Every minute counts: Modern stroke care offers hope beyond paralysis

Recognise the signs, act quickly: timely treatment and advanced neurovascular care can save lives

On World Stroke Day, Dr. M. Aqib explains how early recognition, emergency treatment and advances in neurointervention can help protect the brain and reduce disability.

A sudden weakness of the arm, an uneven smile or difficulty speaking could be the first signs of a stroke, a medical emergency in which every minute matters.

On World Stroke Day, observed on October 29, Dr. M. Aqib, Senior Consultant Neurosurgeon at Dr. Mehta’s Hospitals, emphasises that prompt treatment can make a significant difference to survival and recovery.

“Stroke can affect movement, speech, memory and independence. Recognising the symptoms and reaching a stroke-ready hospital immediately gives patients the best opportunity to benefit from treatment,” he says.

Recognise the warning signs

A stroke occurs when a blood vessel supplying the brain becomes blocked, causing an ischaemic stroke, or ruptures, causing a haemorrhagic stroke.

Dr. Aqib advises people to remember BE FAST: Balance problems, Eyesight changes, Face drooping, Arm weakness and Speech difficulty mean it is Time to seek emergency help. A sudden, unusually severe headache can also indicate bleeding in the brain.

“Note when the symptoms started, or when the person was last known to be well. Do not wait for improvement. Even symptoms that disappear may represent a transient ischaemic attack and require urgent assessment,” he explains.

Restoring blood flow

An urgent CT or MRI scan helps distinguish a blocked artery from bleeding and guides treatment. Eligible patients with an ischaemic stroke may receive intravenous clot-dissolving medication, generally within 4.5 hours. Advanced imaging can identify some patients who may benefit beyond this period.

For selected patients with a major artery blockage, mechanical thrombectomy uses a thin catheter and specialised devices to remove the clot. Depending on imaging and clinical assessment, selected patients may benefit up to 24 hours after they were last known to be well.

“However, this is never a reason to delay reaching hospital,” Dr. Aqib stresses.

DSA: a detailed view of the brain’s blood vessels

Digital subtraction angiography (DSA) uses a catheter, contrast dye and specialised X-ray imaging to provide detailed views of blood vessels and blood flow.

“DSA helps us identify aneurysms, narrowed arteries and abnormal blood-vessel connections, and plan appropriate treatment. It also guides many neurointerventional procedures,” he explains.

DSA is used when clinically indicated; it is not a routine screening test for everyone with suspected stroke.

Treating aneurysms and vascular abnormalities

Neurointerventional care extends beyond clot removal. Depending on the condition, treatment may include aneurysm coiling or flow-diverting stents, embolisation of arteriovenous malformations and fistulas, and carotid angioplasty and stenting in selected patients. Some patients require open neurosurgery, such as aneurysm clipping, evacuation of a brain haemorrhage or decompressive surgery to relieve dangerous swelling.

“The choice depends on the diagnosis, blood-vessel anatomy and the patient’s condition. Treatment must be individualised by the specialist team,” says Dr. Aqib.

Prevention and rehabilitation matter

Controlling blood pressure, diabetes and cholesterol, avoiding tobacco, exercising regularly and maintaining a healthy diet can reduce stroke risk. Detecting and treating atrial fibrillation, an irregular heart rhythm, is also important.

Recovery requires coordinated rehabilitation, including physiotherapy, occupational therapy, speech and swallowing support, and emotional care.

At Dr. Mehta’s Hospitals, the focus is on timely assessment, appropriate treatment and supporting patients through recovery.

“Modern stroke treatment offers hope, but timely action remains essential. Recognise the signs, seek emergency care and continue prevention and rehabilitation. Every minute counts,” he concludes.

Dr. M. Aqib
Senior Consultant Neurosurgeon
Dr. Mehta’s Hospitals