Teen Comes Through Near-Fatal Accident

Neurosurgery, trauma, and neurocritical care teams perform Christmas miracle by saving boy’s life after severe accident

It is exactly a year since the day Taneesh’s life changed forever. A tragic accident left the Bay Area teen fighting for his life, but it also brought him remarkable clarity about what matters most.

Before the accident, Taneesh was a busy, active high school junior who had a job, excelled in soccer, and got top grades at school. He was preparing to attend college to pursue a mechanical engineering degree.

Then, on a fateful rainy day on December 19, 2023, during finals and right before holiday break, everything changed. His friend picked him up from school to get lunch. Taneesh got in the front passenger seat. On the way, his friend lost control of the car. They hit a tree and the roof of the car was crushed, fracturing Taneesh’s skull.

“It was such a bizarre accident. The driver and his girlfriend, who was in the back, walked away uninjured, but Taneesh had life-threatening injuries,” says Hema, Taneesh’s mom.

Based on his critical injuries, emergency responders took Taneesh to the closest Level I Pediatric Trauma Center, which was Lucile Packard Children’s Hospital Stanford.

“I was very lucky that the team brought me to Packard Children’s, one of the best hospitals in the world,” Taneesh says.

Getting advanced neuro-trauma care at Stanford Children’s

Kelly Mahaney, MD, pediatric neurosurgeon, remembers the trauma alert on that Tuesday before Christmas. After she and the team examined Taneesh and worked to stabilize his brain injury, she recalls, they had to tell his family that the medical team was not sure Taneesh would make it.

“It was a tough night in intensive care, and we tried to optimize his care medically but he was really deteriorating. We were not confident he would survive,” says Dr. Mahaney.

A large care team of 30+ neurological and trauma specialists came together to care for Taneesh, including Dr. Mahaney; Laura Prolo, MD, PhD, pediatric neurosurgeon; Stephanie Chao, MD, pediatric surgeon; and, very important, the highly specialized Pediatric Neurocritical Care team—one of the first in the nation and one of only a few in California, a vital addition for an ideal neurological outcome. Experts from Pediatric Plastic Surgery were also present, since Taneesh had complicated face fractures as well.

One of the biggest threats against Taneesh’s life was increasing brain pressure from his severe head trauma. “If brain pressures get too high, normal blood flow to the brain becomes compromised, putting a patient at risk for secondary brain injury, stroke, or herniation—leading to death,” Dr. Mahaney says.

She was prepared to do an emergency decompressive craniectomy—a neurosurgery to remove bone to open the skull and expose the brain, allowing it to swell into the open space, which would reduce pressure. But Taneesh needed to be more stable for surgery.

“We put him on an intracranial pressure monitoring device to keep track of pressures in his brain, and we placed an external ventricular drain to release cerebrospinal fluid to relieve pressure,” says May Casazza, c-ACPNP with the neurocritical team. “We pretty much used every type of specialized neurological equipment we had.”

“Our Level I Pediatric Trauma Center is multidisciplinary and one of only five in California,” adds Dr. Stephanie D Chao, director of the Pediatric Trauma Center.

Going from no brain function to a twitch of a thumb

On the morning after his accident, Taneesh was not showing signs of brain function. Dr. Mahaney talked with his parents about their options. They voiced their desire for the team to do everything they could to save Taneesh, even if that might mean he survived in a comatose state.

“As a trauma team we prioritize having honest conversations with families about how seriously injured their child is in those early hours while we do all we can. We always want families to make informed decisions about their child’s care,” says Katherine Alvarez, PA-C.

“Taneesh’s family was so thoughtful about care decisions, even while in shock,” Dr. Mahaney says.

With the parents’ wishes made clear, the team decided to turn off Taneesh’s sedation to get a better neurological assessment. If he showed signs of even brainstem function, their plan was to go ahead with the craniectomy. Everyone held their breath for the next several hours.

“I checked on him every 20 minutes, and hours later I saw him flick his right thumb. That was enough for us to say there was a chance,” Casazza says. She also checked for pupil reaction and saw some activity. “I spoke with the doctors and we said, ‘Let’s go!’”

Dr. Mahaney brought Taneesh into surgery for the craniectomy. She was joined by Rohit Khosla, MD, FACS, pediatric plastic surgeon, who requested she perform the craniectomy with a bicoronal incision—farther toward the back of Taneesh’s skull to preserve his forehead and face for future plastic surgery. He then marked out where he would make future incisions on Taneesh’s scalp.

“Even though we were unsure whether or not Taneesh would survive, we wanted to ensure we were set up for a later operation to fix his complex facial fractures and frontal sinus fractures all in one shot,” says Dr. Khosla.

All of this happened in the first 24 hours of care.

Uncovering an unexpected challenge—brain aneurysm

On the way to surgery for his craniectomy, Taneesh received a computed tomography angiography (CTA), where dye is used with a CT scan to create an image of blood vessels and tissues in the brain.

“That’s where we detected a traumatic cerebral aneurysm (a bulged brain artery) that had ruptured,” Dr. Mahaney says. “After surgery, I called neuro-interventional radiology to ask them to secure the aneurysm. They took him that night, and because of that, he is still alive.”

Robert Dodd, MD, PhD, cerebrovascular neurosurgeon and neuro-interventional radiologist, performed the procedure. His team was able to stop the bleeding by deploying a tiny platinum coil into the aneurysm. Neuro-interventional radiology at Stanford Children’s offers the latest in minimally invasive tools and procedures, with doctors who specialize in treating vascular neurological conditions via endovascular approach.

