Recognize Stroke Symptoms FAST and Aim for the Best Treatment

Dr Sudhir Kumar

MD (Internal Medicine); DM (Neurology),

Consultant Neurologist,

Apollo Health City,

Hyderabad

Brain stroke, commonly causing paralysis of one half of the body (called as “lakwa” in Hindi) is among the top 3 causes of death and disability in the world (the other two being heart attack and cancer). One in 6 people may develop stroke in their lifetime. Among people aged 40 or more, one in four will develop stroke.

What are the common symptoms of stroke?

Stroke can be easily recognized by the acronym FAST.

• F: Facial droop or asymmetry of the face
• A: Arm weakness on one side
• S: Speech difficulties, such as unclear speech, inability to understand or speak
• T: Time is important and treatment should be initiated at the earliest

Adverse Impacts of Stroke

Stroke brings about a sudden transformation in the sufferer’s life. A completely independent person may become paralysed, making him/her dependent on others for even their basic needs such as bathing, toileting and feeding needs. Moreover, stroke is a major cause of financial burden for the sufferer. The patient is unable to attend to his job due to disability leading to the loss of income. In addition, the treatment of stroke and caring for the stroke patient adds to the financial burden.

Treatment of Stroke

It is important to recognize and treat stroke at the earliest. There is only a single approved treatment for brain stroke– thrombolysis (or clot-buster therapy) using a drug called as tissue plasminogen activator (tPA). The point to note is that this medicine should be started within 4 hours and 30 minutes of onset of brain stroke to achieve maximum efficacy and to avoid any complications. Success of the treatment being linked to time after symptom onset makes it mandatory to identify stroke symptoms and transportation to a recognized stroke centre at the earliest a priority. When you suspect stroke, dial the Apollo hospitals emergency contact number 1066, to avail an ambulance for safe and quick transportation of the patients to the hospital.

In Hyderabad, Apollo Hospital at Jubilee Hills is accredited by Joint Commission International (JCI, USA) for the management of acute stroke since April 2006. At our hospital, there is a stroke team comprising emergency physicians, neurologists, neurosurgeons, radiologists, physiotherapists, intensivists, dieticians and social workers. There is a standard protocol (devised as per the best international guidelines) for taking care of patients with stroke.

The Emergency room (ER) is notified beforehand about the expected stroke patient arrival (pre-arrival notification), which in turn alerts the stroke team. As soon as the patient reaches ER, a clinical examination is carried out to look for features of stroke. CT scan is immediately done (within 20 minutes of arrival to ER). Blood tests are done to ascertain the patients’ eligibility for thrombolytic therapy. These reports are obtained and treatment started within 45 minutes of patients’ arrival to ER (i. e. door-to-needle time is under 45 minutes). Stroke unit and treatment at Apollo Hospitals, Jubilee Hills, Hyderabad, adheres to the best treatment protocols, which is comparable to the best in the world.