R aharman Tamang was using a circular saw to cut a steel rod at a metal shop in Bhaktapur when a section of the rod snapped off and pierced his head.
The rod entered through his left forehead just above his eyebrow, crossed the brain in the midline, and exited from behind the brain on the right side. (See CT scan, below) While doing so, it damaged the basal ganglia and internal capsule, the conglomerate of neurons controlling the movement of the left half of his body. Half of his body became paralysed immediately. Tamang, 20, lost consciousness and went limp.
Relatives rushed him to a nearby hospital in Bhaktapur, which said it was not possible to treat him. They then took him to TU Teaching Hospital at Maharjganj, where he was turned away because there were no beds in the ICU.
By the time they got to the emergency ward of Upendra Devkota Memorial National Institute of Neurological and Allied Sciences in Bansbari it had been four hours since the accident.
Doctors were shocked — they had never seen a case like this. They were doubtful at first that the patient would live. Quickly the team reviewed literature to guide the patient’s care and management. Neurosurgeon Pratyush Shrestha found an article in Pubmed about a similar case in a hospital in Mumbai.
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