Pak J Med Sci
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Encephalocele is a congenital neural tube defect (NTD). The pathophysiology of the NTDs is exceedingly complex. Numerous explanations have been proposed to explain it. ⋯ Double encephalocele is a rare entity. The multisite closure theory appears to be the most plausible explanation for the development of multiple NTDs. The management of double encephalocele requires a case based approach.
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Multiple techniques have been used to treat trigeminal neuralgia (TGN), including pharmacotherapy, radiosurgery, rhizotomy and microvascular decompression (MVD). Blood vessels are considered to be the most common cause of offense and compression to trigeminal nerve. We aimed to determine the causes of classic TGN and efficacy of MVD. ⋯ Microvascular decompression is highly advocated in classic cases of TGN. In the absence of grossly visible offending vascular structure, arachnoid adhesions should be the thorough focus of address.
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To evaluate the precision and safety of a novel technique of free-hand frameless pinless AXIEM™-based navigation guided biopsy of deep-seated brain lesions in a low-middle income country. ⋯ AXIEM™-based Medtronic-Stealth S7 is a quick, reliable, real-time and secure neuronavigation system for taking a free-hand, frameless and pinless biopsy of deep-seated lesions in the brain.
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To evaluate the Outcomes of Fenestration of Lamina Terminalis for Hydrocephalus following Clipping of Ruptured Aneurysms of Anterior Circulation. ⋯ Reducing the likelihood of shunt-dependent hydrocephalus after ruptured aneurysm clipping can be achieved using lamina terminalis fenestration, regardless of fisher grade. It assists in preventing excessive brain retraction, decreasing intracranial pressure, raising brain perfusion, cisternal blood cleansing, and lowering the need for a ventriculoperitoneal shunt in cases of persistent hydrocephalus. Consequently, to reduce the incidence of shunt-dependent hydrocephalus, we recommend routine lamina terminalis fenestration following anterior circulation aneurysm clipping.
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We aimed to determine frequency, clinical presentation, etiology and management in patients presenting with primary amenorrhea in tertiary care setting. ⋯ Primary amenorrhea is a significant problem in adolescent girls. We found Mayer Rokitansky- Kuster- Hauser syndrome (MRKH) syndrome as the commonest cause in our series. There is need to promptly identify the patients who need medical, surgical or psychological management. It is also required to make local strategies and guidelines for evaluation, management and long term follow up.