Stroke

The Stroke Unit at the BLK Super Speciality Hospital is a part of the Centre of Neurosciences and is a specialised unit that provides full prevention, treatment and rehabilitation services, giving hope to stroke patients.

Our unit has a dedicated stroke care team which follows a multidisciplinary approach and works closely with other departments at the hospital to provide the best comprehensive care. We make sure that every patient under our care receives a high standard of stroke management services while having treatment at our unit. 
 

What Is A Stroke?

Strokes (also known as a Cerebrovascular condition) are brain attacks that affect the blood vessels of the brain. They occur when the blood supply to the brain becomes blocked. Stroke is rated as the second-highest cause of death and disability(after cancer), in non-communicable diseases.

In fact, the risk for stroke is quite high among the Indian population and is as high as 800 per 100,000 people and the actual incidence are increasing considerably. Generally there are three types of strokes:

  • Ischemic Stroke: It occurs due to a blood clot that restricts the blood and oxygen from reaching the brain.
  • Haemorrhagic Stroke: It occurs when the weakened blood vessel ruptures as aneurysms or arteriovenous malformations (AVMs).
  • Transient Ischemic Attacks (TIAs): Also called mini-stroke occurs when blood fails to flow in a different part of the brain. However, it may reduce after a short amount of time.

What Are The Signs and Symptoms For Stroke?

The major signs which reflect the probability of having a stroke involve: 

  • The trouble with speaking and understanding
  • Paralysis or numbness of the face, arm or leg (often in one side of the body)
  • The trouble with seeing in one or both eyes (sudden blurriness or blackened vision)
  • A sudden, severe headache (accompanied by vomiting, dizziness or altered consciousness) 
  • The trouble with walking (experience, loss of balance/coordination or sudden dizziness)

In addition to the persistence of the problems listed above, a patient may also experience:

  • Depression
  • Bladder or bowel control problems
  • Pain in the feet and hands (that gets worse with movement)
  • Trouble controlling or expressing emotions

Are You A Candidate For Stroke Unit?

A doctor will evaluate the patient for the current medical condition with the help of diagnostic tests results and will customise a treatment plan accordingly. However, the chance that a patient will experience stroke increases if a patient is: 

  • Overweight
  • Aged 55 years or older
  • Have an inactive lifestyle
  • Alcoholic, smoke or use illicit drugs
  • Holds a personal or family history of stroke

The conditions get worse if the patient has any of the below mentioned medical conditions:

  • Hypertension 
  • Diabetes 
  • Deranged lipid levels 
  • Polycystic kidney diseases
  • Excess of homocysteine in the blood 
  • History of transient ischemic attacks (TIAs), also called mini-strokes

What Are The Various Diagnostic Procedures Required Before Stroke Treatment?

Some of the diagnostic tests that your doctor might as you take in order to evaluate your current medical condition involved:

  • Blood tests
    • For bleeding or clotting disorders
    • Measure blood flow
    • Measure mental function
  • MRI
  • CT scan
  • Carotid ultrasound
  • Cerebral angiogram (is a procedure done to investigate various abnormalities of the blood vessels in the brain)
  • Echocardiogram
  • Positron emission tomography (PET) or PET-CT scan
  • Electroencephalography (EEG)

What Are The Treatment Procedures Use At Stroke Unit?

The surgeons at the Centre for neurosciences will treat patients with serious conditions related to Stroke. The treatment might require clot-busting drugs or angioplasty of the brain vessels in a Cath Lab. Other treatments include:  

