Stroke Of Genius?

Not really. Stroke care is not rocket science. All it needs is better public awareness and access to timely and affordable treatment

- Nirmal Jovial

On a fateful morning in June 2023, Khairunnisa Jalaluddin (name changed), a 55-year-old homemaker from Gudalur in Tamil Nadu, woke up with a pounding headache. As she tried to sit up, a wave of dizziness engulfed her. “To our horror, we discovered that her one side was paralysed, and her speech was slurred,”recalls Shajir, Khairunnisa’s son, who rushed her to the nearest primary care centre. “At the hospital, they asked us to get a CT scan, which was not available locally. So we crossed the border and travelled approximately 50km from our village to a hospital in Sulthan Bathery in Wayanad in Kerala.”There, Khairunnisa was diagnosed with stroke and promptly administered thrombolytic therapy, wherein clot-busting medications were injected directly into the clot to dissolve it.

In current scientific understanding, an intravenous medicine that can break up a clot has to be given within 4.5 hours of the symptoms showing up. Typically, an expensive and strong clot-busting drug like recombinanttissue plasminogen activator (r-tPA) is used to dissolve the clot and open the artery to restore flow to the brain. In some cases, particularly when the clot is too big, this drug is not effective. And if the treatment is given after six hours of the onset of stroke, then catheters and clot retrieval devices (stent retriever) are inserted through a 1mm hole in the artery of the groin (femoral artery) to reach and open the blocked segment of the brain artery.