Stroke

What are the risk factors for stroke?

Anyone can suffer from stroke. Although many risk factors for stroke are out of our control, several can be kept in line through proper nutrition and medical care

Risk factors for stroke include the following:

• Above 60 years of age
• Male
• A family history of stroke
• High blood pressure
• High cholesterol
• Smoking cigarettes
• Diabetes
• Obesity and overweight
• Cardiovascular disease
• A previous stroke or Transient Ischemic Attack (TIA)
• Use of narcotic drugs
• Heavy use of alcohol

How would we know, what has happened to the patient?

CT Scan/MRI reveals the reason and your doctor will tell you exactly what has happened.

Can stroke be treated? And what is TPA?

For the most effective treatment of stroke, a person with a suspected stroke must be given immediate medical attention. It is during the critical first 4 1/2 hours following the stroke that stroke therapy has the highest curative potential. Doctors can now administer an injection of tissue plasminogen activator (t-PA) alteplase the only approved drug in the treatment to dissolve the clots that block blood flow to the brain. If the blockage can be removed with administration of tPA and sufficient blood flow is restored within 4 1/2 hours following the stroke, severity of permanent brain damage (neurological disability) may be reduced.

Why choose to give stroke treatment with TPA Alteplase?

Benefits (Alteplase):

• Alteplase (tPA) may reverse neurologic impairment by dissolving the clot in the brain
• More stroke patients treated with alteplase recovered with reduced or no disability at 3 months and 1 year
• Numerous studies support the safety of alteplase (tPA)
• Over a decade of real-world experience in >400,000 patients

What are the benefits and risks of Alteplase (T-PA) treatment?

BENEFITS (ALTEPLASE):

• Atleast 1 out of 2 alteplase (tPA) treated patients would have minimal or no neurological deficit for 3 months from treatment and the benefits were similarly seen after 1 year
• Whereas, only 1 out of 4 patients will recover after stroke without alteplase (t-PA)
• Fewer patients die due to alteplase therapy v/s given no drug (17% vs 21%)

Risks:

• It is important to understand both the benefits and risks of the alteplase (t-PA) treatment and then make a decision. The most common complication during alteplase therapy is bleeding inside the brain
• 6 out of 100 patients treated with alteplase within 3 hour from symptoms onset may have ICH at 36 hours
• But only 1 in 100 patients who experience alteplase related ICH may have a fatal outcome

Is Alteplase (TPA) treatment recommended?

Alteplase (tPA) is part of stroke management guidelines of:

• Indian Stroke Association
• American Stroke Association
• World Stroke Organization

How can Stroke be prevented?

• Knowing and controlling blood pressure
• Maintaining low cholesterol levels
• Healthy diet, no smoking and narcotic drugs and controlled intake of alcohol
• Controlling diabetes
• Managing weight
• Managing stress

How to identify a Stroke or Brain attack? Look for these simple signs (Act FAST) to identify stroke early so that appropriate treatment can be started as soon as possible

Face: Ask the person to smile. Does one side of the face droop?

Arms: Ask the person to raise both arms. Does one arm drift downwards?

Speech: Ask the person to repeat a simple sentence. Are the words slurred? Can he/she repeat the sentence correctly?

Time: If a person shows any one or more of these symptoms, time is important. Get to the hospital fast. Brain cells die every minute.

Dos and donts when dealing with a Stroke/Brain attack/paralysis

• Make the person lie down
• Loosen all tight clothing
• If he is vomiting, turn him gently onto one side and allow him to vomit fully so that he can breathe well
• If he is getting a seizure or fit, gently hold him but do not put any pressure on him
• Try to call the doctor/hospital before arrival
• Try to contact the patients relative
• Do not try to give him some medicine unless advised by the doctor
• Do not try to give him something to eat or drink
• Do not try to make him stand or walk
• Do not panic but rush him/her to a hospital

Comprehensive Stroke care programme

Kokilaben Dhirubhai Ambani Hospital has established a comprehensive stroke care programme for the management of acute and chronic stroke patients.

Acute Stroke service

Acute stroke service is an integrated programme which is activated as soon as we get a call that someone is having symptoms suggestive of stroke or is brought to emergency services of our hospital. The Code Stroke Plan includes stroke ambulance, emergency care services, neuro-imaging, neurological intensive care unit, neuro-intervention services, neurosurgical services and a dedicated stroke unit.

First time in the city we are offering comprehensive acute neurointervention services under a single roof consisting of intravenous stroke thrombolysis for patients presenting in 4.5 hours of onset, intra-arterial stroke thrombolysis within 6 hours and mechanical clot withdrawal (Penumbra Device) for those coming within 8 hours of the onset of stroke.

A dedicated stroke unit has been set up under guidance of a stroke neurologist which will provide comprehensive stroke care services. This will provide cardio-respiratory monitoring and specialised stroke nursing services

Stroke OPD

A dedicated stroke OPD is set up consisting of stroke neurologist and stroke rehab specialist to provide preventive, therapeutic and rehabilitation services. This will function twice a week on Tuesday & Friday, 3-6 pm.

Comprehensive Stroke Package

Two appointments with stroke neurologist, two appointments with stroke rehab specialist, 20 rehab sessions and complementary membership of stroke support group.

Stroke Prevention Package

A comprehensive risk factor reduction by lifestyle modification, smoking cessation, exercise, stress management and medications will be provided to prevent first ever stroke in persons with risk factors and transient ischemic attacks and re-stroke in those who had one.

Stroke rehabilitation programme at KDAH

Stroke rehabilitation (rehab) is a medically supervised program that provides optimal environment for recovery, functional improvement and reduction in secondary complications and disability. It provides compensatory strategies, appropriate equipment & modifications and continuity of care so that the stroke survivor can reach maximum possible level of functional independence. Stroke Rehabilitation (rehab) Programme helps the normal surrounding brain to take up the function of the damage area.

Multidisciplinary Team

The Multidisciplinary Team of rehabilitation medicine specialist (physiatrist), stroke neurologists, rehab nurses, physical & occupational therapist, psychologist, biomedical engineer, orthotist, nutritionist and medical social worker provide integrated services.

Technology

Latest cutting edge technology is available that can match with any of the rehabilitation facilities across the globe. The key technologies are:

• Gait & Motion Analysis Laboratory
• Balance Assessment and Training System (BATS)
• Body-Weight Support Treadmill Gait Training System (BWSTT)

Stroke and Paralysis support group

You can make a difference in your life or in the life of your dear one suffering from stroke by joining the Stroke and Paralysis Support Group. We meet every Second Saturday of the month at Kokilaben Dhirubhai Ambani Hospital.

For registration, please call 7498403405

• 1 in 6 people in their lifetime will get a stroke.
• Every year 20 million people will suffer from stroke in the world
• 5 million will die due to stroke
• 50% of survivals will be left with some disability
• Every 2 seconds there is 1 stroke in the world

You can make a difference in your life or in the life of your dear one suffering from stroke by joining the Stroke and Paralysis Support Group. We meet every Second Saturday of the month at Kokilaben Dhirubhai Ambani Hospital.

For registration, please call 7498403405

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