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Golden window for surviving stroke

Monday, 29 October 2012 - 3:59pm IST | Place: Ahmedabad | Agency: dna

This is the crucial time after a stroke within which a patient must be treated.

Dr Nitin Shah (name changed), a senior orthopaedic surgeon, suffered a stroke and was rushed to a stroke specialist within 60 minutes. The doctor, at the time of hospitalisation, had complete facial deviation and paralysis in an arm and leg. Four days later, he walked out of the hospital.
Vimla Patel (name changed) suffered stroke and resulting paralysis while she was in Rajkot. She was brought to a neurologist four days later. By then it was too late for the doctors to help her. Movements in her arm and leg are minimum despite several physiotheraphy sessions.

What worked for Dr Shah and proved dangerous for Patel was the time within which they sought expert help after a stroke. Neurologists in the city say that when stroke strikes, the best thing to do is to get the patient through the golden window. The golden window refers to the limited time period within which a patient needs to be given medical help to help restore blood supply to the brain, so that the damage can either be reversed or arrested.

But neurophysicians and stroke specialists in the city rue the fact that lack of awareness among the people, paramedics and family physicians leads to loss of precious time. Dr Arvind Sharma, a neurologist and stroke specialist, said that a period of around 4.5 hours after a stroke is what is called the golden window.

“It is imperative to get help and start treatment within this period to ensure minimum damage to the brain,” said Dr Sharma. He, however, said that usually in case of stroke, people first go to their family physician before coming to hospitals that are equipped to handle such cases.
“Often, by the time the family physician realises that it is a stroke and rushes the patient to a nearby hospital, the golden window period is lost,” said Dr Sharma.

According to him, when proper intervention is provided within the golden window period, a patient has better chance of recovery and regaining functions that he had lost due to the stroke. Ignorance about the golden window period can be known from the fact that of the 20 to 22 patients who come to Dr Sharma every month, just 1 or 2 make it within the critical period.

Consultant neurophysician Dr Sucheta Muderikar said that in a stroke, essential supply of blood to the brain is stopped. “If the blocked blood vessel can be re-opened during the golden window, most of the affected part of the brain can be saved, except for the core damage,” said Dr Muderikar.

According to her, damage depends on what part of the brain the blood supply has been affected. She agrees that patients don’t act with urgency. “They first go for a CT scan. By the time they come to a stroke centre, it is too late. It is better to rush to such a centre where treatment can begin immediately,” said Dr Muderikar.

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