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Indian teenager with tennis-ball sizedbrain matter oozing out of his skull haslife-changing surgery to remove thependulum growth dangling from hisnose

Known only as Manikandan, the 13-year-old was subjected to a life in isolationCondition called encephalocele caused part of his brain to bulge out of his skullHis poverty-stricken parents became desperate for life-changing treatmentEarlier this week he had the Government-funded operation to remove the mass 

By STEPHEN MATTHEWS LONDON and SANJAY PANDEY IN KERALA, INDIA FOR MAILONLINEPUBLISHED: 16:29 BST, 30 June 2017 | UPDATED: 17:40 BST, 30 June 2017

An Indian teenager has had a tennis-ball sized part of his brain that oozed out of hisskull removed form his face by surgeons.

Known only as Manikandan, the 13-year-old was subjected to a life in isolation due tothe rare medical condition called encephalocele.

It caused part of his brain to bulge out of his skull, similar to a pendulum, makinghim look 'ugly' in the eyes of locals in the Kerala region.

Having obstructed his vision and left him deformed, his poverty-stricken parentsbecame desperate for life-changing treatment.

The plantation workers' begged for Government help and earlier this week he hadthe operation to remove the unsightly ball of brain matter. 

A 10-strong team of surgeons at Amrita Institute of Medical Sciences removed thedeformity during an 11 hour procedure - giving him hope for the future.

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Page 2: Site Web brain matter oozing out of his skull has life ... teenager has surgery to... · 'I thank the doctors of Amrita Hospital from the bottom of my heart for enabling him ... other

Known only as Manikandan, the 13-year-old was subjected to a life in isolation due to the raremedical condition called encephlocele

He had an operation to remove the unsightly ball of brain matter earlier this week - giving himhope to live a normal life in future

His father Selvan, who earns barely enough to survive, said: 'We belong to theMarasar tribe and work in a plantation. 

'I have five children, who are all normal and healthy, except Manikandan who wasborn with a swelling on the nose which kept growing. 

'Because of the huge deformity on his face, he never went to school or mingled withothers, as people used to make fun of his appearance. 

'After surgery, he is eager to go back home, start school and make friends. 

'I thank the doctors of Amrita Hospital from the bottom of my heart for enabling himto lead a normal life.'

Dr Subramania Iyer, who led the team of doctors during the operation, said: 'It was acomplex surgery. 

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Page 3: Site Web brain matter oozing out of his skull has life ... teenager has surgery to... · 'I thank the doctors of Amrita Hospital from the bottom of my heart for enabling him ... other

It caused part of his brain to bulge out of his skull, similar to a pendulum, making him look'ugly' in the eyes of locals in the Kerala region (pictured: brain scan before the surgery)

Having obstructed his vision and left him deformed, his poverty-stricken parents becamedesperate for life-changing treatment

'Manikandan’s encephlocele was very large which had pushed the bone of his righteye outwards. 

'For surgery, his skull was opened and the normal brain isolated from the sac of non-functioning brain matter hanging from his face.' 

The removal of the deformity had left a defect in the skull, so a portion of that had tobe reconstructed - a 'huge surgical challenge'. 

Dr Iyer added: 'We had to reposition patient’s eye sockets to remove the deformity inthe right eye, and the nose was also remodeled.' 

Manikandan has now recovered fully from the surgery and is ready for discharge,local reports suggest. 

He will now be able to attend school and participate in all social activities like anyother child of his age. 

WHAT IS ENCEPHALOCELE? 

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Page 4: Site Web brain matter oozing out of his skull has life ... teenager has surgery to... · 'I thank the doctors of Amrita Hospital from the bottom of my heart for enabling him ... other

WHAT IS ENCEPHALOCELE? Encephalocele is a rare type of neural tube defect (NTD) present at birth thataffects the brain. 

The neural tube is a narrow channel that folds and closes during the third andfourth weeks of pregnancy to form the brain and spinal cord. 

Encephalocele is described as a sac-like protrusion or projection of the brainand the membranes that cover it through an opening in the skull. 

Encephalocele happens when the neural tube does not close completelyduring pregnancy. 

The result is an opening in the midline of the upper part of the skull, the areabetween the forehead and nose, or the back of the skull.

Usually encephaloceles are found right after birth, but sometimes a smallencephalocele in the nose and forehead region can go undetected.

How rare is it? 

Center for Disease Control and Prevention estimates that each year about 375babies in the United States are born with encephalocele.

In other words, about 1 out of every 10,000 babies born in the United Stateseach year will have encephalocele. 

What causes it?

There is a genetic component to the condition, meaning it often occursamong families with a history of spina bifida and anencephaly. 

Some researchers also believe that certain environmental exposures beforeor during pregnancy might be causes, but more research is needed. 

Can it be prevented?

Currently, there is no known way to prevent encephalocele, although stepscan be taken to lower the risk.

Source: Center for Disease Control and Prevention

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