When 62-year-old Mohan Ram woke up one Sunday, he felt numbness in his right arm and found it extremely difficult to move. With great presence of mind, he called his family doctor, who rushed him to a hospital where a CT scan facility was available. The neurologist diagnosed a clot in his brain that had triggered a stroke, paralysing the right hand.
Mr. Ram was lucky to reach the nearest hospital within the golden hour of four hours. But not all patients get lucky as there are not enough neurologists in the country. This, coupled with lack of diagnostic facilities in most smaller hospitals, results in patients suffering.
Of the less than 2,000 neurologists in the country, not more than 170 are in Karnataka, with most of them concentrated around Bengaluru. What’s worse, government hospitals across the State have less than 10 neurologists.
Doctors describe a stroke as the sudden onset of neurological deficit due to vascular causes. People should not ignore warning signs such as dizziness, sudden weakness in limbs and difficulty in speaking or understanding words.
Patients should reach the hospital within three or four hours of the stroke. “In the absence of adequate number of neurologists and stroke-ready hospitals, most patients are deprived of timely treatment,” said G.T. Subhas, president of Bangalore Stroke Support Group that was started two years ago.
Dr. Subhas said the earlier the patient is rushed to a hospital, the better the outcome. “In the past, providing thrombolytic treatment for a patient within three hours was considered essential to restore normal brain function.
But recent studies of the American Stroke Association shows that normal brain function can be restored if thrombolytic agents are administered even 4 and a half hours after the stroke. Early intervention will greatly reduce morbidity and mortality.”
Girish Kulkarni, additional professor of Neurology in NIMHANS, said the WHO has recognised stroke as one of the leading causes of death worldwide. “In India, it is the third commonest cause of death and first commonest cause of disability in adults. There is a need for more and more doctors to specialise in neurology,” he said.
Neurological disorders being the most complex among all health problems, Dr. Kulkarni said risk factors include diabetes, high blood pressure and high cholesterol, apart from stress, smoking and alcohol consumption. “Patients can develop severe complications, which include motor impairment, respiratory problems, speech, sensory, vision and hearing impairment. Concentration, memory and learning ability can also be affected,” he said.
The Bangalore Stroke Support Group is working towards creating awareness on detection and prevention of stroke.
“We educate and train doctors about the latest developments in management of stroke and educate caregivers of stroke survivors. Telemedicine is an important tool in rural areas where doctors can get guidance from experts,” Dr Subhas said.
