Stroke Treatment in India
What is a Stroke?
A condition when a burst or clogged artery interrupts the flow of the blood to the brain. This deprives the brain of food and oxygen and as a result of this brain cells begin to die. This dead brain cells cause loss of the functions of the different body parts. Loss of feeling, reasoning problems, language problems, problems of visual and vision perception, speech problems, coma, swallowing difficulties, muscle weakness or paralysis are the problems caused by a stroke. A stroke requires prompt treatment in order to minimize the damage caused to the brain and also try to avoid its potential complications.
Types of Stroke
A stroke can be categorized into two types :
Hemorrhagic Strokes : This type of stroke occurs when a blood vessel bleeds and burst within the brain. This accumulated blood compresses the nearby tissues of the brain. This could be due to :
Hemorrhagic strokes has two main types :
Ischemic Stroke : This occurs when something is causing blockage in an artery which is carrying blood to the brain. The potential causes are :
There are two common types of ischemic stroke :
When there is temporary blockage in the blood supply to the brain and there is a feeling of stroke for a little time. This entire process is termed as mini stroke or a transient ischaemic attack (TIA). A mini stroke is an indication that a part of the brain is not getting sufficient blood and this can result into a severe stroke in the future.
Causes of a Stroke
When there is bleeding in and around the brain :
Blockage of blood vessels in the brain :
Symptoms of a Stroke
There are many signs indicating the occurrence of a stroke that largely depends on what part of the brain is affected. Its several symptoms include :
Diagnosis of a Stroke
A blood tests and a physical exam are performed for diagnosing stroke. Sometimes imaging is also used. CT scan or computerized tomography helps in determining whether a person has a stroke and also the type of stroke. The structures of the arteries can be viewed by performing a specialized CT scan where a dye is injected into the vein. In order to view the damaged brain tissue, MRI or magnetic resonance imaging test is performed.
The clotting in the carotid artery (a major artery that travels up the neck into the brain) can be indicated by performing a carotid ultrasound. Echocardiography ultrasound can be done presents the images of the heart that helps in determining whether the stroke is caused by an embolus.
Treatment of a Stroke
The treatment for both hemorrhagic and ischemic stroke is different.
The purpose of treating ischemic stroke is to restore the flow of the blood in the brain. Medications are given in the first four and a half hours of the stroke for destroying the clots in the blood vessels. An injection of tissue plasminogen (TPA) can also be given to a patient for improving the probability of a full recovery.
The main purpose of treating a hemorrhagic stroke is to stop bleeding and decrease the pressure on the brain. Instead of blood thinners, clotting drugs can be given. After the area has been healed and the bleeding is controlled, the damaged and leaky blood vessels are then repaired.
The first stroke device approved by FDA is Merci retriever. The aim of this device is to restore the flow of the blood in the neurovasculature by removing thrombus in those patients who have ischemic stroke.
The penumbra system (endovascular thromboaspiration) is the last FDA approved device that has been primarily developed for removing a clot in the case of acute ischemic stroke. In order to eliminate or reduce the clot burden, this system uses dual approaches to clot extraction by using debulking and aspiration of the thrombus. Clot retrieval is then used where a ring device holds the thrombus by capturing it in clasps with a cylinder. This is then withdrawn at the time of flow arrest. This new aspiration device (the penumbra system) has an excellent safety profile and a high rate of ‘target vessel’ recanalization.
Robot for Brain Stroke Patients
Apollo Hospital Hyderabad launched a ‘stroke robot’ that helps in diagnosing and also recommends suitable treatment for brain stroke patients. A physician can “e reach” the patient’s bedside in remote areas to render immediate care.
Even if the patient can’t reach the hospital within 48 hours of stroke, RP-7 remote presence Robot enables the physician to check the crucial signs of the patient effectively and diagnostics can be provided within few minutes. By the means of this robot, a doctor can speak with the family member of the patient and simultaneously can also check ventilator and monitor settings also.The Apollo group has installed one system each in the neurology department at seven of its hospitals across the country.