Time lost is brain lost: 50% of acute stroke patients are kept waiting at doctors' clinics

"Time lost is brain lost." This was the message repeated by doctors at TSS NIMHANS Knowledge Conclave on Stroke (brain attack) here on Saturday as a study done by Indian Stroke Association showed that 51% of acute stroke patients are kept waiting at the doctor's clinic for help instead of getting emergency aid.

The door to needle time in stroke-ready hospitals should ideally be 60 minutes, said Dr Shobha N, Consultant Neurologist and Stroke Physician, Manipal Hospital, who was talking about what constitutes a stroke-ready hospital at the Conclave. Four-and-a-half hours is the golden period considered crucial for a stroke patient beyond which clot buster therapies like tPA may not be effective in reducing complications and improving the chances of survival.

An IV injection of recombinant tissue plasminogen activator (tPA) — also called alteplase (Activase) — is the gold standard treatment for 'ischemic' stroke (restriction of blood supply to tissues). An injection of tPA is usually given through a vein in the arm within the first three hours. Sometimes, tPA can be given up to 4.5 hours after stroke symptoms started.

Dr Girish Kulkarni, Professor of Neurology, NIMHANS, who heads the stroke unit at the hospital said, "Per lakh population, the prevalence is 200. In India, the survival chances is lesser because of our unhealthy habits and sedentary lifestyle. Each injection in clot buster therapy costs Rs. 30,000 to Rs. 40,000. But all these conditions can be prevented by healthy and timely food, and 20 minutes to 30 minutes of walking everyday."

The conclave was attended in large numbers by constables and officers of the Karnataka State Police as the chief guest Rohini Katoch, DCP South, could not make it. Actor Raghvendra Rajkumar who was a stroke survivor in 2013 also spoke about his rehabilitation days.