New Delhi: Stroke is a leading cause of death and long-term disability globally, profoundly affecting individuals and families. In India, the incidence of stroke has surged dramatically over the past three decades. A recent study in Lancet Neurology highlights this alarming trend, revealing that the country reported over 1.25 million new stroke cases in 2021, up from 650,000 in 1990—a 51% increase. One in 4 of us are at risk of having a stroke.
Despite these challenges, advancements in stroke care bring hope. A key development is the emergence of specialised stroke centres within high-level healthcare facilities. These centres are dedicated units focused on the swift diagnosis, treatment, and rehabilitation of stroke patients. Equipped with cutting-edge technology and multidisciplinary teams, they provide comprehensive care aimed at improving patient outcomes.
The Time-Sensitive Nature of Stroke
A stroke occurs when there is a disruption in blood flow to the brain, either due to a blockage or sudden bleeding. There are two primary types of strokes: ischemic strokes, which result from blocked blood vessels, preventing the brain from receiving vital oxygen and nutrients; and haemorrhagic strokes, which occur when blood leaks into the brain, creating pressure that damages brain cells. Approximately 80% of strokes are ischemic, while the remaining 20% are haemorrhagic.
The concept of “time is brain” emphasises the critical need for swift action in stroke cases. Each minute that passes can result in the loss of millions of brain cells, heightening the chances of lasting disability or fatality. Specialised stroke centres are structured to respond to this urgency, utilizing a multidisciplinary team approach. This includes neurologists, neurosurgeons, specialised nurses, and rehabilitation therapists, all collaborating effectively to provide comprehensive care.
Advanced Diagnostic and Treatment Capabilities
These centres are equipped with state-of-the-art imaging technologies, such as CT scanners and MRI machines, which enable rapid identification of the stroke’s type and location. This rapid assessment is vital, as different types of strokes necessitate distinct treatment approaches.. Ischemic strokes may be treated with clot-busting medications (thrombolysis) or mechanical thrombectomy, a minimally invasive procedure to remove the clot. Haemorrhagic strokes require different management strategies, often involving neurosurgical or neuro-endovascular intervention.
Specialized centres possess the expertise and resources to carry out these advanced interventions swiftly. They also have access to the latest research and clinical trials, allowing patients to benefit from innovative treatments that may not be available in other facilities.
Comprehensive Rehabilitation Services
Stroke recovery is a journey. Even after the acute phase of stroke is managed, many individuals face significant physical, cognitive, and emotional challenges. Comprehensive stroke centres offer integrated rehabilitation services that begin as early as possible. These services include physical therapy, occupational therapy, speech therapy, and psychological support.
A dedicated group of rehabilitation specialists collaborates with patients to help them regain lost abilities, adjust to new challenges, and enhance their overall quality of life. The seamless integration of these services within the stroke centre facilitates a smooth transition from acute care to rehabilitation, thereby maximizing the potential for a successful recovery.
The advantages of specialised stroke centres extend beyond immediate treatment. These centres are vital in secondary stroke prevention, focusing on minimizing the risk of subsequent strokes. This involves managing risk factors such as high blood pressure, high cholesterol, diabetes, and atrial fibrillation. Patients receive tailored advice on lifestyle changes, active exercise, medication management, and follow-up care to help reduce their risk.
When a stroke is suspected, seeking treatment at a designated stroke centre can greatly improve survival and recovery. The multidisciplinary approach, advanced technologies, and comprehensive rehabilitation services lead to better patient outcomes and a higher quality of life. Opting for a specialized centre provides patients with the best opportunity for a full and meaningful recovery. In stroke care, the principle that “time is brain” underscores the importance of specialised medical attention.
(The article is authored by Dr Sunil V Furtado, HOD & Senior Consultant – Department of Neurosurgery, Ramaiah Institute of Neurosciences, Ramaiah Memorial Hospital)
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