Background Stroke constitutes a major health problem worldwide, nowadays endovascular treatment is considered to be a standard of care in acute ischemic stroke patients with large vessel occlusion, accurate prediction of outcome of thrombectomy is essential for health care providers, patients and families. We studied different clinical and radiological variables that could predict functional outcome in stroke patients after thrombectomy. Thirty-four consecutive ischemic stroke patients were included, received intravenous tissue plasminogen activator (iv-tpa), then mechanical thrombectomy was done. Patients were clinically assessed at admission with National Institute of Health Stroke Scale (NIHSS) then evaluated by the Alberta Stroke Program early computerized tomography (CT) score (ASPECTS), clot burden scale (CBS) and collateral score (CS) in multiphase computerized tomography angiography (CTA) then good and poor outcomes at 3 months were defined by Modified Rankin Scale (MRS) of 0–2 and 3–6 points, respectively. Results Factors associated with good outcome (MRS 0–2) were lower admission NIHSS score (p < 0.037), small infarct core aspects ≥ 6 (p < 0.001), low clot burden (CBS 7–10) (p = 0.046) good collaterals (2–3) (p = 0.038) and absence of post-procedure hemorrhage (p < 0.0005). Conclusions Low admission NIHSS score, absence of post-procedure hemorrhage, small infarct core, low clot burden and good collaterals are reliable factors for good clinical outcome.

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This manuscript aims to outline how pre-existing resources can be used for stroke care and how public and government awareness can be raised (influencer model). We likewise portray the achievement of the LGH stroke program as an example of advancement. In LGH, reperfusion treatment has begun in recent years and this paper portrays the one of a kind experience in Pakistan. The aim of this study is to do a comparative analysis between Pakistan, Thailand and Egypt and their approaches to stroke care management and treatment. These countries fall under similar economic standing (LMICs) but Egypt and Thailand have relatively better healthcare systems for stroke management as compared to Pakistan. Hence, this paper looks into these differences and presents potential solutions to how stroke care management can be improved in Pakistan. Additionally, current stroke management in Pakistan is reviewed.

To report a case of post-traumatic direct carotid-cavernous fistula (CCF) treated with Merlin’s XCalibur as a standalone treatment. XCalibur is a balloon mounted flow diverter covered with polymer biostable membrane. A single device was deployed across the rent which resulted in the complete exclusion of fistula. This is the second case of its kind to be reported for the treatment of post-traumatic direct CCF with an XCalibur device. The device proved to be effective and safe and did not require any additional coiling, thus this paper has immense value and benefit for the medical community at large as it displays a new technique being successfully used.

This manuscript aims to outline how pre-existing resources can be used for stroke care and how public and government awareness can be raised (influencer model). We likewise portray the achievement of the LGH stroke program as an example of advancement. In LGH, reperfusion treatment has begun in recent years and this paper portrays the one of a kind experience in Pakistan. The aim of this study is to do a comparative analysis between Pakistan, Thailand and Egypt and their approaches to stroke care management and treatment. These countries fall under similar economic standing (LMICs) but Egypt and Thailand have relatively better healthcare systems for stroke management as compared to Pakistan. Hence, this paper looks into these differences and presents potential solutions to how stroke care management can be improved in Pakistan. Additionally, current stroke management in Pakistan is reviewed.