A stroke happens when the blood flow to a portion of the brain is suddenly cut off, depriving brain tissue of oxygen and nutrients. Because brain cells are particularly sensitive to oxygen deprivation, permanent damage can occur in minutes.
Every year, India reports approximately 1.5-1.8 million new instances of stroke. The annual incidence ranges between 130 and 170 per 100,000 people. Stroke prevalence has risen dramatically over the previous three decades. 15–20% of stroke patients are under 45 years old.
Based on how they occur, strokes are classified into two types:
Ischemic Stroke
An ischemic stroke develops when a blood clot stops a blood artery supplying the brain. A clot can form in the brain artery (thrombotic stroke) or go to another region of the body, such as the heart (embolic stroke).
Ischemic strokes are the most prevalent kind of stroke in India, accounting for 67-74% of all cases.
Hemorrhagic Stroke
A hemorrhagic stroke occurs when a blood vessel ruptures, causing bleeding in or around the brain. The bleeding affects the brain tissue and raises intracranial pressure.
This form of stroke is frequently associated with uncontrolled hypertension, aneurysms, or vascular abnormalities.
Early detection of stroke symptoms is crucial for successful treatment. The FAST technique facilitates the detection of key warning indications:
F for Face Drooping: Sudden drooping or numbness on one side of the face.
A for Arm Weakness: Sudden weakness or inability to lift one arm.
S for Speech Difficulties: Slurred speech, trouble speaking, or difficulty understanding speech.
T for Time to Seek Emergency Care: Getting medical assistance right away is crucial. Strokes are considered medical emergencies.
Other symptoms could include sudden vision loss, severe headache, dizziness, confusion, or loss of balance.
A stroke is caused by a combination of medical factors, lifestyle choices, and non-modifiable factors:
Medical Risk Factors
High blood pressure is the primary risk factor for ischemic and hemorrhagic strokes. Diabetes, high cholesterol, heart disease, and abnormal heart rhythms all raise the risk of a stroke significantly.
Lifestyle & Environmental Factors
Smoking, physical inactivity, poor diet, obesity, and long-term exposure to air pollution are all major contributors to a stroke. These are modifiable risk factors.
Non-Modifiable Risk Factors
Non-modifiable risk factors for a stroke include increasing age, male gender, family history, and genetic predisposition.
| Feature | Ischemic Stroke | Hemorrhagic Stroke |
|---|---|---|
| Primary cause | Blocked blood vessel | Ruptured blood vessel |
| Approximate proportion | ~67–74% | ~26–33% |
| Initial imaging goal | Exclude bleeding | Confirm bleeding |
| Acute management focus | Restore blood flow | Control bleeding and pressure |
| Common associations | Atherosclerosis, heart disease | Hypertension, aneurysms |
Stroke diagnosis includes undertaking early, coordinated investigations to diagnose the kind of stroke and direct treatment.
Clinical Assessment: Emergency physicians and neurologists evaluate symptom onset times, neurological abnormalities, vital signs, and medical history. Stroke severity can be estimated using established neurological criteria.
Brain CT scan (non-contrast): Doctors predominantly recommend a brain CT scan for stroke diagnosis. It quickly distinguishes ischemic stroke from hemorrhagic stroke and helps eliminate alternative causes of acute neurological symptoms.
MRI: Brain MRI, particularly diffusion-weighted imaging, is extremely sensitive at detecting early ischemia-related brain injury. MRI provides precise information on the extent and location of brain injury, which is especially important when CT data are ambiguous.
CT Angiography (Angio): CT angiography allows you to see blood vessels in the brain and neck. It facilitates the detection of major artery occlusions, arterial narrowing, aneurysms, and other vascular anomalies, as well as improved treatment planning.
Lab Tests: Blood tests examine blood glucose levels, coagulation status, renal function, electrolytes, and cardiac rhythms. These tests assure patient safety and help guide treatment alternatives.
Acute stroke care is built on the principle that every minute matters. Rapid therapy decreases brain injury and improves outcomes.
Emergency Evaluation
After quick airway, respiratory, and circulatory stabilization, patients undergo rapid brain imaging and neurological evaluation.
Thrombolysis (tPA) Eligibility
Intravenous thrombolysis is the use of clot-removal medications to restore blood flow in ischemic stroke patients who qualify.
Thrombolysis treatment for stroke or tPA injection is recommended based on:
Time since symptom onset
Findings from the imaging scan
Blood pressure and laboratory values
Absence of contraindications
Time Window & Workflow
Intravenous thrombolysis is often advised within 4.5 hours of symptom onset. To reduce the time it takes from door to needle, hospitals use standardized stroke pathways.
Complications & Monitoring
Patients are routinely monitored for brain degeneration, bleeding problems, blood pressure fluctuations, and metabolic abnormalities.
BP Control
Proper blood pressure control helps to maintain enough cerebral circulation and lowers the danger of hematoma expansion.
Neurosurgery Evaluation
Some people may require surgery to relieve pressure, drain blood, or address underlying vascular abnormalities.
ICU Monitoring
Critical care hospitals must regularly check their patients’ neurological status, intracranial pressure, and systemic disorders.
Specialist stroke critical care units include multidisciplinary teams that provide 24-hour care. These units prioritize early complication prevention, extensive neurological monitoring, and coordinated care planning.
Depending on the degree, kind, and timing of treatment, recovery from a stroke can vary from one patient to another.
Rehabilitation Programs: Stroke rehabilitation includes physiotherapy for mobility, occupational therapy for everyday activities, and speech therapy for communication and swallowing problems.
Long-term Recuperation: Functional improvement may last several months or more. Continuous rehabilitation and follow-up care are essential for achieving optimal independence and quality of life.
HCG Hospitals offers comprehensive stroke treatment in India, including advanced neuroimaging, emergency services, support for stroke intensive care units, and coordinated rehabilitation programs. Multidisciplinary teams collaborate to provide rapid, coordinated, patient-centered stroke care.
The first few hours following a stroke are referred to as the “golden period,” because prompt medical attention can greatly lessen brain damage.
A certified stroke specialist will determine eligibility based on the type of stroke, the period of symptom onset, imaging results, and personal medical history.
The results of strokes vary. Early intervention and therapy promote recovery; however, certain disabilities may persist depending on severity.
Yes. Meaningful recovery can occur at any age with prompt treatment and planned therapy.
A stroke is confirmed via brain imaging, such as CT or MRI, in conjunction with laboratory testing and clinical evaluation.
Disclaimer: This information is intended to educate patients and caregivers. It does not replace professional medical advice. All treatment decisions should be made in consultation with a qualified doctor.
(Prof.) Dr. Narendra Hiregoudar
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