Background Digital subtraction angiography (DSA) is a fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment. Images are produced using contrast medium by subtracting a “pre-contrast image” or mask from subsequent images, once the contrast medium has been introduced into a structure, hence the term “Digital subtraction angiography.” Indocyanine green video angiography (ICG-VA) is a safe and practical method of real-time delineation of microvasculature used in the surgical management of intracranial aneurysms, arteriovenous malformations, and other vascular lesions. Intraoperative ICG-VA is used as an adjunct in addition to intraoperative or postoperative DSA, and in other cases, it is used as the sole method to confirm the complete obliteration of clipped intracranial aneurysm. The only limitation of ICG-VA is the nonvisibility of vessels that are not in the operative field. Intraoperative ICG is useful in the clipping of intracranial aneurysms to ensure a gross patency of branch vessels; however, the presence of residual aneurysms and subtle changes in flow in branch vessels is best seen by DSA. Methods ICG angiography was done during the surgery and the findings of intraoperative ICG angiography were compared with postoperative DSA that was done between 6 and 12 weeks. DSA was done to see any compromise of lumen of parent vessel by clip, any residual aneurysm. Results In our study, intraoperative ICG complete aneurysm obliteration was present in all 30 (100%) patients, while in postoperative DSA complete aneurysm obliteration was diagnosed in 27 (90.0%) patients. Parent vessel patency was present in all 30 (100.0%) patients in both intraoperative ICG-VA and postoperative DSA. In intraoperative ICG distal branch patency was present in 26 (86.7%) patients, while in postoperative DSA distal branch patency was diagnosed in 27 (90.0%) patients. Conclusion We compared the intraoperative ICG finding and postoperative DSA finding and found that DSA is more sensitive than ICG in depicting residual aneurysm neck, hence reducing the risk of rupture of the aneurysm in future. Intraoperative ICG has high special resolution reflex feedback, intraoperative repositioning time is less and thus critical ischemia time is reduced. In a developing country like ours where DSA facilities are limited, ICG can be optimal investigation to delineate the vascular anatomy and confirmation of clip position thus reducing mortality.

Acute brain infarct is an uncommon complication of electrical injury, and only a few cases have been reported. A young man sustained a high-voltage electrical injury followed by a fall from height. Imaging revealed right hemibrain infarct. He was operated for that, but did not make much progress. Electric shock injury with the high-voltage current even for short period of contact may cause massive infarction of brain, and prognosis remains dismal.

Background Head injury is a major health hazard throughout the world. Overall, the mortality/morbidity has not changed much in the last few decades. In developing nations, the situation is worse. Methods The study was conducted for a period of 1 year. The data collected include demographic profile, mode, circumstances and timing of the injury, neurological assessment using Glasgow Coma Scale (GCS) scoring, computed tomography (CT) scan findings, type of management, and outcome. Results Transport-related injuries and falls were the common cause of head injury, with more severe injuries seen in patients without wearing helmets and seat belts. The youth is at high risk of receiving head injuries. The summer season showed a maximum incidence of head injuries. The most common lesions on CT scan were linear fracture of the skull and brain contusion. Mortality rate was 26% and it correlated with the GCS at presentation. Conclusion Head injury mostly affects young people and males outnumber females. Road traffic accident is the major cause. People not abiding by the traffic rules, such as wearing helmets and seat belts, were at high risk of developing head injury and poor outcome.