May 01, 2002 11:00 pm

ENTERPRISE — Enterprise's kindergarten teacher is back home after a three-week complication from an earlier case of meningitis.

Judy Fletcher, 54, underwent a 2 1/2 hour craniotomy about midnight April 8 to remove a subdural hematoma, her husband Gary Fletcher told The Observer.

A lemon-size piece of skull was removed and then reattached with titanium rivets. In the days following surgery, a significant amount of cerebral spinal fluid was drained.

After two weeks in rehabilitation, Fletcher again is able to talk. She walks with the aid of a cane. Fine motor skills, such as fastening buttons, are impaired, but her prognosis is for a full recovery within a year, Gary Fletcher said he was told by the neurosurgeon.

Once the remaining blood, fluid/membrane and air pockets from drainage tube sites are resorbed by the bloodstream, the brain is expected to resume its natural shape and reattach to its lining, from which it was torn when pushed inward by accumulating fluid.

The condition is not expected to recur; however the neurosurgeon cautioned that 20 percent of such patients can develop hydrocephalus — an accumulation of spinal fluid inside the brain.

"I guess that since we spent the holidays and our birthdays in St. Alphonsus hospital, we just had to go back there for our 34th anniversary too," Judy Fletcher said.

She was flown last month by La Grande's Air Life to Boise. Her first flight to Boise was in mid-December, after she collapsed from a meningitis-induced seizure. She was in a coma for two weeks. Complications included encephalitis, pneumonia and anemia.

She spent two months in the hospital undergoing medical treatment, sinus surgery and rehabilitation. She lost her hearing and received a cochlear implant, which was damaged during the recent craniotomy. A Boise audiologist has since reprogrammed her implant's speech processor, so that she can hear sounds.

Fletcher has difficulty discerning language. The audiologist attributes that to this second brain trauma, Gary said. After the brain is healed, the auditory nerve can better function and Fletcher will be able to learn how to interpret the sounds. Fletcher is recuperating at home, but will return to Boise for neurological followup and physical, occupational and speech therapies.

The Fletchers say they have a lot for which to be thankful.

"Most of all the generous outpouring of prayer and support that brought Judy from the brink of death," Gary said.

— From Observer staff reports