Dr Jayanta Roy, Senior consultant neurologist & Director stroke program, Institute of Neurosciences, Kolkata talks about the role of golden hour in treating a stroke
When it comes to stroke, time is of the essence. The initial 4.5 hours following a stroke, often referred to as the ‘Golden Hour,’ are crucial for the victim’s survival and long-term outcome. During this time, prompt medical intervention can minimise stroke-related damage significantly. Understanding the types of strokes, timely interventions, and leveraging the advancements in telemedicine can equip us with the knowledge to combat this life-threatening event, both immediately and in the long-term.
Understanding stroke: Ischemic vs hemorrhagic
A stroke occurs when there is an interruption in the blood supply to the brain, which can be caused by a clot (ischemic stroke) or a bleed (hemorrhagic stroke). Ischemic strokes are more common and occur when blood vessels become blocked, often by blood clots. Hemorrhagic strokes, on the other hand, occur when a blood vessel in the brain bursts, leading to bleeding in or around the brain.
Immediate medical attention is vital to determine the type of stroke and the course of treatment. For ischemic strokes, the primary treatment is thrombolytic therapy, which involves administering medications to dissolve the clot and restore blood flow to the brain. The most common drug used is tissue plasminogen activator (tPA), which can significantly improve outcomes if administered within the Golden Hour. This therapy is particularly tailored for ischemic strokes and is not suitable for individuals experiencing a hemorrhagic stroke.
For hemorrhagic strokes, the treatment often involves measures to control bleeding, reduce pressure in the brain, and stabilise vital signs. Surgical interventions may also be required to alleviate symptoms and prevent further complications. The pathway to immediate care can be a bit more complex for those residing in remote areas; however, the advent of telemedicine has paved the way for timely intervention regardless of geographical barriers.
Telemedicine: Bridging the geographical divide
Telemedicine is a boon, especially in remote areas where immediate medical attention for stroke victims might be a challenge. With telemedicine, healthcare professionals can evaluate the patient, diagnose the type of stroke, and recommend a treatment plan in real-time, ensuring that the Golden Hour is utilised effectively. Moreover, telemedicine can help guide patients in remote areas to the nearest stroke-ready centers. Platforms like Stroke of Support can help find the nearest stroke-ready center by entering the PIN. This direction to appropriate medical facilities can be life-saving, bridging the gap between rural areas and urban healthcare facilities, thus creating a continuum of care that is crucial for better outcomes in stroke treatment.
Rehabilitation: The road to recovery
The journey of recovery post-stroke is as crucial as the initial treatment. It involves a comprehensive rehabilitation program tailored to meet the individual needs of the patient. This phase focuses on helping the stroke survivor regain lost abilities, learn new skills when necessary, and adapt to new circumstances. Rehabilitation programs may include specific therapies such as speech therapy to improve communication, physiotherapy to regain mobility, and occupational therapy to enhance the performance of daily activities. These therapies work in tandem to help restore fine motor skills and cognitive abilities, crucial for post stroke quality of life. For example, occupational therapy can be instrumental in retraining fine motor skills, which are crucial for tasks like writing or buttoning a shirt. Similarly, cognitive training as a part of rehabilitation can significantly improve a survivor’s memory, attention, and problem-solving skills, which are fundamental for regaining independence and improving the overall quality of life. Through a well-rounded rehabilitation program, stroke survivors can overcome the challenges posed by stroke, fostering a fruitful and independent life post-recovery.
Community involvement: Fostering a supportive environment
As the adage goes, “It takes a village to raise a child,” similarly, it takes an informed and proactive community to foster a nurturing environment for stroke survivors on their path of rehabilitation. The combination of prompt medical attention, technological advancements, and robust rehabilitation strategies comes together to lessen the impact of strokes. Together, these elements champion stroke survivor recovery and reintegration, painting a picture of hope and resilience.
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