Acute Stroke & Neurovascular Disorders

Rapid assessment and management of stroke including thrombolysis protocols, neurovascular evaluations, and post-stroke rehabilitation planning by Dr. Chetan Padghan, Consultant Neurologist in Pune.

Understanding Stroke & Neurovascular Disorders

A stroke occurs when blood supply to the brain is suddenly interrupted — either by a blocked artery (ischemic stroke) or a ruptured blood vessel (hemorrhagic stroke). Without prompt treatment, brain cells begin to die within minutes, making stroke one of the leading causes of death and disability worldwide.

Neurovascular disorders encompass a range of conditions affecting blood vessels that supply the brain and spinal cord, including transient ischemic attacks (TIAs), cerebral venous thrombosis, and vascular malformations.

Types of Stroke

Ischemic Stroke

Ischemic stroke accounts for approximately 85% of all strokes. It occurs when a blood clot blocks an artery supplying the brain. Causes include:

Large vessel atherosclerosis — plaque buildup in major brain arteries
Cardioembolic stroke — blood clots originating from the heart (e.g., atrial fibrillation)
Small vessel disease (lacunar stroke) — blockage of small penetrating arteries
Cryptogenic stroke — stroke of undetermined cause after thorough evaluation

Hemorrhagic Stroke

Hemorrhagic stroke occurs when a blood vessel in the brain ruptures, causing bleeding into or around the brain:

Intracerebral hemorrhage — bleeding within the brain tissue
Subarachnoid hemorrhage — bleeding into the space surrounding the brain

Transient Ischemic Attack (TIA)

Often called a “mini-stroke,” a TIA causes temporary neurological symptoms that resolve within 24 hours. A TIA is a warning sign — it significantly increases the risk of a full stroke in the near future and requires urgent evaluation.

Recognizing Stroke Symptoms — The FAST Approach

F — Face drooping: One side of the face droops or feels numb
A — Arm weakness: One arm becomes weak or numb
S — Speech difficulty: Speech becomes slurred or difficult to understand
T — Time to call emergency services: Immediate medical attention is critical

Additional Symptoms

Sudden severe headache with no known cause
Sudden confusion or trouble understanding
Sudden vision changes in one or both eyes
Sudden dizziness, loss of balance, or difficulty walking
Sudden numbness or weakness, especially on one side of the body

Why Time Matters — “Time Is Brain”

During a stroke, approximately 1.9 million neurons are lost every minute. Early intervention is critical:

Intravenous thrombolysis (clot-dissolving therapy) can be administered within 4.5 hours of symptom onset
Mechanical thrombectomy may be performed in select patients up to 24 hours after onset
Every minute of delay reduces the chance of a good outcome

Our Approach to Stroke Management

Dr. Chetan Padghan provides a structured, protocol-driven approach to stroke care:

Acute Phase

Rapid clinical assessment and neuroimaging (CT/MRI)
Thrombolysis eligibility evaluation and administration
Blood pressure management and neuroprotection
Close monitoring in neurocritical care settings

Diagnostic Workup

Brain CT and CT angiography
MRI with diffusion-weighted imaging (DWI)
Echocardiography and cardiac rhythm monitoring
Cerebral angiography when indicated
Blood investigations for stroke risk factors

Secondary Prevention

Antiplatelet or anticoagulant therapy as appropriate
Risk factor modification — hypertension, diabetes, cholesterol management
Lifestyle counseling — diet, exercise, smoking cessation
Regular follow-up and monitoring

Post-Stroke Rehabilitation

Coordination with physiotherapy, occupational therapy, and speech therapy
Cognitive rehabilitation for post-stroke cognitive impairment
Psychological support for post-stroke depression and anxiety
Long-term follow-up and functional assessment

Other Neurovascular Conditions We Manage

Cerebral venous thrombosis (CVT) — blood clot in the brain’s venous sinuses
Carotid artery stenosis — narrowing of the carotid arteries
Intracranial stenosis — narrowing of arteries within the brain
Vascular malformations — arteriovenous malformations (AVMs) and aneurysms
Cerebral small vessel disease — affecting small blood vessels in the brain

When to Seek Immediate Help

If you or someone around you experiences sudden onset of any neurological symptoms — facial drooping, arm weakness, speech difficulty, vision changes, severe headache, or loss of balance — seek emergency medical care immediately. In stroke treatment, every minute counts.

Dr. Chetan Padghan is a Consultant Neurologist in Pune with expertise in acute stroke management, neurovascular evaluations, and comprehensive post-stroke care. Schedule a consultation for stroke risk assessment or post-stroke follow-up.