Stroke is the third largest cause of death across the globe and in India it is the second largest cause of death after cancer according leading neurologists. Participating the World Stroke Day organised here on October 29, neurologists said that stroke is a disease associated with morbidity and in India it is the reported to be first common cause for morbidity. Current incidence of stroke reported in India is between 100 and 150 per one lakh population.
Tissue plasminogen activator (TPA) is mostly used as an intravenous and intra arterial for thrombolysis. Neuroprotective agent like Citicholine, recently approved for acute stroke, is also being used to treat the brain attack. A mechanical gadget like penumbra device is used for mechanical thrombolysis. The doctors, however, held the view that prevention of life style disorders could be the best way to avoid a stroke.
According to Dr Guruprasad, Consultant Neurologist, Columbia Asia Hospital, Tissue plasminogen activator is the best option when administered within 4.5 hours of onset of symptoms, in posterior circulation stroke and it can be given up to 12 hours. But the most important is the access to early treatment for patients. It is crucial to treat a patient as fast as possible so that more brain cells can be saved.
With no new drugs, TPA has been a preferred drug option for quite a few years. But evidence is showing that statins and anti platelet drugs also play a key role in the treatment. However, best way to prevent a stroke is to control blood pressure, diabetes, regular exercises, quit smoking, overcoming anaemia and dislipidemia, he added.
The best drug delivery device used to administer the drug to control the stroke from causing further damage to the patient is in-situ thromobolysis or intra arterial thromobolysis. This is one of the best delivery systems as it acts at the site of the clot and minimal drug quantity is required to lyse the clot, said Dr Guruprasad.
Going hand-in-hand with the drugs is the need for dedicated facility to treat stroke. The two dedicated stroke ICUs in Karnataka are National Institute of Mental Health in the government sector and BGS Global Hospitals in the private segment. The latter has a full fledged state-of-the-art stroke ICU for managing stroke patients. There is also a comprehensive stroke clinic conducted every Friday from 10 am to 1 pm. A Stroke rehabilitation facility is also available through neuro-psychologist, physiotherapist, speech therapist and occupational therapist. The main drugs used to treat stroke cases are TPA, Citicholine and Adovolan said Dr N K Venkataramana, vice chairman and chief neurosurgeon, BGS Global Hospitals.