Browsing by Author "Agrawal, Pooja"
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Publication The First Successful Endovascular Management of Posterior Fossa Arteriovenous Malformations in Nepal: Case Series(Nepal Medical Association, 2020) Phuyal, Subash; Agrawal, Pooja; Dawadi, Kapil; Paudel, Raju; Lamsal, RiteshAbstract: Posterior fossa arteriovenous malformations represent 7–15% of all intracranial AVMs. They carry a higher risk of rupture than supratentorial AVMs and are associated with considerable rates of morbidity and mortality. Available treatment options include conservative management, microsurgical resection, radiosurgery, endovascular embolization, or combinations of these modalities. Recent advances in endovascular techniques have revolutionized their management with better clinical outcomes. We illustrate two cases of posterior fossa AVMs treated by endovascular techniques with good clinical outcomes. The first patient also had associated flow-related aneurysms. One of these aneurysms had already ruptured, so it was coiled first followed by AVM nidus embolization using the same microcatheter. The second patient had a diffuse type of posterior fossa AVM for which staged-embolization was planned and the first-stage partial embolization was successfully performed.Publication Twin to Twin Transfusion Syndrome: A Case Report(Nepal Medical Association, 2022) Agrawal, Pooja; Vaidya, Achala; Vaidya, Anshu; Phuyal, Subash; Pandey, AsmitaAbstract Twin-twin transfusion syndrome occurs in multiple gestations and involves a chronic flow of blood from one twin to another twin and is a rare entity. We present a case of 32-years-old primigravida with a twin pregnancy who presented with increasing abdominal girth inappropriate with her gestational age at 21 weeks of her pregnancy. Ultrasound findings were suggestive of twin-twin transfusion syndrome. The patient was provided with treatment options but due to polyhydramnios and short cervix, the patient went into spontaneous labour the same day with a poor pregnancy outcome. Twin-twin transfusion syndrome leads to a high rate of perinatal morbidity due to its poorly understood aetiology and difficulty in diagnosing and treatment. Early diagnosis during antenatal ultrasound is important in reducing morbidity and mortality rates.