Lanka Hospitals, the international standard tertiary care hospital which has a wide range of treatments suited to treat types of strokes, ranging from surgical intervention to clot busting drugs, says early diagnosis and intervention is key to the well-being of the patient.
A stroke, which could be called a ‘brain-attack’ in laymen’s language, is a condition where the blood flow is reduced causing part of the brain to die. The damage to the brain increases with time and it is essential to restore blood supply to minimize further damage and put the patient on the path to recovery.
There are two main types of stroke. One type of stroke is called a ‘Haemorrhagic stroke’ where a blood vessel is weakened and bursts releasing blood.
“If there is a rupture of the blood vessel, blood will be deprived to a section of the brain, which damages that part of the brain and it will also get collected inside the cavity of skull, generating higher pressure and causing further damage,” saidLanka HospitalConsultant NeurosurgeonDr. RuviniAbeygunaratne.
“The patient can deteriorate very quickly,” she further added. A Neurosurgeon can intervene at this point in two ways, one by evacuating the blood clot and secondly if necessarybut removing part of the skull allowing the swelling brain to expand without being squeezed in a surgical procedure called ‘decompressivecraniectomy’.
The second type of stoke is called ‘Ischaemicstroke’, where an area of the brain is damaged a by a clot (stroke of ‘embolic’ origin), in a blood vessel which blocks blood flow. If the area affected is small, it may not require any procedures and can be medically managed. But if the area is large and causes significant brain swelling, there is a role for surgical ‘decompressivecraniectomy’. The clot may also be dissolved by certain medication and can also on occasion be evacuated by a radiological procedure.
Sometimes symptoms of a stroke may only last for less than 24 hours -these are called ‘Mini strokes’ or ‘Transient Ischeamicattacks’. “These are also called ‘Mini strokes’, which one would tend to recover from completely and could be taken as ‘warnings ‘of a ‘bigger attack,” Dr. Abeygunaratnesaid.
“One should seek help of a neurologist who would ideally start medication to thin the blood.”
A key success factor in the treatment and management of stroke is to immediate action. The patient should be bought for assessment and management to a hospital as soon as possible. Time is of essence.
If it is not a Haemorrhagic attack or an Ischemic attack, which does not cause a massive pressure in the brain neurosurgeons do not get involved.
At Lanka Hospitals, patients are also treated by a ‘clot-busting’ drug or Thrombolytic agent, which was earlier only available at government hospitals.”Sometimes a patient will have the chance of a dramatic reversal of deficit after a Thrombolysis service,” saidConsultant NeurologistDr.SrikanthSrinivasan.
Not all patients are candidates to be treated by a Thrombolytic agent – but if they meet the necessary criteria, the hospital will be able to commence the Thrombolysis service immediately.
“If timely treatment has not taken place, they will be left with effects such as permanent speech deficits, permanent paralysis, etc. Generally once a stroke deficit takes place, it will take months for those deficits or ‘effects’ to go away.”Hence, the treatment partly depends on how soon one could reach a hospital and what specialties there are to deal with same,”Dr.Srinivasan further added.
Tests such as a CT scan and an MRI scan will help the neurologist to ascertain the attack.
Lanka Hospitals has full-time neurologists and full-time neurosurgeons, who will give immediate attention to patients coming in.