Published: September 06, 2017 by Rob Cahill on https://www.uth.edu/hurricane-harvey/#heroes

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Performing what may be the first neurosurgical case at Harris Health System’s Lyndon B. Johnson Hospital, from the left, are Gabrielle Hatton, M.D., Erik P. Askenasy, M.D., Lisa Toelle, M.D., and David Roife, M.D.

When Erik P. Askenasy, M.D., was called to the emergency room at Harris Health’s Lyndon B. Johnson Hospital on Sunday, Aug. 27, the colorectal surgeon found a man with a significant intracranial bleed who was at risk for serious neurological injury unless the blood clots compressing his brain were removed.

On a typical day, LBJ, which doesn’t perform neurosurgery, would refer a patient with a life-threatening brain injury to a hospital that does. That wasn’t an option at the height of Hurricane Harvey, despite the efforts of Alan Vierling, the hospital’s executive vice president and administrator, who got on the phone and tried to organize transportation for the patient.

“He called Life Flight, the Coast Guard, FEMA (Federal Emergency Management Agency), ambulances, everyone. But no one could make it because of the flooding and torrential rain,” said Askenasy, a 2005 graduate of McGovern Medical School at UTHealth.

Askenasy soon came to the realization that he was going to have to operate to relieve the pressure on the patient’s brain. Askenasy is an assistant professor of surgery at McGovern Medical School and a member of the UT Physicians Colon and Rectal Clinic.

When Askenasy explained the situation to family members, they understood that because of Hurricane Harvey and the flooding, transportation to a designated neurosurgical center would not be possible. They agreed that operating now was in the patient’s best interest.

With the decision made, Askenasy coordinated with the operating room staff to gather together the instruments to perform the procedure, called a craniotomy. Since LBJ does not perform these procedures, “we had to be a little innovative” when getting the necessary equipment, he said.

Askenasy and McGovern Medical School chief surgery resident David Roife, M.D., would cut out a section of the man’s skull, remove the blood clots on top as well as in one of the lobes of his brain, and then stitch the man’s scalp back together. The bone would be stored in the man’s abdomen and later grafted back on after the swelling went down.

“I had been in contact with one my mentors who happens to be a neurosurgeon and described the circumstances regarding this particular case. He indicated that performing the surgery was indeed the correct move and needed to be done quickly,” Askenasy said. “So, we proceeded and by God’s grace, we were able to decompress the brain and remove the blood clots. Everything went well.”

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