A young patient approached a tertiary care hospital with long-standing unilateral nasal obstruction and discharge. After a brief clinical examination, the treating ENT surgeon diagnosed a nasal polyp and advised surgical removal, assuring the patient and family that it was a routine, low-risk procedure. The surgery was performed the very next day.
What followed immediately after the operation, however, was anything but routine. The patient developed severe and persistent headaches within hours. A CT scan conducted post-operatively revealed subarachnoid haemorrhage — a serious intracranial bleed. Despite this finding, the patient continued to be managed conservatively at the same hospital over the next several days, with repeated scans showing no meaningful improvement. It was only later, after an MRI was obtained elsewhere, that a skull-base defect with herniation of brain tissue into the nasal cavity was identified, necessitating neurosurgical intervention at another centre.
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