A stroke is defined as a condition that occurs when a blood vessel in the brain ruptures and bleeds. It can also occur when there is a blockage in the blood supply to the brain and the rupture or blockage prevents blood and oxygen from reaching brain tissue. Stroke is one of the leading causes of death and disability in India. The estimated adjusted stroke prevalence ranges from 84 to 262/100,000 in rural areas and from 334 to 424/100,000 in urban areas. Additionally, in India, stroke rehabilitation is not easily accessible or effective, the main reasons being the lack of care facilities, especially in rural areas, and medical care which can sometimes become a financial burden. for many families.
As the incidence of strokes is increasing in India, it is essential to understand and recognize the symptoms as prompt diagnosis and treatment are of utmost importance for treatment; in fact, every minute counts. During the first hour – known as the “Golden hour”, if the patient receives the necessary treatment, it can reduce brain damage and even help the patient return to daily life with minimal negative repercussions.
It is very important to recognize the symptoms of a stroke, and some of them include the following:
- Numbness or weakness of the face, arm or leg, especially on one side of the body, which may occur suddenly
- Confusion, difficulty speaking, or difficulty understanding speech
- Visual disturbance, in one or both eyes
- Difficulty walking, dizziness, loss of balance or lack of coordination
- Severe headaches with no known cause
- Nausea or vomiting
If these symptoms are visible in a person, it’s time to seek medical attention immediately, as the right treatment at the right time can save lives and help reduce the impact on quality of life. The unfortunate fact is that many patients do not reach the hospital in time, which is why immediate medical help cannot be provided to them. Many people only come to the hospital after weeks, when the damage becomes completely irreversible. The recovery and rehabilitation of a stroke patient should begin as early as possible. Recovery after a stroke should start in the hospital, where a team of experts will help stabilize the patient and assess the impact of the stroke. The health care team is adept at identifying the underlying factors and beginning the therapy process to help the patient regain some of their affected skills.
Treatment of stroke in the early phase aims to open blocked blood vessels in the brain, either with intravenous medication or mechanical clot extraction devices in the catheterization laboratory. Other therapies found to be helpful in promoting stroke recovery in later stages of stroke are non-invasive brain stimulation (magnetic or electrical) and botulinum toxin (botox) injections to reduce limb pain and spasticity. . While acute treatment and injections of botulinum toxin have been around for many years, the promising technology of non-invasive brain stimulation (TMS-TDCS) is relatively new. These are continually being evaluated, validated and show promise for the future in providing effective treatment for stroke patients. They may lead to better outcomes, although patients may have missed the “golden hour” of acute treatment. As technological advancements and capabilities continue to soar, these treatment options, including electrical brain stimulation and Botox injections, can offer patients a new life, reducing the negative effects that come with delayed treatment. This means that these new technologies are helping to harness the brain’s ability to repair itself in new ways, improving outcomes for patients and the healthcare team.
Operation– Emergency surgery may sometimes be needed to remove blood from the brain and repair broken blood vessels. Surgeons usually achieve this through a procedure known as a craniotomy, where a section of the skull is removed so that the source of the bleeding can be accessed. During the operation, the surgeon will repair any damaged blood vessels and, at the same time, ensure that there are no blood clots, so that blood (and oxygen) flow is not restricted in the brain.
Non-invasive brain stimulation– Non-invasive brain stimulation has been shown to provide a wide range of benefits for neurology patients, especially those affected by stroke. From improving motor skills, cognition and speech to preventing atrophy, brain stimulation can help patients overcome many side effects of stroke. This is especially effective in patients who cannot make it to the hospital during Golden Hour after a stroke.
Such is the case of a 28-year-old software engineer who, after suffering a stroke, was unable to receive timely treatment, and brain stimulation with TMS (Transcranial Magnetic Stimulation) and TDCS (Transcranial Direct Current Stimulation) was offered to her as an evolutionary technique, which significantly improved her condition. For three years, this treatment helped him improve his communication skills and even keep his job; his life and livelihood would otherwise have been significantly affected due to the stroke.
Botox– Numerous studies have shown that repeated intramuscular injections of botulinum toxin after stroke can improve muscle tone and reduce pain in the hands and legs of patients. There was a recent case study of a patient working as a journalist who suffered a stroke two months ago. Unfortunately, he was unable to get to the hospital in time, and these botulinum toxin injections (which are given into the calf muscles) were given to him to reduce the spasticity and shaking of the affected limbs. Once injected, its effects usually last about 4 to 6 months, after which patients must receive another injection or the spasticity may return. The patient was also offered non-invasive brain stimulation to improve his chances of recovery.
In conclusion, although non-invasive brain stimulation and botulinum toxin injections are effective treatment options, especially when there is a delay in hospitalization of a stroke patient, it is undeniable that early diagnosis can lead to truly positive results. That is why stroke awareness, recognition of its symptoms and arriving at the hospital in time for treatment are very essential to save a patient from stroke and its consequences.
The opinions expressed above are those of the author.
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