Stroke

BE FAST — Balance loss (sudden), Eyes (sudden vision problem), Face drooping on one side, Arm or leg weakness on one side, Speech slurred or confused, Time to call an ambulance. Don't wait to see if it passes, don't try Ayurvedic first aid, don't drive to a small nursing home — go directly to the nearest large hospital with a CT scanner and neurologist. Clot-buster medication works only within 4.5 hours; the earlier the better. Every minute of delay kills nearly 2 million brain cells.

A TIA (transient ischemic attack) is a temporary blockage of a brain artery that resolves in minutes to hours without permanent damage — but it is a serious warning. Roughly 1 in 10 TIA patients has a full stroke within 90 days, and many of those within 48 hours. A TIA needs the same urgent evaluation as a stroke: same-day imaging, blood tests, ECG, echocardiogram, and starting appropriate prevention (aspirin, statin, BP control, AF anticoagulation if indicated). Never dismiss a temporary weakness or speech problem as 'nothing happened.'

Ischemic stroke: clot-buster medication (tPA) within 4.5 hours can dissolve the clot and reverse damage. For large clots in major brain arteries, mechanical thrombectomy (a catheter-based clot extraction) can be done up to 24 hours in selected patients — a treatment now available at major Indian stroke centers. Both require immediate transport to a stroke-ready hospital. Hemorrhagic stroke: treatment focuses on controlling blood pressure, reversing any blood thinners, and sometimes surgery to relieve pressure.

Structured stroke rehabilitation — physiotherapy for movement, occupational therapy for daily activities, speech therapy for language and swallowing — determines how much function returns. Best outcomes come from starting rehab within days of the stroke, continuing intensively for 3-6 months, then progressing over 1-2 years. Home-based rehab programs work when hospital-based ones aren't accessible. Family involvement matters hugely. Even patients with initially severe deficits often regain significant function with the right rehab.

Control BP (under 130/80 — biggest single lever), treat high cholesterol with a statin if indicated, quit tobacco (including gutka and chewing forms), manage diabetes tightly, screen for and treat atrial fibrillation (anticoagulation if present), stay active (150 minutes per week), maintain healthy weight, moderate alcohol, and eat a Mediterranean-style diet. This combination prevents roughly 80% of strokes. Aspirin is used only when clearly indicated — not as routine prevention in low-risk people.