Tuesday, June 7, 2011

Importance of timely treatment in brain stroke (paralysis)

STROKE TREATMENT: Benefits the most within the FIRST 4.5 HOURS

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)
Consultant Neurologist
Apollo Hospitals, Hyderabad
Phone: 0091-40-23607777/60601066
Email: drsudhirkumar@yahoo.com


Shankarabarathi said...

Loving the information on this website , you have done great job on the posts. Thanks for providing such a great list with us.
Hospitals in Chennai

Abdirahman said...

Thanks Dr Sundhir for the valuable information. My name is Abdi and my Mom has been suffering from a Stroke for about 1.5 years and her left side of the body was affected. She has been under medication with a drug called Nootropil 800mg (Piracetam)and Aspirin but she has not made any good signs of recovery as she unable to do her daily activities independently. However, she can stand and walk little with support. She has not received good treatment at the onset of the attack and neither did she receive good physiotherapy as we could not find it in our country, Somalia. Not to forget that she also has knee joint problem on the same side and she feels pain whenever she tries to walk or do some activities so she started to go against doing activities but we try our best to make her do little things.Kindly advise me on what we should do for her to improve her health to at least make her do her daily activities independently and walk properly. Thanking you in advance.

Dr. Sudhir Kumar said...

Hi Abdirahaman,

It is unfortunate that your mom did not get the best treatment for stroke at Somalia. As of now, the improvement depends on physiotherapy. If she has spasticity or stiffness of arms/legs, botox injections would also help.

ASLAM KHAN said...

Hello Dr Sundhir, My name is Sameer from Bidar, KA. My Dad age 57yrs old, he had open heart surgery 5 months back after surgery he got multiple clots/blockage in his brain and Dr's told he got Paralysis. We giving meds suggested by Dr's. Here the List....
Pantncid 40mg Morning BF
Thyroxin 25mg Morning BF
Ecosprin Gold 20mg Afternoon AF
Cerebrain 90mg Afternoon AF
Zolfresh 10mg Evening AF
Rosuvas 20mg Evening AF
Cilodoc 100mg Morning AF
Lasilactone 50mg Morning AF
PrexaronPlus 500mg Morning&Evening AF
Modalert 200mg Morning AF
Ramitox 8mg Evening AF
Rabesec DSR Afternoon AF
Sporlac DS Morning AF

Also we are taking physiotherapy for 2 times a day. Now the situation is he is still bedridden patient

Please Advise...

Thanks & Regards
Sameeritcell at gmail (.) com

Anonymous said...


My uncle 70 years old. He has recently fell down and been immediately admitted to hospital.Doctor told us that he had a brain stroke and he is one side paralysed and did not recognise anyone. After few days he spoke to us but tell some names and cries very often.This has happened almost months before.He is till same not regained any memory.Sometime he is very angry and scold everyone hwo is near by to him and sometimes very emotional and cry.
My question is do memory loss treated as i feel very sad for all family member to see like that. Is there any chance gradually he can regain some memory.

Your reply is highly appreciated as I am in a way to search for good advice.Thanks in advance.


Thakur Dharam Singh said...

Wishing for the Day...!


My father aged 55 years old. He was reached in the morning at 4.30 a.m as he was a cab driver and had a word with mom about the day at 11.00 a.m in the morning he could not speak and fallen right side then immediately taken him to hospital and admitted. Doctor told us that he had a brain stroke done all the scan process CT-scan and MRI resulted left side brain center point 30% clot and he is one side paralyzed right side of the body.

After that I taken him to ESI hospital, they treated hardly for 8 days and discharged him. I really surprised without proper treatment how they could discharge and I worried about that he is not taking food through mouth, we are feeding through food pipe. Suggest me Sir, what should I have do in this situation. Please advice on this after reading this.

Your reply is highly appreciated as I am in a way to search for good advice.

Thanks in advance.


Dharam Singh

Nishant Agarwal said...

Awesome blog! Brain is the most important organ in our body; here it says how to take care of our brain. Thanks for the valuable information about stroke treatment.

Dr. Sudhir Kumar said...

Thanks Nishant

Dr. Sudhir Kumar said...

I would be pleased to see your father at Apollo Hospital, Jubilee Hills, Hyderabad and advise the best medical treatment.

Best wishes,

Dr Sudhir Kumar MD DM

Anonymous said...

Good post however I was wondering if you could write a litte
more on this
subject? I'd be very thankful if you could elaborate a little bit
further. Many thanks!

Dr. Sudhir Kumar said...

Do you have any specific queries or points to be covered?

Anonymous said...

Good post however I was wondering if you could write a litte more on this
subject? I'd be very thankful if you could elaborate a little bit
further. Many thanks!

pratibha kanere said...

Sir my mother is suffering from paralysis.Can you treated my mother .Is there any special treatment. Please give me advise.

Dr. Sudhir Kumar said...

Hi Pratibha,

I would be pleased to see your mother and decide the best treatment.

Shradha jain said...

Hi sir,My Bua is suffering from paralysis. Her food pipe was shrink and it's only 1/2(half)mm. So Dr. Asked us for operation they have made a hole in the neck. Now doctor is saying no chances to recover you can take her home. Plz suggest is any treatment possible. I am from Ujjain(M.P.). I request you sir plz suggest something as soon as possible. Her condition is very critical.

Dr. Sudhir Kumar said...

Hi Shradha, I would be pleased to see the patient and offer the best medical treatment advice.

ajay said...

Hi Dr. Kumar, Thanks for reading my comment in this blog. My mother got small infarct on left MCA territory, that cause numbness on right hand index finger. She has been treated by local nurophysician and been given following medication. 1. Ecosprin(150mg) 2. Azerva(40mg) 3. Folvite 4. Colihez-p (800mg) 5. Nuhenz. Is this treatment in right direction? She NEVER had a history of BP and diabetic, just wondering now what could have cause this problem and also probability of happening this problem again in future. How to prevent happening again? Thanks for your help.

Dr. Sudhir Kumar said...

Hi Mr Ajay, Treatment is along correct lines. To find the cause of stroke, we need to perform additional tests, after seeing the patient.