Pune: Stroke Care at Jehangir Hospital

Stroke is a disease that affects the arteries leading to and within the brain. It is increasingly becoming a significant cause of premature death and disability in countries like India. This rise is primarily driven by demographic changes and exacerbated by the growing prevalence of key modifiable risk factors. A stroke occurs when a blood vessel, responsible for carrying oxygen and nutrients to the brain, is either blocked by a clot or ruptures.

Golden Hour Care

The Department of Neuroscience at Jehangir Hospital offers efficient, round-the-clock services and is renowned for its exceptional care during the critical "Golden Hour" for stroke patients.

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This initial 4.5-hour period is considered the most crucial because, following the artery blockage, approximately 2 million neurons are lost every minute. Patients who receive clot-dissolving injections within this timeframe have a significantly higher chance of survival and are more likely to avoid long-term brain damage. In the case of acute ischemic stroke, the "door-to-needle" time is set at 60 minutes or less after the patient's arrival at the hospital, ensuring swift and effective treatment.

"Our team of skilled neurosurgeons is equipped with vast experience and knowledge to offer the best possible care to patients through techniques ranging from open surgeries to minimally invasive treatments," says Dr. Prashant Khandelwal, Neurosurgeon at Jehangir Hospital.

Code Stroke Programme

A "Code Stroke" is activated through the public announcement system, and this alert summons the stroke team, including the emergency physician, emergency department nurse, intensivist, neurologist, radiologist, interventional neurologist, and on-call neurosurgeon. Within the critical 4.5-hour window from the onset of a stroke, a patient may qualify for fibrinolytic therapy. We prioritise minimising the time from a patient's arrival at the Emergency Department. When the patient is eligible for endovascular therapy, such as mechanical thrombectomy, our interventional neurologist and radiologist are readily available for immediate management.

Neurosurgery

The occlusion of blood vessels that supply the brain, particularly the internal carotid artery or middle cerebral artery, can result in significant cerebral ischemic damage, accounting for roughly 10% of ischemic stroke cases. When damage affects more than 50-75% of the brain in the middle cerebral artery territory and causes a cerebral midline shift of over 4mm within the initial 48 hours, it signifies a life-threatening infarct volume known as Malignant Cerebral Infarction. Neurological deterioration typically occurs within 5 days, with the highest frequency of deaths attributed to brain herniation to the opposite side, often leading to brain death around day 3 after onset. The mortality rate for malignant MCA infarction is approximately 80% without neurosurgical intervention. In this condition, decompressive craniectomy stands as the sole available therapeutic approach. While it does reduce mortality in these patients, it often leaves the majority with some degree of disability.

Rehabilitation

The rehabilitation team at Jehangir Hospital offers a thorough cognitive and physical disability assessment and therapy for a diverse array of neurological disorders. This includes conditions like stroke, traumatic brain injury, hypoxia, brain infections, epilepsy, neurosurgery, Parkinson's disease, multiple sclerosis, movement disorders, ataxias, and more.

The medical professionals at the hospital not only comprehend the emotional and physical impact of neurological conditions but also endeavour to provide optimal care and support to their patients. In addition to the primary treatment plan, various other therapies are utilised to alleviate the symptoms of neurological disorders. These encompass:

• Physical therapy
• Occupational therapy
• Speech therapy
• Recreational therapy

All of which contribute to improving motor coordination, strength, balance, endurance, and the acquisition of new skills, while also facilitating adaptations to compensate for motor deficits.

Dr. Sandeep Borse, Neurologist at Jehangir Hospital says, "Strokes, often devastating neurological events, highlight the urgency of education, prevention, and rapid response. Strokes are preventable, treatable, and manageable when identified early. Individuals need to make lifestyle changes to reduce risk factors and need to understand the importance of immediate medical attention. Jehangir Hospital strives to improve stroke care and rehabilitation, ultimately working toward a future where the burden of stroke is reduced, and lives are saved and improved."

Advanced Neuroscience Treatment

Jehangir Hospital's Neuroscience Treatment offers extensive care with advanced technology and experienced doctors, ensuring superior treatment outcomes. The team's commitment to personalised and holistic care makes Jehangir Hospital the top choice for individuals with neurological disorders.

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