Apollo Lifeline NATIONAL : 1860-500-1066
EMERGENCY
Joint Commission International.
Joint Commission International.

What is stroke?

Stroke refers to a brain disease caused by either blockage of blood supply or rupture of a blood vessel to a particular part of the brain. This results in reduction of blood and oxygen supply to the affected part of brain resulting in loss of function

What are the common symptoms of stroke ?

A patient with stroke may present with one of the following symptoms or signs:

  • Sudden weakness or numbness of the face, arm or leg, especially on one side of the body.
  • Sudden confusion or difficulty in speaking or understanding
  • Sudden problems with vision such as dimness or loss of vision in one or both eyes.
  • Sudden dizziness or problems with balance or coordination
  • Sudden problems with movement or walking
  • Sudden , severe headaches with no other known cause

What are the types of stroke ?

Stroke can be of two types

Ischemic: Occurs due to blockage of blood supply to a part of the brain.

Hemorrhagic: occurs due to rupture of a blood vessel in the Brain, commonly reffered to as brain hemorrhage .

Are some people more likely to suffer from stroke than others ?

Anyone can get a stroke. However, the incidence increases after 40 years of age and is more likely to affect men, as compared to women.

What are the risk factors for stroke ?

Common risk factors include:

  • Diabetes mellitus
  • Hypertension
  • High blood cholesterol
  • Smoking
  • Heart Disease
  • Chronic alcoholism

What should one do when suspecting stroke in a friend, relative or oneself?

As effective treatments for stroke work only within the first 3-6 hours of stroke onset , reaching a hospital equipped with modern stroke treatment facilities at the earliest is of utmost importance. Every minute is important. After 3-6 hours, the brain cells are irreversibly damaged and any form of treatment cannot completely reverse the damage. For emergency please call 1066

Why is there a need to act fast?

Modern and effective therapies for stroke work best within the first 3-6 hours. For ischaemic stroke, intravenous tissue plasminogen activator (Actilyse) is effective if used within three hours of stroke onset. Between 3-6 hours, intra arterial Actilyse and urokinase can be used. Beyond six hours, there are no effective therapies available.

For brain hemorrhage, intravenous activated recombinant Factor VII (Novoseven) can be used within four hours of stroke onset. Beyond this, there are no effective therapies available.

Where are these treatment options available ?

At present, very few centers in India offer these treatments for stroke, apollo Hospitals at Hyderabad is well equipped for modern stroke treatment. It is the only center in the world to be certified for stroke management by Joint Commission International, USA. Actilyse and Novoseven are routinely used in our hospital for stroke patients

How much do these drugs cost ?

Use of Actilyse or Novoseven will cost and additional Rs.60000. This may appear an expensive option. However studies have shown that overall costs of treatment are much less when these drugs are used. This is possible because the length of hospital stay, duration of ICU care and need for mechanical ventilators are reduced and patients can return to independent functioning and employment earlier.

Are there any adverse effects with these drugs ?

Overall, these drugs are safe. The only side effect of note with Actilyse is bleeding (from nose, urine, gut etc). Serious bleeding occurs in only 0.5% of treated patients. With Novoseven, thrombosis (heart attack or ischemic stroke) may occur in about 5%. However, these adverse effects are out weighed by the benefits of these drugs.

How long does a patient with acute stroke need to stay in the hospital ?

The average length of hospital stay is 4-6 days. Hospitalization may get prolonged if patient develops chest infections are requires intensive physiotherapy.

What are the aims of hospitalization ?

Besides acute stroke care, tests are performed to detect the risk factors and rehabilitation program is started (Physiotherapy exercises, occupational therapy, speech therapy and feeding)

Who are the members of stroke care team in the hospital ?

Stroke management is multi-disciplinary and involves Neurologist, Emergency Physician, Neurosurgeon, Cardiologist, Radiologist, Rehabilitation Consultant, Physiotherapist, Occupational Therapist, Speech Therapist, Psychologist, Dietician, Nurse and Medical Social Worker.

What are the points to be noted by care giver for home care ?

Instructions on the discharge summary should be regularly administered. Blood sugar and blood pressure monitoring should be routinely done if these diseases are present. Patients on oral anticoagulants (Warfarin etc) should regularly check their prothrombin time (PT/INR) and report to the doctor. Rehabilitation instructions should be followed. Patients should be brought to the hospital for check up when instructed.

What are the points to be noted by care giver for home care ?

Instructions on the discharge summary should be regularly administered. Blood sugar and blood pressure monitoring should be routinely done if these diseases are present. Patients on oral anticoagulants (Warfarin etc) should regularly check their prothrombin time (PT/INR) and report to the doctor. Rehabilitation instructions should be followed. Patients should be brought to the hospital for check up when instructed.

What is the best diet for a stroke patient ?

Diet should contain more green vegetables and fresh fruits. Diet rich in fat and sugar should be minimized. Non vegetarian food especially red meat should be decre4ased. Excessive intake of coffee or tea should be avoided. Excessive alcohol dinking is also bad.

How long does it take for complete recovery of the patient ?

The time taken for recovery varies among different patients and depended on the treatment given, age of the patients, severity of stroke at the onset and the type of stroke. Patients receiving Actilyse or Novoseven recover faster, which could be only few days in many cases. Similarly younger patients with milder stroke and non- hemorrhagic stroke recover faster. Patients who do not receive any specific therapy may require weeks to months to recover.

Does stroke leave any long lasting damage in the patient ?

Stroke is a disabling disease and results in various problems in patients. This could include paralysis of one side of the body, inability to speak or understand spoken words, difficulty in reading and writing, imbalance while walking, decreased vision or loss of sensation on one side of the body.

Are there any measures available to rehabilitate the patients with stroke ?

Yes. Various options are available that include physiotherapy, occupational therapy, speech therapy, psychological support, feeding options (through a naso-gastric tube etc)

Are there any medications for long term use in stroke patients ?

Yes. This includes antiplatelets such as aspirin, cholesterol lowering drugs (statins), medicines for BP and sugar control etc