Primary intraventricular brain abscess is a rare entity. Not many cases are reported yet. Moreover, proper guidelines for the treatment, conservative treatment or surgery, has not yet been established. Its outcome is also unpredictable and usually poor.We present a 11-year-old girl with wide spread intraventricular brain abscess. There was no obvious cause for the abscess formation. Cardiac status was normal by history and ECHO. She was treated surgically with external ventricular drainage (EVD). There was significant improvement after EVD. Intraventricular flushing was done with the solution of injection Gentamycin and hydrocortisone. However, the patient expired while planned for discharge from the hospital due to sudden cardiac arrest.A bigger study is needed to assess the various factors of intraventricular brain abscess including epidemiology, treatment, outcome etc in the Nepalese context.Nepal Journal of Neuroscience 12:88-90, 2015
Basilar tip aneurysm is the commonest aneurysm in posterior circulation. It comprises of about 5% of total aneurysms of cerebral circulation. Giant basilar tip aneurysm is rare and is technically challenging. Bigger is the aneurysm more complex is its structure leading to technical difficulty in its treatment, may it be surgical clipping or endovascular coiling.We present 50-year-old male patient presented with sudden and severe headache with altered consciousness. CT head showed sub arachnoid hemorrhage and CT angiography showed giant basilar tip aneurysm measuring more than 23 mm in length. Moreover basilar tip bifurcation and both the posterior cerebral artery arose from posterior aspect of lower part of the trunk of aneurysm. Because of the huge size and origin of the major branches from aneurysm trunk surgical clipping seemed highly risky. Patient was planned for coil embolization in India. But due to cost factor surgical clipping was planned.Successful clipping was done through right frontotemporal transtentorial approach. Small residual aneurysm was noted in the anterior lower part of aneurysm trunk which was wrapped with hemostatic agents. Complete resection of the aneurysm was done showing complete obliteration of the aneurysm. Post operatively patient was neurologically intact except ipsilateral oculomotor nerve palsy.Patient was discharged on 6th post operative day.Nepal still lacks endovascular coiling facility. Cost factor is a major hindrance for this. Surgical clipping is still the fi rst choice of treatment for any aneurysm in Nepal. There is no alternative to skill development and successful clipping for treating aneurysm in Nepal.Nepal Journal of Neuroscience 12:40-42, 2015
Brachial plexus schwannomas are rare benign nerve sheath tumors and only about 5% of schwannoma arise from the brachial plexus. They create a great challenge to surgeons due to their rare occurrence and complex anatomical location. We present a case of 37 yrs female presented with a right supraclavicular mass with severe radiating pain in right hand. Further investigation was done with MRI and FNAC which turns out to be huge right brachial plexus schwannoma. Gross total resection was done without any neurological motor defi cits. Nepal Journal of Neuroscience. Vol. 13, No. 2, 2016, Page: 92-93
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