  • In case of a haemorrhagic stroke, the treatment will depend upon the cause of the stroke. The major types of stroke  causes are: 
    • Aneurysm - Treatment Method: In endovascular coiling, a very thin metal wire is inserted inside the brain aneurysm, through a miniature catheter, by a highly experienced surgeon. This microcatheter is navigated through the web of brain arteries under image guidance in a cath lab. Once the catheter reaches the desired location, a series of handmade coils are placed inside the aneurysm and detached from outside the body. These small coils form a coil mass which blocks the blood flow to the aneurysm and subsequently lead to the healing of the artery.
    • Arteriovenous Malformation (AVM) - Treatment Method: An Arteriovenous Malformation (AVM) is an abnormal collection of blood vessels occurring within the brain itself. In an AVM, there is a sort of short circuit which causes the blood to travel rapidly from the arteries directly into the veins. This can lead to a pressure build-up and cause bleeding from the AVM or the veins, which do not have enough support in their walls. Patients can be asymptomatic or may suffer from headaches, seizures, or deterioration of neurologic functions. If haemorrhage occurs, patients may experience severe headaches, stroke-like symptoms, or even loss of consciousness. The treatment of AVMs may include surgical excision, radiation treatment, or embolisation. In most cases, embolisation is used to block the blood supply to the AVMs, making the treatment safe. In 70% of the cases, embolisation may fully treat a lesion. In some cases, patients might have to undergo a surgical resection or radiation therapy to complete the treatment
    • Carotid Disease (Stenosis) - Treatment Method: In recent years, the use of Angioplasty and Stenting for the treatment of cerebrovascular diseases has grown immensely. Patients with more than 70% symptomatic carotid stenosis are the ones who greatly benefit from this intervention procedure. Patients may also have a history of a previous stroke or Transient Ischemic Attacks (TIAs). This procedure is performed under monitored anaesthetic care with the patient sedated or under general anaesthesia, depending on their medical condition, making it a highly personalised treatment.
    • Tumour Embolization - There are several groups of patients in whom bleeding from a tumour needs to be controlled. This may include pre-operative treatment of the neck masses (paragangliomas and juvenile angiofibromas) or skull base lesions (meningiomas) to decrease the time and risk of surgery. Patients with epistaxis, i.e. persistent severe nose bleeding, may also benefit from tumour embolisation

All the above procedures are called neuro-intervention procedures and are done in a Neurovascular Cath Lab.

  • In the case of Ischemic Stroke:
    • Stroke Therapy - Treatment Method: The incidences of serious stroke-related, long-term disabilities are rising every year. The current emphasis is on recognizing strokes as early as possible, and all attempts are made to open clogged arteries to prevent the loss of brain neurons. The earlier the endo-vascular treatment is performed, the better the outcome. This is done by using a clot-removing device, which traps and removes a clot from the artery of the brain in a cathlab. The functional outcomes of this procedure are significantly better as compared to traditional treatments of stroke.

What Are The Precautions One Must Take After The Stroke Treatment?

The important precautionary measures one must consider taking after the treatment are: 

  • Take all the medications prescribed by the doctors
  • Eat a very healthy diet including fresh veggies and fruits
  • Avoid the use of tobacco and excessive smoking
  • Heavy consumption of alcohol is prohibited
  • Visit your doctor for regular check-ups in the outpatient clinics
  • Keep your blood pressure under control
  • Manage your diabetes level to normal
  • Treat obstructive sleep apnoea
  • Exercise regularly-start from a mild brisk walking and increase it slowly

Are There Any Complications Involved?

Some of the risk factors associated with Stroke treatment include:

Risk factors associated with medication:

  • Stomach upset 
  • Pain 
  • Nausea 
  • Dizziness 
  • Increase in blood sugar level 
  • Challenge in thinking, remembering and recognising things 

Physical conditions post-stroke treatments include: 

  • Weakness 
  • Numbness 
  • Stiffness

These risk factors are very mild and usually reversible with adjustments in stimulation or with the help of some medication. However, if the patient experiences these symptoms for a longer duration then he must see a doctor immediately.

Find Complete Relief from BLK Experts

If you think you are facing similar conditions, or have suffered from them in the past, please contact the BLK Hospital team to schedule an appointment at : +91-11-30403040

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