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Stroke

Stroke

A condition when a part of the human brain is deprived of blood (thrombosis or embolism) or a blood vessel bursts and blood puts pressure on the brain.

Stroke Unit

The department of Neurology is backed by Neurosurgery and Neuro Radiology; together these three departments deliver the most aggressive treatment in cases of Stroke.
 

Stroke Facts:

  • One in six people worldwide will have a stroke in their lifetime.
  • Stroke kills someone every six seconds.
  • Every other second stroke attacks a person regardless of age or gender
  • Fifteen million people experience a stroke each year; six million of them do not survive
  • Stroke is a third leading cause of death in India
  • The incidence of stroke is 130 per 100,000 populations every year
  • About 20% of heart patients are susceptible to stroke
 

Be Stroke Smart

  • Reduce the risk
  • Recognise symptoms.
  • Respond FAST - call 108
 

Most Important


The earlier the treatment, the better the outcome with minimum lasting damage to body functions.

Risk Factors


Risk Factors means conditions which may lead to stroke. Risk Factors for Stroke are:
  • Old age
  • Family history
  • Men are more likely to have a stroke
  • More stroke deaths occur in women
Modifiable Risks:
  • Stop Smoking
  • Take exercise
  • Avoid Alcohol
  • Obesity
Other Risk Factors:
  • High blood pressure
  • High cholesterol
  • Diabetes Mellitus

Controlling risk factors reduces possibility of stroke. So if you have any of the above conditions please eat and exercise regularly and get health checks too.

Causes

  • Atherosclerosis: Means hardening of the arteries.
  • Plaque made of fat, cholesterol, calcium, and other substances builds up in the arteries, leaving less space for blood to flow.
  • A blood clot may lodge in this narrow space and cause an ‘ischemic stroke’.
  • Atherosclerosis also makes it easier for a clot to form.
  • Hemorrhagic strokes result from high BP that causes a weakened artery to burst.

Symptoms


Stroke symptoms appear suddenly. They must always be treated as a medical emergency. They include a sudden onset of any of the following:
  • Weakness of the face, arm, and/or leg on one side of body.
  • Numbness in the face, arm, and/or leg one side of body.
  • Inability to understand spoken language.
  • Inability to speak.
  • Inability to write
  • Vertigo and/or gait imbalance.
  • Double vision.

In Hospital


When a stroke victim arrives in Shalby, after a clinical exam, the 128 slice CT scan of the brain (done in seconds) reveals haemorrhagic or ischemic stroke. If Stroke is haemorrhagic, treatment is surgical and/or conservative. If stroke is ischemic, treatment depends upon the time lag. The earlier a stroke patient is brought to Shalby, the better are his/her chances of recovery. The first 4.5 hours are critical for treatment.

Types of Stroke


Ischemic Stroke:
The most common type of stroke is known as an ischemic stroke. Nearly nine out of 10 strokes fall into this category. The culprit is a blood clot that obstructs a blood vessel inside the brain. The clot may develop on the spot or travel through the blood from other parts of the body like the heart.


Hemorrhagic Stroke:
Hemorrhagic strokes are less common but are more likely to be fatal. They occur when a weakened blood vessel in the brain bursts. The result is bleeding inside the brain that can be difficult to stop.


TIA:
Means ‘Transient Ischemic Attack’ and is often called a ‘minor-stroke’. It needs Immediate Action. So TIA is often called ‘Take Immediate Action’. Blood flow is temporarily impaired to part of the brain, causing symptoms similar to an actual stroke. When the blood flows again, the symptoms disappear.

 

A TIA is a warning sign that a stroke may happen soon. It’s critical to see your doctor if you think you’ve had a TIA. Therapies help reduce stroke risk.

More Time Lost = More Damage:
Every second counts when seeking treatment for a stroke. When deprived of oxygen, brain cells begin dying within minutes. Administering clot dissolving drugs can curb brain damage, if given in 4.5 hours of symptoms. Once brain tissue has died, the body parts controlled by that area will not work properly.

Testing Severity by F.A.S.T.:
It is a simple test to check severity.
Face: Check smile. one side droops?
Arms: When raised, does one side drift down or fall down?
Speech: Can the person repeat a simple sentence? Do words slur?
Time: Time is critical. Call 108 immediately if any symptoms are present.
 

Diagnosis of Stroke


The main diagnostic tools in stroke are:
Transcranial Doppler
  • Non invasive method.
  • Bedside procedure.
  • Brain blood vessels are visualised in real time.
  • Used for diagnosis as well as treatment of Stroke.
  • Used for monitoring small blood clots in brain.

128 Slice CT Scan
  • Very fast Angiography & CT Scan in fraction of a second
  • Done without sedation
  • Sections as thin as 0.6 mm can be visualised
  • Images are sharp
  • 3D reconstruction of all parts of brain can be seen
  • Perfusion studies show how much blood supply the brain is receiving
  • Virtual studies are possible

Management of Stroke

 

  • Do this while rushing the patient to hospital :
  • Keep the patient in the lateral position.
  • Do not elevate the head
  • Keep the past history of the patient with details of diseases and medicines ready

Golden Period
The first 4.5 hours are called the golden time for treating stroke because ideal treatment if given in this period leads to better outcomes.


During transit

  • The attending doctor or paramedic will::
  • Circulation & BP is monitored.
  • Breathing is monitored
  • Airways are kept open
  • IV line is secured

In the Hospital

  • Two IV lines secureds.
  • Immediate CT scan of brain (128 slices)
  • Regulate BP
  • Ventilator support
  • Blood investigations
  • ECG
  • Echocardiography
  • Carotid and Trans-Cranial Doppler
     

Exclusive in Shalby
128 slice CT Scan
Transcranial Doppler
Digital Substraction Angiography of Brain
Dedicated Stroke Team

 

Emergency Care
For an ischemic stroke, emergency treatment focuses on medicine to restore blood flow. A clot-busting medication is highly effective at dissolving clots and minimizing long-term damage, but it must be given within 4.5 hours of the onset of symptoms. Hemorrhagic strokes are treated by controlling high BP, bleeding, and the swelling in the brain through surgery if needed.
 

Prevention


Doing this will help in the prevention of stroke.
Stent
If the carotid artery (which supplies blood to the brain) is clogged, and the patient has symptoms of TIA or stroke, a procedure called carotid angioplasty with a stent is done. This restores blood supply to the brain.
Endarterectomy
Blocked Carotid arteries may be opened by surgical removal of plaques formed due to atherosclerosis to restore the blood flow.
 

Thrombolysis


Depending on how quickly the patient has been brought to the hospital, Stroke will be treated as follows:
  • Intravenous treatment is given when patient is brought within 4.5 hours
  • Intra Arterial treatment is given when patient is brought within 9 hours

 

Center Of Excellence

Neurology

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Chairman's Message

Vikram Shah - Best Orthopaedic Surgeon   Dr. Vikram Shah

We at Shalby Hospitals believe in making available High Quality, expert healthcare to people across the world by inventing, adapting and imbibing World's Best technologies and practices. Providing Total Health Care under one roof at most affordable costs has been our passion which helped us establishing a chain of multi-specialty hospitals and vibrant OPD Centres across India and in many parts of the world. Shalby today enjoys a place of pride in the Medical Tourism Map of India as a favoured destination. Our journey continues in tandem with our mission of providing enduring health solutions and our hospital chain built around this philosophy shall outlive the expectations of our valued patients, worldwide.