Stroke: A stroke is a medical condition in which blood flow to the brain is affected resulting in cell death. There are two main types of stroke: Ischemic, due to lack of blood flow, and Hemorrhagic, due to bleeding. Both result in parts of the brain not functioning properly.
Signs and symptoms of a stroke may include an inability to move or feel on one side of the body, problems in understanding or speaking, dizziness, or loss of vision to one side. Signs and symptoms often appear soon after the stroke has occurred. If symptoms last less than one or two hours it is known as a transient ischemic attack (TIA) or mini-stroke. A hemorrhagic stroke may also be associated with a severe headache. The disability of a stroke can be permanent.
Stroke symptoms typically start suddenly, over seconds to minutes, and may progress further. The symptoms depend on the area of the brain affected. The more extensive the area of the brain affected, the more functions that are likely to be lost.
Early recognition: Early recognition of symptoms of stroke is of paramount importance since early intervention has a favorable outcome. Various systems have been proposed to increase recognition of stroke. Different findings are able to predict the presence or absence of stroke to different degrees. Sudden-onset face weakness, arm drift (i.e., if a person, when asked to raise both arms, involuntarily lets one arm drift downward) and abnormal speech (slurring speech) are the findings most likely to lead to the correct identification of a case of stroke, increasing the likelihood by 5.5 when at least one of these is present. Similarly, when all three of these are absent, the likelihood of stroke is decreased. While these findings are not perfect for diagnosing stroke, the fact that they can be evaluated relatively rapidly and easily make them very valuable in the acute setting. A mnemonic to remember the warning signs of stroke is FAST (facial droop, arm weakness, speech difficulty, and time to call emergency services).
Services available at Aditya Birla Memorial Hospital
Accident and Emergency department at our hospital is well equipped for management of Stroke. Ambulance service in the hospital is available to ensure timely transfer of patient to the hospital. The outcomes are best for patients when the patient reaches the hospital and treatment with tissue plasminogen activator (t-PA) is initiated within 60 minutes (door to needle time) where indicated. Treatment with tissue plasminogen activator (t-PA) should start within 4 hours from when patient starts developing symptoms.
Investigations: Our hospital provides wide range of laboratory and radiology investigations to assist in the early diagnosis. Neuroimaging services like CT scan, MRI, Functional Neuroimaging, PET scan and SPECT are available in the hospital. Digital Subtraction Angiography is also performed in the hospital which helps in diagnosis and management of stroke.
Treatment: Acute Stroke Intervention is done via intra venous or intra arterial route using tissue plasminogen activator (t-PA) or via Mechanical Thrombectomy performed by Interventional Radiologist.
Minimal Invasive Surgery for Intracerebral and Intraventricular Hemorrhage and Clot Evacuation is performed for treatment of life threatening stroke.
Stroke rehabilitation services are provided which includes psychology counseling, physiotherapy and dietary services to the patient to facilitate early recovery of the patient.
Stroke prevention: Medical and surgical management is used for stroke prevention which includes Carotid Endarterectomy (CEA) and Stenting.