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Background: Stroke presents as the second most prominent factor contributing to global mortality. Immediate brain imaging can be valuable for assessing functional recovery potential. This study investigated the association between Alberta Stroke Program Early CT Score (ASPECTS) and functional outcomes in patients with left and right-hemisphere strokes. Methods: A prospective cohort study was conducted in July-Dec2 022, at a tertiary care hospital in Karachi including patients of either gender presenting within 2 days of stroke while excluding posterior circulation strokes, TIA & unwilling patients using a non-probability consecutive sampling technique. A total of 152 patients with acute ischemic stroke involving anterior circulation were analyzed and patients were categorized into two groups: the left hemisphere group (n=76) and the right hemisphere group (n=76) accordingly. ASPECTS scores were calculated from brain CT scans, while functional outcomes were measured using the modified Rankin Scale (mRS) at the three-month mark. Descriptive analysis and chi-square test were applied using SPSS vr25. Results: Patients (n=152) had a mean age of 61.75 ± 13 years, with males comprising 67% of the cohort. ASPECTS scores were notably higher in left hemisphere strokes (median 9, IQR 2) than right hemisphere strokes (median 8, IQR 3) (p=0.036). Higher ASPECTS scores (≥7) correlated with improved outcomes (mRS ≤2) in both hemispheres. There was no statistically significant difference in both groups’ functional outcomes (p=0.182). Conclusion: ASPECTS predicts functional outcomes in acute ischemic strokes equally well regardless of the affected hemisphere.

Background: Hyponatremia is considered as a common electrolyte imbalance in hospitalized patients. Cerebral salt wasting syndrome (CSWS) is an abnormality in the renal sodium transport in patients with intracranial disease, in the face of preserved thyroid and adrenal function. However, treatment of CSW and syndrome of inappropriate antidiuretic hormone (SIADH) varies, making an accurate diagnosis significant. In order to differentiate CSWS from syndrome of inappropriate antidiuretic hormone (SIADH), this study aimed to detect CSWS related hyponatremia (benign and reversible condition) in its early stages. Methods: This retrospective cross-sectional study was conducted at the Department of Neurosurgery, Ziauddin Medical University Hospital, Karachi, Pakistan from August 2016 to August 2019. All patients who had a cerebral lesion along with hyponatremia and natriuresis were included. Patients with SIADH, though considered in the differential diagnosis, were not included in the study. Data was analyzed by using SPSS (Statistical Package for the Social Sciences) and p

Basilar tip aneurysms are the commonest aneurysms of the posterior circulation and constitute around 5-8% of all cerebral aneurysms. Ruptured basilar tip aneurysms may present with signs and symptoms of subarachnoid hemorrhage (SAH) with sudden, extremely severe headache, nausea and vomiting, stiff neck, blurred or double vision, sensitivity to light, seizure, drooping eyelid and loss of consciousness. At times, the hemorrhage could be fatal, reaching mortality beyond 20%. Basilar tip aneurysms have complex anatomy and have always been considered difficult to treat. Two well-known options to treat basilar tip aneurysms include the microsurgical approach and the endovascular approach. Endovascular treatment is now a cost-effective, preferred and logical rationale for the management of intracranial aneurysms. This case reports the first ever coiling procedure that was performed at Ziauddin Hospital (North Campus) for a basilar tip aneurysm and the other major challenge faced at our center was that the neck was wide, hence requiring a supporting balloon. Keywords: Aneurysm; Subarachnoid Hemorrhage; Cerebral Aneurysms.

Background: It has been well documented that administering a prophylactic antibiotic brings down the rate of postoperative wound infection very strikingly in carpal tunnel release (CTR) surgery. Carpal tunnel syndrome (CTS) is definitely a compressive neuropathy of the upper limbs, which is both benign and frequent. The study objective was to determine the postoperative wound infection rate in carpal tunnel release surgery after having administered a single dose of a prophylactic antibiotic. Methods: This cross-sectional study was carried out at the department of Neurosurgery, Dammam Medical Complex-Saudi Arabia. The study was based on 122 patients who were operated for carpal tunnel release procedures at the centre. Pre-operatively all patients were subjected to nerve conduction studies (NCS) to document CTS as the definitive diagnosis. As a routine, every patient was administered intravenous loading dose of cefuroxime (1.5g) at least 1 hour prior to surgery. All patients were treated as day care cases and were discharged after a few hours of surgery. On discharge, no further antibiotics were administered. Their wounds were examined at three, ten and fourteen days. Suture removal was performed on the fourteenth postoperative day. Results: Superficial redness over the site of incision was noted in three of the patients and wound infection in two others. These two patients improved with oral antibiotics. Not a single patient needed re-exploration. Conclusion: The current study showed that this is an efficacious and a very safe protocol to follow. Assuming the fact that the incidence of surgical site infection (SSI) in CTR surgery is low, the results were not different when compared to the results from other centres.