Stroke is a major cause of death and disability worldwide. Every 40 seconds a person suffer from stroke. Only very few percent of people with stroke get appropriate and timely treatment. This is largely due to lack of awareness in identifying the symptoms of stroke. Stroke can be of two types 1) ischemic when the blood supplying a part of brain or spinal cord is blocked and 2) hemorrhagic when the blood vessel in the brain gets bursted and cause leakage of blood into brain tissue and causes damage. To reduce the burden of stroke and provide timely and comprehensive management of stroke patients we have a full fledged stroke care unit which is equipped with managing all forms of strokes. The stroke team involves a team of neurologists, Interventional radiologists, neurosurgeons, physiotherapists, intensivists, ER physicians, stroke nurses and dieticians for the holistic care of the patient.
We have a comprehensive stroke clinic to cater to people suffering from all forms of stroke like ischemic and hemorrhagic (both intracerebral and subarachnoid).
Our centre has specialized resources and personnel available at all times (24 hours a day, 365 days a year) to provide assessment and management of stroke patients with written stroke protocol for all stroke services like emergency care, in-hospital care and rehabilitation, the ability to offer thrombolytic therapy to suitable ischemic stroke patients; timely neurovascular imaging and expert interpretation; and coordinated processes for patient transition to ongoing rehabilitation and secondary prevention. We also have interventional radiology services to assist the stroke management in the form of high quality imaging of brain and blood vessels and mechanical clot extraction if the patient reach early to the emergency services. All these services for stroke are monitored closely for quality measurement system to monitor the quality of stroke care and patient outcomes.
The Acute Stroke Unit is an Intensive care unit providing specialist services for people who have had a new/suspected stroke. In the Stroke Unit we provide intravenous thrombolysis (clot busting) therapy upto 4.5 hours which is usually started even in CT room for appropriately selected patients and monitored closely in the ICU for upto 72 hours for any treatment / stroke related complications. The patients who comes late (more than 4.5 hours) are usually assessed by a team of neurologist s and neuroradiologists and then after undergoing special imaging they are selected for interventional stroke management in the form of extracting the clot by using special devices like stent retrievers. Once the acute phase of stroke is completed they are assessed for rehabilitation by therapists for weakness, balance and speech training. If you need to remain in hospital for more than a couple of weeks, you will move from the Acute Stroke Unit to the Stroke Rehabilitation Unit. We aim to move you when you are well enough and you will stay on the Stroke Rehabilitation Unit until you are ready to leave hospital.
Here patients are treated by any combination of our therapists, depending on how your stroke has affected you. Rehabilitation is a 24 hour process, not just when you are seeing the therapists, and the nurses will encourage you to practise your activities on the ward and to do what you can for yourself.
You will have named therapists who will treat you. You will have an individual plan for your needs. Your treatment plan will progress as you improve.
If you are well enough, you will have a therapy timetable. Therapy sessions might be at the bedside or in the therapy rooms/gym. You might have individual or group sessions.
Neurointerventions for ischemic stroke and aneursyms
When a patient with acute ischemic stroke reaches hospital emergency outside the window period for iv clot busting drugs, we assess the patient for the area of salvageable brain tissue by special CT and MR imaging protocols and suitable patients are taken up for interventional stroke management like mechanical removal of clot by special devices like stent retrievers. When the patient has cerebral bleeding due to rupture of aneurysms, we assess with the help of angiography the location and size of aneurysm and do endovascular coiling ( through a small puncture in the thigh and closing the ruptured aneurysm)
Things to remember
Time is brain and every second lost is neurons lost. Hence to avail maximum benefit, we need to identify signs of stroke. The stroke symptoms can be easily remembered by the acronym BE FAST.
- B : Balance issues
- E : Eye problems like blurred vision, difficulty in seeing one half of the field
- F : Facial droop or asymmetry while smiling
- A : Arm drift or weakness
- S : Slurred or speech difficulty in any form
- T : Time to call emergency services