A stroke, also known as a cerebral vascular accident (CVA) or brain attack, occurs when the blood supply to the brain is interrupted, resulting in damage to brain cells and tissues. Blood flow can be interrupted either due to a blockage or rupture of an artery blood vessels,
in India, stroke According to the Indian Stroke Association, strokes are among the leading causes of disability and death, with 1.8 million stroke cases reported every year. “One in four people in India are likely to suffer a stroke in their lifetime,” says Dr. Vipul Gupta, Chief, Neuro-Interventional Surgery, and Co-Chief, Stroke Unit, Artemis Hospital, Gurugram. According to WHO data published in 2020, India recorded 6.97 lakh deaths or 8.23% of the total deaths due to stroke.
type of stroke
Depending on the cause of the disruption of blood flow, strokes can be of two types: ischemic and hemorrhagic. “When the blood supply to the brain is blocked due to a clot or plaque in an artery, it is known as ischemic stroke, whereas 20-25% of strokes are hemorrhagic, which occurs when a blood vessel bursts or ruptures, causing bleeding,” says Dr. Gupta.
Another type of stroke is transient ischemic attack (TIA) or a mini-stroke, where the blood supply is temporarily blocked, and it is restored once the blockage is removed. A hemorrhagic stroke can be caused by either high blood pressure or an aneurysm, where inflammation of the blood vessels causes them to burst. The main causes of stroke are high blood pressure, heart disease, diabetes, smoking and obesity. “If you control these issues, you can reduce your risk of stroke by up to 70%,” says Gupta.
cost
It is much easier and cheaper to prevent a stroke than to treat it. If the stroke patient is not provided with prompt medical care, the damage will require extensive treatment and long-term rehabilitation, significantly increasing costs.
doctor’s consultation fee
- Neurologist: Rs.1,000-2,000
clinical trial
diagnosis It needs to be done quickly to reduce and treat brain damage. The faster medical care is provided to the patient, the higher the chances of recovery. An easy way to identify symptoms is the term ‘fast’, especially for ischemic stroke: F for face, which becomes asymmetrical, ie, slack on one side; For an arm that becomes numb or cannot be moved; S for speech, when the patient is unable to speak; and T for time, which needs to be as short as possible to initiate treatment.
In the case of a hemorrhagic stroke, the patient will develop an excruciating headache within a few minutes and will need immediate medical attention.
blood test: This is done to check blood sugar, blood clotting etc.
CT scan: The scan can help detect bleeding, diagnose ischemic stroke, etc.
MRI: It also helps diagnose an ischemic stroke and decide the course of treatment.
Angiography: This involves X-ray imaging and the use of a catheter inserted into the blood vessel to determine the size and location of the blocks.
cost of treatment
Transient ischemic attack (TIA) course of treatment: Since this is caused by a blockage, usually due to clots, treatment involves taking blood thinners to dissolve the clots. It may also involve angioplasty or surgery, which means opening a blood vessel by inserting a stent, and does not require prolonged hospitalization.
- Medicine cost: Rs.1,000-2,000
- Angioplasty/Stent: Rs.2.5-3 Lakh
The course of ischemic stroke treatment: In an emergency, there are two main treatment courses to open up blocked blood vessels.
Thrombolytic drug: This includes medication to dissolve clots through thrombolytic drugs via injection. These drugs are stronger than blood thinners and can also dissolve hard clots. However, these must be administered within 4.5 hours of a stroke and should only work for small blood vessels.
Mechanical Thrombectomy: In case of acute ischemic stroke due to blockage in large arteries, another treatment involves getting inside the blocked vessel and removing the clot through a device called a stent retriever. This can be done within 24 hours of a stroke and helps to reverse it by restoring blood flow. “It is the most effective procedure across the world, although awareness and reach is low in India,” says Dr Gupta. It also requires a longer hospital stay, usually 4-8 days.
hemorrhagic stroke
Mode of Treatment: In this case, there are two types of treatment depending on the cause of the bleeding. The first is where the bleeding is due to hemorrhage, and the second is due to an aneurysm. The patient’s treatment and hospital stay will depend on how extensive the bleeding is. “Some patients may have to stay in the hospital for a few weeks as it may require surgery, ventilators and an ICU stay,” says Gupta.
Bleeding due to hemorrhage: This includes treatment through medication or open surgery to control bleeding. The blood vessel is usually small and may not need repair.
- Drug cost: Rs.1,000-2,000
- Open surgery cost: Rs 2-3 lakh
Bleeding due to aneurysm:
There are two ways to treat it which include either open surgery or through an interventional procedure known as coiling. “The risk involved in open surgery is very high and may require a longer stay in the ICU/hospital. The intervention method is safe and most patients nowadays are treated with this method,” says Dr. Gupta.
- Open surgery cost: Rs 2-3 lakh
- Cost of Coiling: Rs.3-10 lakhs
rehabilitation
Course of Treatment: Rehabilitation after stroke may require nursing care and physiotherapy. This can be a short or long term process depending on the severity of the stroke. This can range from one week to lifelong care. “In severe cases, the best option is to admit a patient to a rehab center, where proper nursing care and physiotherapy can be provided. These are cheaper than hospitals and more convenient than home treatment,” says Dr Gupta. However, at present there are very few good centers in India.
- Nursing: Rs.50,000-1 lakh per month
- Physiotherapy: Rs 10,000-30,000 per month
- Rehab: Rs 5,000-10,000 per day
- Medicine: Rs 1,000-3,000 per month
All costs are for Delhi, are indicative and may vary for different hospitals/clinics and laboratories.