Putaminal Hemorrhagic Stroke, Surgical Intervention and Rehabilitation Challenges in Pakistan: A Case Report and Review

The United States has seen the relative rate of stroke death fall by 35.8% and the actual number of stroke deaths decline by 22.8% from 2000 to 2010, primarily due to reduced stroke incidence and lower case fatality rates [1]. Despite substantial progress in acute stroke care over the last few decades, stroke continues to be the leading cause of long-term disability in the United States [2]. The numbers are catastrophic in Southern Asia3 due to increased life expectancy, poor awareness of preventative measures, and an escalating burden of stroke. In 2001, WHO estimated that 86% of deaths related to stroke worldwide occurred in developing countries [3], with 350,000 new cases annually in Pakistan alone [4]. Stroke epidemiology in this region also differs in terms of a higher incidence at younger ages (occurring about 10 years earlier than in the West), a higher prevalence of hemorrhagic stroke, and higher age-specific prevalence rates of stroke in women [5].