Brain stroke, commonly causing paralysis of one half of the body (called as "lakwa" in Hindi) is among the top 3 causes of death and disability in the world (the other two being heart attack and cancer). Stroke brings about a sudden transformation in the sufferer's life. A completely independent person may become paralysed, making him/her dependent on others for even their basic needs such as bathing, toileting and feeding needs.
Moreover, stroke is a major cause of financial burden for the sufferer. The patient is unable to attend to his job due to disability leading to the loss of income. In addition, the treatment of stroke and caring for the stroke patient adds to the financial burden.
Therefore, it is important to recognize and treat stroke at the earliest. There is only a single approved treatment for brain stroke- thrombolysis (or clot-buster therapy) using a drug called as tissue plasminogen activator (tPA). The point to note is that this medicine should be started within 4 hours and 30 minutes of onset of brain stroke to achieve maximum efficacy and to avoid any complications.
Success of the treatment being linked to time after symptom onset, makes it mandatory to identify the stroke symptoms and transportation to a recognized stroke center at the earliest a priority. In Hyderabad, Apollo Hospital at Jubilee Hills is accredited by Joint Commission International (JCI, USA) for the management of acute stroke since April 2006.
In the best centers for stroke treatment, there is a stroke team comprising of an emergency physician, neurologist, radiologist, physiotherapist, intensivist, dietician, etc. There is a standard protocol for taking care of patients with stroke. The ER is notified beforehand about the expected stroke patient, which in turn alerts the stroke team. As soon as the patient reaches ER, a clinical examination is carried out to ascertain the stroke. CT scan is immediately done (within 20 minutes of arrival to ER). Blood tests are done to ascertain the patients' eligibility for thrombolytic therapy. These reports are obtained and treatment started within 45 minutes of patients' arrival to ER (i. e. door to needle time is less than 45 minutes). Stroke unit and treatment at Apollo Hospitals, Jubilee Hills, Hyderabad, adheres to all the above.
Dr Sudhir Kumar MD (Medicine) DM (Neurology)
Apollo Hospitals, Hyderabad