Advances in stroke medicine are transforming the lives of stroke victims in a big way. Recently in Apollo Main hospital, Chennai, a 50 year old gentleman made good recovery and walked home after a short period of rehabilitation and a 38 year old young mother of 2 girls made a miraculous total recovery from a devastating large stroke. Both these patients arrived into the hospital within the ‘golden hour’, i.e. 4.5hrs from the start of symptoms. The sooner treatments are started the better the outcomes are, as every passing second leads to progressive damage in the brain cells.
Intravenous thrombolytic drugs (clot busting drugs) have been shown to improve outcomes at 3 -6 months after stroke and have reduced disability if treated within the golden hour. Newer advances where a catheter is passed nearer to the clot and subsequent local thrombolytic use or retrieval of clots are done show immediate results. In fact our 38yr old lady walked out of bed on day 2 with no disability and was discharged in 5 days.
Life is priceless, when stroke strikes, time is precious and earlier presentation to hospitals with acute stroke interventional teams will transform lives. At Apollo hospitals we have a 24/7 acute stroke team to treat all stroke emergencies using cutting edge newer treatments and experienced specialists.
A 17 year old boy presented with acute weakness of the left limbs with mild unsteadiness was found to have an acute infarct in the Right Thalamus and subthalamus region. An extensive workup for common and uncommon risk factors for stroke in the young were negative. After a few weeks the patient developed Hemiballismus (Wild and uncontrollable flinging of the limb) in the affected Upper limb which was not responding well to treatment. As the patient also developed dyspeptic symptoms, Gastroenterologist opinion was obtained. Following further workup, patient was found to have multiple small aneurysms in the abdominal arteries as seen on the on 320 Slice CT Angiogram. A diagnosis of the Polyarteritisnodosa was made and the patient was started on Cyclophosphamide, in consultation with the Rheumatologist. The patient had a remarkable improvement in his symptoms and is doing well.
This case illustrates the importance of Team Work, cutting across Specialties and also the importance of Technology. If not for the 320 Slice CT Angio, the diagnosis could have been missed.