A young woman who had part of her skull removed and implanted into her stomach in order to save her from massive brain damage spoke yesterday about her extraordinary path to recovery.
Nicki Peach was 24 when she suffered severe head injuries while on holiday in Gran Canaria in May 2004. She was climbing over a fence to get into her holiday apartment but fell over on to concrete, smashing in the side of her skull. For three weeks, Peach lay in a coma. Surgeons at the Hospital Insular in the island's capital, Las Palmas, thought she would die if she did not receive surgery.
Her brain had to be able to swell beyond its normal size to cope with its trauma. So they carried out a 'decompressive hemicraniectomy', in which part of her skull was removed to allow brain tissue to expand. To preserve the tissue around the removed bone it was implanted into her stomach where it could remain uninfected. Peach was then taken by air ambulance to the UK, where doctors at the Hospital for Neurology and Neurosurgery at Queens Square in London took the bone out of her stomach and re-attached it to her head
Hemicraniectomy was first used to deal with post-traumatic brain swelling in 1901 but it has not been widely used because there was insufficient evidence of its benefits. Several major clinical trials are now investigating its use, including one which aims to see if could help patients suffering from severe strokes. When the brain begins to swell and cannot be contained in the cranium, there is a risk the brain stem will become twisted. Eventually blood flow becomes impeded, resulting in brain damage or even death.
Once Peach had recovered from surgery, she was taken for care to the Royal Hospital for Neuro-Disability in Putney, south London. She was bed-bound, unable to communicate and could only make slight movements of her right arm. Treatment included hydrotherapy, music therapy and physiotherapy.
'It has been a long, slow climb back to normality,' said Peach, a former office manager, who returns to her Chingford, east London, home next week. 'A speech therapist was teaching me how to pronounce words again, because for months I was unable to speak. Then one day, a nurse pressed against my nose, and I swore - so that was my first word. But the whole place clapped me, because it meant that I would be able to talk.
'It took me a long time but now I can walk again with a stick. The physiotherapists have been very patient and helped me so much; I still have a weakness down my left side, but I'm getting stronger.'
