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STROKE

What is stroke ?

A stroke is a sudden loss of brain activity. It’s caused when the flow of blood to the brain is interrupted that is ischemic stroke, or there is a rupture of blood vessels in the brain that is a hemorrhagic stroke. The interruption in the blood flow or the rupture of blood vessels causes brain cells in the affected area to die. The effects of stroke depend upon the area of brain injury and extent of damage caused.

 

How does a stroke occur ?

There are two types of stroke.

  • Ischemic stroke
  • Hemorrhagic stroke
Ischemic stroke :

It is a similar to a heart attack, except it occurs in the blood vessels of the brain. Clots can occur either in the brain’s blood vessels in blood vessels leading to the brain or even blood vessels elsewhere in the body which then go to the brain. Clots block blood flow to the brain’s cells. Ischemic stroke can also occur when too much plaque or fatty deposits and cholesterol clogs the brain’s blood vessels. About 80% of all strokes are of this nature.

Emergency treatment and medication :

Therapy or treatment with clot buster drugs must start within minutes to hours if they are given into the vein and the sooner, the better. Quick treatment not only improves chances of survival but also may reduce further complications. Drugs that may be administered

Aspirin :

Aspirin is an immediate treatment given in the emergency. It prevents blood clots forming and reducing the chances of having another stroke.

Intravenous injection of tissue plasminogen activator (TPA) :

An injection of TPA is usually given through a vein in the arm. It is given within 4 to 5 hours after stroke symptoms begin. It restores blood flow by dissolving the blood clots.

Emergency procedures :

Doctors sometimes treat ischemic strokes with procedures that must be performed as soon as possible.

Medications are delivered directly to the brain. Doctors may insert a long thin tube catheter through an artery in the groin and thread it to the brain delivering TPA directly into the area where the stroke is occurring or has started.

Other procedures :

To decrease your risk of having another stroke your doctor may recommend a procedure to open up an artery that has been narrowed by fatty deposits. Options will vary depending on the situation.

Carotid endarterectomy :

in carotid endarterectomy a surgeon removes plaque from arteries that run along side of the neck to the brain. In this procedure your surgeon makes an incision along the front of your neck, opens your carotid artery and removes plaques that block the carotid artery. This procedure may reduce the risk of ischemic stroke.

Angioplasty and stents :

In any angioplasty a surgeon gains access to carotid arteries most often through an artery from the groin. A balloon is used to expand the narrowed artery. The stent can be inserted to support the open artery.

Hemorrhagic stroke :

A blood vessel in the brain breaks or ruptures. The result is blood seeps into the brain tissue, causing disruption to brain cells. Most causes of hemorrhagic stroke are high blood pressure and brain aneurysms. An aneurysm is weakness or thinness in a blood vessel wall.

Emergency treatment of hemorrhagic stroke focuses on controlling bleeding and reducing pressure on the brain. Surgery may be performed to help reduce future risk.

Emergency measures :

drugs or transfusions of blood products to counteract the blood thinner’s effects may be administered. You may also be given drugs to lower pressure in the brain intracranial area, lower your blood pressure and prevent vasospasm or seizures.

Surgical blood vessel repair :

surgery may be considered to repair blood vessel abnormalities associated with hemorrhagic strokes.

Surgical clipping :

A surgeon places a small clamp at the base of the aneurysm to stop blood flow to it. This clamp can prevent the aneurysm from bursting or it can prevent re bleeding of an aneurysm that has recently been haemorrhaged.

Coiling (endovascular embolization) :

In this procedure surgeon inserts a catheter into an artery from the groin and guides it to the brain using x-ray imaging. Surgeon then guides detachable coils onto the aneurysm. The coil fits the aneurysm, which prevents blood flow into the aneurysm and helps the blood to clot.

Intracranial bypass :

in some unique circumstances, bypass of intracranial blood vessels using surgery may be an option to treat poor blood flow to region of the brain or vascular lesions that are complex and aneurysm repair.

Stereotactic radiosurgery :

using multiple beams of highly focused radiation stereotactic radiosurgery is an advanced minimally invasive treatment used to repair vascular malformations.

Warning signs and symptoms :
  • The symptoms of stroke usually develop quickly over minutes or hours can be long lasting or temporary. Symptoms may include
  • Sudden weakness, numbness and or tingling in the face, arm or leg
  • Sudden loss of vision, especially in an eye or vision is doubled
  • Temporal loss of speech or trouble understanding
  • severe and unusual headaches which may be sudden.
  • Loss of balance and being especially with any of above signs
Risk factors of stroke :

50% of all strokes are preventable. Many risk factors that can be controlled before they cause problems are in our hands by eating good food, avoiding stress, exercising regularly.

