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Center for Neurology & Neuro Surgery

The Center for Neurology & Neuro Surgery is the super-speciality setup concerned with the prevention, diagnosis, treatment and rehabilitation of neurological disorders that affect the Brain, Spinal cord and Peripheral Nerves, myoneural junction and muscles.

Common Neurological problems:

What Is Stroke?

A stroke, or brain attack, is caused by the sudden obstruction of blood flow to the brain or bleeding inside the head. This can cause brain cells to stop functioning or die. When nerve cells in the brain die, the function of body parts they control is harmed or lost. Stroke can manifest with loss of consciousness, weakness of limbs, slurring or loss of speech and memory disturbance. The patient needs to be brought immediately to the hospital. If thrombolysis is done at the appropriate time, (within 3 hours of stroke) the severity of the stroke can be reduced which makes a significant difference to the outcome.

People who are suffering a stroke must get immediate medical care. It is very important they get to a hospital within 60 minutes of the onset of a stroke. You can reduce your chances of death or disability if you recognize the signs of stroke and get immediate medical help. Quick medical attention and treatment can save lives. It can also prevent more serious, long-lasting problems.

Stroke risk increases sharply with age, doubling every decade after the age of 55. However, stroke can occur at any age. Men have slightly more strokes than women. Strokes claim the lives of more women than breast cancer. People with a family history of stroke and heart disease have an increased stroke risk.

Symptoms

  • Sudden numbness or weakness of face, arm, or leg, especially on one side of the body.
  • Sudden confusion, trouble speaking or understanding speech.
  • Sudden difficulty seeing in one or both eyes.
  • Sudden trouble walking, dizziness, loss of balance or coordination.
  • Sudden severe headache with no known cause.

There are also very important risk factors that often can be controlled: talk to your doctor about this

  • Monitoring and reducing high blood pressure
  • Limiting tobacco use
  • Managing cholesterol levels
  • Maintaining a healthy weight
  • Controlling diabetes

Types of Stroke

There are two types of stroke, "ischemic" and "hemorrhagic."

Eighty percent of all strokes are ischemic. Ischemic strokes can be caused by narrowing of the large arteries to the brain. This is also called "atherosclerosis." Ischemic strokes include:

Hemorrhagic strokes involve bleeding into or around the brain, including:

Diagnosis

The neurologist or emergency doctor must examine you to understand your condition and find out what caused the stroke. Diagnostic tests to determine treatment could include:

  • Neurologic exam
  • Brain imaging tests (computerized tomography scan CT; magnetic resonance imaging MRI) to understand the type, location, and extent of the stroke.
  • Carotid and transcranial ultrasound and angiography -tests that show blood flow and bleeding sites
  • Blood tests for bleeding or clotting disorders.
  • EKG (electrocardiogram) or an ultrasound examination (echocardiogram) of the heart to identify cardiac sources of blood clots that could travel to the brain.
  • Mental function tests.

Treatment

Once the doctor completes the diagnostic tests, the treatment is chosen. For all stroke patients, the aim is to prevent further brain damage.

If the stroke is caused by blocked blood flow to the brain, treatment could include:

  • T P A (tissue plasminogen activator), a clot-busting drug that is injected within three hours of the start of a non-bleeding stroke.
  • Drugs that thin the blood, including anticoagulants (warfarin) and antiplatelet medications (aspirin or ticlopidine); a combination of aspirin and sustained release dipyridamole.
  • Surgery that opens the insides of narrowed neck blood vessels (carotid endarterectomy).

If bleeding causes the stroke, treatment sould include:

  • Drugs that maintain normal blood clotting.
  • Surgery to remove blood in the brain or decrease pressure on the brain.
  • Surgery to fix the broken blood vessels.
  • Blocking off bleeding vessels by inserting a coil.
  • Drugs that prevent or reverse brain swelling.
  • Inserting a tube into a hollow part of the brain to lower pressure.

Rehabilitation

After a stroke, a person may have some disability. The disability depends on the size and location of the stroke. The right side of the brain controls the left side of the body; in right-handed individuals it is important for attention and visual-spatial skills. The left side of the brain controls the right side of the body; in right-handed individuals (and 50 percent of left-handed people) it controls language speaking and understanding. Language disorders are also called "aphasias."

Rehabilitation helps regain functions lost from damage due to stroke. During rehabilitation, most people will get better but do not recover completely. Unlike skin cells, nerve cells that die do not recover and are not replaced by new cells. However, the human brain is adaptable. People can learn new ways of functioning, using undamaged brain cells.

This rehabilitation period is often a challenge. The patient and family work with a team of physical, occupational, and speech therapists, along with nurses and doctors. Most of the improvement will take place in the first three to six months of the process. But some people can make excellent progress over longer periods.


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