Saving the Brain from Strokes Why Every Minute Counts

The official theme for World Stroke Day on October 29, 2025 is ‘Every Minute Counts’. Dr. Srinivasan Paramasivam, Senior Consultant Neurosurgeon and Head of Neuroendovascular Surgery, Apollo Hospitals, Greams Road, Chennai elucidates on this medical emergency that needs immediate action.

Understanding Stroke “Strokes usually come like a bolt from the blue, without warning signs, affecting the brain. Stroke occurs either due to stoppage or lack of blood supply to the brain or due to bleeding within or outside the brain. When a stroke happens, the patient develops neurological deficits,” says Dr. Srinivasan, “The misconception stroke is a disease of old age has changed today because strokes are happening in younger people in their 30s and 40s due to lifestyle changes, poor dietary habits, lack of exercise, excessive smoking and alcohol consumption.” When a stroke happens in a small vessel in the brain, the patient may experience transient ischemic attack (TIA) or mini-stroke presenting with mild symptoms such as vision disturbances, hand weakness or giddiness but they recover.

Signs of Stroke 

• Weakness of the hands or legs
• Deviation of the mouth when smiling
• Disorientation and inability to understand
• Difficulty in speaking
• Vision or balance disturbance

"Stroke awareness gains great significance because, 'Time is brain'. The earlier we act, the better the chances of preserving the brain from damage and improving the functional recovery of the patient. Our goal in stroke treatment is to bring back the normal functions of the patients as much as possible"

Dr. Srinivasan Paramasivam, Senior Consultant Neurosurgeon &Head of Neuro-endovascular Surgery, Apollo Hospitals, Greams Road, Chennai

Treatment 

Thrombolysis 

Thrombolysis has been a time-tested treatment in the management of acute ischaemic strokes (AIS). A thrombolytic agent or a clot bursting medicine is administered immediately to open up the blocked vessel. The therapeutic time window for administering a thrombolytic agent in the case of AIS is about 4.5 hours. But every effort must be made to reduce the time delay to take the patient to the hospital to prevent resultant neurological deficit.

Mechanical Thrombectomy 

Mechanical thrombectomy is a minimally invasive procedure to remove a blood clot from a major artery, performed for severe acute ischemic strokes. During the procedure, a catheter is inserted into an artery (usually in the groin or wrist) and guided to the blockage, where improvised devices like stent retriever or a suction device is used to pull out the clot using advanced techniques. This procedure can be done within 24 hours from the time the stroke has happened.

Though it can be done up to 24 hrs, the earlier the better. As time passes more neurons die and every minute counts, to prevent neurological deficit and achieve functional recovery.

Causes 

• Primary disease in the blood vessels of the brain, accelerated by uncontrolled diabetes , hypertension, high cholesterol.
• Increased risk of developing blood clots due to genetic conditions or immobility, certain medical conditions.
• Heart problems, especially arrythmia can cause clot formation.

Role of Imaging in Stroke Management 

The first step when a patient is brought to the hospital with a stroke is clinical evaluation, followed by imaging. Imaging techniques for stroke diagnosis and management use CT and MRI scans in conjunction with advanced angiography to identify the type of stroke, locate vessel blockages, assess the extent of brain damage and guide treatment decisions. CT is faster for initial evaluation and ruling out bleeding and MRI is used to detect early ischaemic changes.

Artificial Intelligence in Stroke Treatment 

Today Artificial intelligence (AI) plays a crucial role in stroke treatment by speeding up diagnosis and guiding therapy through automated analysis of medical images, supporting clinical decisionmaking, and improving rehabilitation. By analysing medical scans in a matter of minutes, AI can quickly identify issues like large vessel occlusions or haemorrhages, which enables faster treatment decisions and expands treatment windows for procedures like mechanical thrombectomy.

Prevention

• About 80 percent of strokes are preventable.
• Regular master health check-up
• Control of diabetes, hypertension, cholesterol
• Healthy lifestyle with regular work-outs
• Preventing stress and lack of sleep

Featuring insights from Dr. Srinivasan Paramasivam, Senior Consultant Neurosurgeon &Head of Neuro-endovascular Surgery, Apollo Hospitals, Greams Lane, Chennai

📞 For appointments, call Apollo Hospitals Chennai at 044 4040 1066