Unsuspected Hypothyroidism as a Cause of Delayed Return of Consciousness Following Post Burn Contracture Neck Release Surgery

A 40 yr old female posted for post burn contracture neck release surgery encountered an unusual delay in the return of consciousness following anaesthesia and surgery. The patient was retrospectively evaluated for the reasons leading to the delayed return of consciousness. The patient was otherwise healthy except for the fact that she was dull, reserved, detached and disinterested in her surroundings and the burn contracture of the neck was following a suicidal attempt. A chance idea that the extensive contracture in the neck would have destroyed and burnt the thyroid gland due to the widespread fibrous scar occupying the front of the neck lead us to suspect hypofunction of the thyroid gland as the culprit and initiated us to investigate and evaluate the thyroid function. The patient was subsequently found to be severely hypothyroid. The need for a mandatory thyroid evaluation in all dense post burn contracture of the neck is discussed.