“Many community hospitals, even many leading children’s hospitals, do not have access to neuro-interventional radiologists, so the fact that we offer this specialty care and our teams collaborate closely means that we were able to get Taneesh care in a timely fashion, which was critical,” Dr. Mahaney says.

The aneurysm was caused at the time of the accident. A part of Taneesh’s skull bone lifted up and lacerated an artery. It’s why his trauma case was extraordinarily complex and partly why he needed so many procedures.

“It’s pretty unusual. We see it in wartime injuries, but it isn’t something we see often in traumatic accidents,” Dr. Mahaney says.

Before receiving the coil procedure, Taneesh had important visitors—his two best friends, including the driver of the car during the accident. In an astounding show of grace, Taneesh’s parents, Hema and Manju, invited them in. Even though he couldn’t respond, the driver was able to say, ‘I’m sorry, Taneesh.’

“That was quite a moment for me to witness. His parents, trying to get their son through the night, telling his friends it’s OK, we’ll get through this, and showing such forgiveness,” Casazza says.

One more hurdle on the road to improvement

Despite his surgery and the coiling of the aneurysm, Taneesh’s brain pressure stayed unexpectedly high the next day, and he was also having vasospasms. Dr. Dodd expressed concern about a blood clot caused by his ruptured aneurysm. He advocated that the neurosurgery team surgically remove it.

Dr. Mahaney took Taneesh back to surgery that day to perform an endoscopic procedure to evacuate the clot, which helped put him on the road to improvement after a rough start. “It’s remarkable the progress he made. Over Christmas I asked my family to pray for him, and when I came back and heard about his improvement, it felt like a Christmas miracle,” she says.

Follow-up surgery to repair his facial fractures

Over the month at Stanford Children’s, Taneesh continued to heal. His brain pressures came down, and he woke up more each day. He was stable enough for another critical surgery—a combined neurosurgery to close his skull flap from the craniectomy and plastic surgery to repair his facial fractures.

“He had extensive fractures. His forehead, midface, around his eye sockets, and his nose were fractured in several pieces, and they were disconnected from his skull. Luckily, it spared his jaw,” Dr. Khosla says.

The Pediatric Plastic Surgery team at Stanford Children’s are experts in facial surgery, offering highly advanced techniques including facial trauma microsurgeries (transferring tissue) and 3-D computer-guided surgical planning, among others.

“We have a lot of experience with facial injuries, and we know how to put faces back together,” Dr. Khosla says. “In surgery, our team lined up his bones and held them together using titanium plates and screws. We were able to achieve close to normal facial projection and symmetry.”

Thanks to Dr. Khosla’s exceptional skills and his planning two steps ahead during those unpredictable early days, no one would ever know Taneesh had had a facial injury.

“What’s special about Stanford Children’s is that we are always accessible to one another and we don’t think twice about collaborating or planning together across disciplines, and that worked seamlessly when caring for Taneesh,” Dr. Khosla adds.

After recovering at Stanford Children’s, Taneesh was moved to a hospital closer to home for extensive rehabilitation therapies, where he spent another month. Later, he continued therapy at home and at other nearby facilities.

A new lease on life and not wasting one second

“I wake up every day and tell my dad, ‘Today is the best day of my life!’ I am getting better every day, and even if it is just a little bit, it is more than it was the day before,” Taneesh says. “When you hit rock bottom, everything is upwards and every day is a best day.”

Taneesh was a determined, kind teenager before the accident, but now those traits are supercharged and with a clarity that is nearly unheard of in a 17-year-old boy. “The accident made me realize how lucky I am and helped me understand what’s important in life—close family and friends.” He also has immense gratitude for dedicated medical professionals who tirelessly guided him through tough times.

He was extremely touched by how his family from near and far rallied to see him through. They came to Stanford Children’s and filled the entire waiting room on his floor. He was also heartened by frequent visits from his school community, including the principal, the school president, teachers, and coaches. “They came throughout winter break and even when they had a school to run. Someone from school was there every day,” Taneesh says.

After months of rehabilitation, Taneesh is back to school for his senior year and even more focused on realizing his dream of becoming a mechanical engineer and entrepreneur with hopes of helping people with disabilities. He’s once again considering college, and with his resilience and tenacity, he has made up for the lost semester and expects to graduate on time. His positive outlook is uncompromising, and his steady smile is infectious.

“I’m back, and I want to be better in every aspect—mentally, emotionally, and physically—than I was before the accident,” he says.

Taneesh and his family endured incredible pain and suffering, but he doesn’t even mention it. He is finding new ways to enjoy his beloved sport, soccer, by mentoring and training his younger brother and his team.

“Taneesh physically suffered, but the outcome is that he is a better person. His sense of gratitude and his sense of purpose and clarity are profound,” Manju says.

To mark the first year of what he calls his rebirth after the accident, and to say thank you to Stanford Children’s, Taneesh started a holiday fundraiser called Helping Hands! through Stanford Students for Philanthropy for young patients. “I want to raise awareness and share empathy for those who need intensive care, and I invite people to join me,” he says.

A highlight for the family and the team at Stanford Children’s was the family’s visit to the ICU to say thank you. “It was touching to see the staff so overwhelmed, some even in tears, at seeing Taneesh on his feet,” Hema says. She recalls running into Dr. Mahaney, whom Taneesh calls his superhero.

“Dr. Mahaney is extremely focused and composed, but on that day she showed her emotions when she saw us,” Hema says. “She said, ‘You made my day, getting to see you!’ and I broke down and said, ‘You made our lives, doctor.’”