Brain Stroke is a condition in which the blood supply to some part of the brain is stopped either due to a blockage in the blood vessel or rupture of the blood vessel. When blood supply to some part of the brain is stopped then the functions ccntrolled by that part of the brain are impaired. The most common symptoms experienced by the patient are slurring of the voice, jaw appears to be jammed, mouth shape is distorted, saliva starts coming out, there is weakening of one side of the body. The most important symptom which differentiates a stroke from a heart attack is that there is weakening on only one side of the body which means paralysis of one side of the face, one arm or one leg. Brain stroke is a big emergency because if the blood supply is not restored within the first 6 hours of the incident then the part of the brain where blood supply has been affected would become permanently damaged.
Brain Stroke mostly happens in older people but these days cases of brain stroke in young patients are also not very uncommon. The stroke mostly happens early in the morning during the winter season. The stroke patient should be immediately rushed to a hospital which has the facility of MRI and a Neurology team so that the diagnosis and treatment can be done as soon as possible because in cases of stroke - `Time is Brain'.
In most cases of stroke the patient first goes to a clinic or a smaller hospital where crucial time is wasted and by the time the patient reaches a Neuro Hospital where MRI can be carried out, the crucial first six hours have elapsed. In such cases the recovery would not be as good and would take much longer time and much more money.
Brain Stroke is of two types - Ischemic and Haemorrhagic:
Ischemic Brain Stroke occurs when there is a clot in any vessel supplying blood to the brain. This clot prevents the flow of blood any further and stroke symptoms appear. Many times such events happen for a short period and then the patient becomes normal. Such events are known as Transient Ischemic Attack (TIA) or Mini Stroke and should not be ignored as this could be the early sign of a major stroke in the offing. When a stroke patient is brought to the hospital emergency the first task for the neurology team is to identify the type of stroke. This is done by doing an MRI of the Brain. If the patient has Ischemic Stroke then some blood tests are done and an injection is given which can bust the blood clot and immediately restore blood supply to the brain. This procedure is known as Thrombolysis and makes the patient normal within few hours. The procedure of thrombolyis should be carried out within the first 6 hours of the event for it to have any significant effect.
Haemorrhagic Stroke is one in which one of the blood vessel ruptures and blood flows into the brain outside the vessels. This also prevents the flow of blood to the brain and causes stroke. If the MRI reveals that the patient is having Haemorrhagic Stroke then the patient is put in the ICU and medical management is done to dissolve the blood which has spread in the brain. In some rare cases, surgery might be done to removed blood from the brain. The patients of haemorrhagic stroke require prolonged rehabilitation after discharge from the hospital and the recovery is slow.
In most cases of Neurological conditions the main cost goes towards diagnosing the problem. For brain stroke patients who are rushed to a Neurology hospital the first step is to get an MRI Scan of the Brain done which costs Rs. 10000 - 12000 at different hospitals. Some blood tests alongwith the MRI scan are also done. If the MRI Scan reveals brain stroke then the cost of Thrombolyzing the patient would cost Rs. 75000 - 90000 if the stroke is ischemic in nature. The patient will have to be admitted to Neuro ICU for 3-4 days and the total hospitalization may be for 3-4 days. The total cost for the treatment of Ischemic Brain Stroke would cost Rs. 2 - 2.5 lacs. However if the stroke is haemorrhagic then the patient is managed conservatively in the ICU and then in the ward. Patients of Haemorrhagic stroke may stay in the hospital for 15-20 days. In such cases the cost of hospitalization would be in the range of 1.5 - 1.8 lacs. However the cost of physiotherapy post discharge would be in the range of 20-25 thousand per month and the rehabilitation may last 1-2 years. Brain stroke patients who come to India for rehabilitation spend close to USD 5000 for each month of hospitalization and physiotherapy. Typically such patients require 30-45 days of intensive rehab during which they recover 25-30 % in terms of mobility and functions.
The most important thing to remember in the treatment of Stroke is that `Time is Money' - If the patient reaches a stroke centre within the first six hours of the event then the money spent on the treatment would be much lesser and the recovery would be remarkable.
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