge obstacle that we needed to overcome.

It took five months to complete, with two major surgeries and seventeen weekly procedures.

For the first step, Phil had a balloon expander put into his scalp. Every week, the balloon under his scalp was filled with fluid in order to stretch and grow the skin. After sixteen weeks, he had almost 400mls of fluid in the balloon and an 8cm “growth” on top of his head.

More surgery, and a ceramic skull

The next step was to give Phil a ceramic skull. The surgery took seven hours to complete and involved three fantastic surgeons.

Because it was a fairly revolutionary reconstruction, Phil was interviewed by a camera crew, and the whole thing was filmed to train other surgeons.

The results

About two months after the surgery, Phil’s recovery took a noticeable leap, which has kept coming and coming. He is more chatty and more confident, and his information processing and memory have all started improving, too.

Rachel said:

Although very very stressful, and an extra layer of trauma and worry on top of recovering from a very serious accident, Phil’s surgery has made a very positive difference to his life and our life as a family.

You can read more about Phil's recovery, and the impact it had on his family here.