Kate Barry – Skull Fracture

Kate Barry was a happy-go-lucky 5-year-old who started kindergarten in September 1998. Like all parents on the first day of school, Stephen and Barbara Barry were both thrilled and anxious about letting Kate go. But the Barrys had more reasons for their mixed emotions than most parents. Just six short months ago, Kate was in a coma at UPMC Children’s Hospital of Pittsburgh after falling out a second-story window.

It was a warm March afternoon and Kate and her brother were watching from a living room window as their sister played outside with a friend. To get a better view, Kate stepped up on the windowsill and pressed against the screen. Suddenly, the screen came loose and Kate fell two stories onto the driveway below.

When the paramedics arrived, they immobilized, stabilized, and transported Kate by ambulance and helicopter to UPMC Children’s Hospital Emergency Department. “Everything happened so fast,” says Barbara. “When we arrived at the Emergency Room, I was in shock and not sure what was going on, but everything just fell into place. As soon as we needed a doctor, nurse or social worker to answer our questions, they were there. No one knew what Kate’s outcome would be, but they were honest and they gave us hope.”

Kate’s initial CT scan (X-ray of the head) showed significant brain swelling, two skull fractures, and internal bleeding. In addition, spinal fluid was leaking from her ear. Kate was admitted immediately to the Pediatric Intensive Care Unit (PICU), where she spent the next 13 days on a ventilator, partially paralyzed and in a coma.

David Adelson, MD, pediatric neurosurgeon and associate director, UPMC Children’s Benedum Pediatric Trauma Center, took control of Kate’s case. After carefully weighing Kate’s treatment options and consulting with his colleagues and the Barrys, Dr. Adelson inserted a catheter in Kate’s head to relieve and monitor her intracranial pressure and provide a release for the spinal fluid that was building up inside. Kate was also treated with national protocols developed specifically for the treatment of head trauma patients by Dr. Adelson and his colleagues.

Through careful monitoring, Dr. Adelson managed Kate’s oxygenation, controlled her brain’s metabolism, maintained a specific body temperature and administered medicines that provide neuroprotection. From this point on, Kate’s parents could only watch the monitors and wait. Only time would tell how much, or even if, Kate would recover.

“The weeks we spent with Kate in the PICU were the worst days of our lives,” says Stephen. “Somehow, Dr. Adelson and the PICU staff got us through it. Dr. Adelson was constantly monitoring Kate’s progress and counseling Barbara and me as we tried to comprehend what was happening.” After 12 days of intensive therapy and extremely close observation, the pressure and swelling in Kate’s brain slowly began to subside.

On her 13th day in the PICU, Kate was stable enough to be moved to the Tenth Floor. “We were thrilled that Kate was being moved out of the PICU,” says Stephen. “We still didn’t know what the final outcome would be, but we really didn’t care. We were happy to have her in any condition.” While Kate’s recovery was still uncertain, the Barrys began talking with Dr. Adelson about plans for continuing her care and rehabilitation at The Children’s Institute.

One day before she was going to be transferred to The Children’s Institute, the Barry’s wait was over. All of a sudden, during a simple phone call from her father, Kate exploded with words. She was confused, excited and not making much sense, but it was the first time she had spoken since her fall. “Words just can’t express how happy we were to hear her speak,” says Barbara. “For weeks, we had thought we might never hear her voice again.”

Today, following months of intensive physical, occupational and speech and language therapy, Kate has regained all her past knowledge except for any memory of the fall or her stay at Children’s. “She looks, acts and speaks just like any other little girl her age,” says Stephen. “And every morning as she leaves for kindergarten without a care in the world, we thank God, Dr. Adelson and Children’s Hospital for bringing her back to us.”