Many risk factors such as uncontrolled blood pressure, cholesterol that is out of balance, diabetes, irregular heartbeat, physical inactivity, Smoking and obesity. These factors have to be brought under control to prevent a stroke.

Doctors can evaluate the risk for stroke and help control risk factors. Sometimes one may experience warning signs before a stroke occurs; these are called transient ischemic attacks and are short, brief episodes of the stroke symptoms. Some people have no symptoms or warnings prior to stroke or symptoms are so mild that they go unnoticed. Regular checkups are important to avoid any further serious complications

Our goals :
  • Reducing the occurrence of stroke through identification and control of stroke risk factors.
  • Reducing morbidity and mortality of a stroke through emergency treatment for patients with acute stroke.
  • Acting as information powerhouse for the troubled patients and their care takers to prevent further complications.
  • Serving as a centre for excellence in treatment of stroke affected patients.
  • Personalised plans for each patient are based on an initial evaluation of prognosis of the patient.
  • KIMS stroke prevention clinic has a team of expert Doctors to treat patients who are at risk of having a stroke. We also provide complete ongoing care for those who have already experienced a stroke to prevent re occurrence of the same, by providing précised treatment.
  • At KIMS we provide preventive care and screening for patients at high risk for stroke and other neurovascular conditions as well as umpteen number of consultations for the diagnosis and treatment of complex disorders such as brain aneurysms. Carotid diseases, cervical artery dissection, stroke and vascular malformations treatments are our specialised line of treatments. Treatment ranges from medication to surgery, such as the surgical removal of plaque from arteries or routing of blood flow to bypass abnormal blood vessels in the brain.
  • We have an independent institution within the KIMS group to provide state of the art treatment to stroke patients.
Team approach :

We have a specialised team of excellent doctors, surgeons, neuro-surgeons specialised in every area of Brain treatment to provide the best possible treatment with utmost care along with the help of para medical staff to provide round the clock services. Surgical and non surgical treatments are provided as per the case prognosis of the patients and at affordable costs.

Latest technology :

KIMS uses advanced technology and detailed imaging tests to diagnose strokes or other cerebrovascular conditions, to determine the cause of symptoms and to administer the best possible treatment.

Stroke recovery and rehabilitation :

The aim or goal of a stroke rehabilitation program is to help relearn skills lost which were affected by stroke.. Stroke rehabilitation can help regain independence and improve quality of life which is quintessential. The severity of stroke complications and each one’s ability to cover lost abilities varies from individual perspective. Researchers have found that the central nervous system is adaptive by nature and can recover some functions to a great extent. They also have found that it is necessary to keep practicing regained skills.

Stroke care focuses on regaining strength to recover as much function to return to independent living. The impact of the stroke depends on the area of the brain and the amount of tissue damaged.

If stroke affects the right side of the brain, movement and sensation on the left side of the body may be affected. If stroke damaged the brain tissue on the left side of the brain, movement and sensation on the right side of your body may be affected. Brain damage to the left side of the brain may cause speed and language disorders. May have problems with breathing swallowing, balancing and vision.

Most stroke survivors receive treatment in a phased rehabilitation program. Doctors will recommend the rigorous therapy programs that one can handle based age, overall health condition and degree of disability from the previous stroke. Your doctor will take into consideration life style, interests and priorities and the availability of family members or other caregivers.

Rehabilitation program may start before one leaves the hospital. It may continue in a rehabilitation unit of the same hospital, another rehabilitation unit or skilled nursing facility, an outpatient unit or at home.

 

When should stroke rehabilitation Start ?

It is common for stroke rehabilitation to start as soon 24 to 48 hours after stroke, during hospital stay. If medical problems persist, doctors may wait to begin rehabilitation.

 

How long does stroke rehabilitation last ?

The duration of your stroke rehabilitation depends on the severity of the stroke and related complications. Some stroke survivors recover quickly; many need some form of stroke rehabilitation on long term basis, possibly months or years after the stroke. The amount of patience the care givers show ultimately helps the stroke affected patient to recover quickly.

Treatment outcomes :

To evaluate the care of patients diagnosed with stroke is to look at the percentage of patients receiving timely and effective care that are appropriate. The goal of KIMS is 100 percent.

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