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Neuro Emergencies: Our Motto is Integrated Neuro Care at MGM Mon , Jan 11

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Neuro Emergencies: Our Motto is Integrated Neuro Care at MGM

  • Strokes are one of the leading causes of death around the world, but despite this, most people don’t know how to identify a stroke. If identified early enough and treated within the ‘Golden Hour’, the effects of a stroke are often reversible. All you need to do is BEFAST in identifying the main signs of a stroke.
  • B – Loss of balance
    E – Blurry vision
    F – Drooping on one side of the face
    A – Numbness of an arm
    S – Slurred speech
    T – Time to act
  • When it’s the time to act, call 044-45242444 for an ambulance or come directly to MGM’s 24×7 Emergency Centre.

Stroke and its treatment

  • A stroke occurs for one of two reasons, there is either lack of blood flow to the brain or the brain suffers a haemorrhage. A haemorrhagic stroke can either be because of a ruptured aneurysm, a bleed in the brain due to high blood pressure or any other vascular problems like arteriovenous malformations (AVMs) and other tumours.
  • At MGM Healthcare, Integrated Neuro Care is our primary approach. There are several specialties within Neurosciences itself — Neurology, Neurosurgery and Spine Surgery, Neuro Critical Care — and these are supported by Neuroradiology and Neuro Rehabilitation. So, when a patient with a neurological emergency is brought in, the neurologists, neurosurgeons and neurocritical care specialists all examine the patient to collectively decide the best treatment for them, given their condition.
  • The treatment of a stroke begins in the CT room. Once the CT scan is done, if no bleeding is visualised, tissue plasminogen activator (tPA) (a medication to dissolve clots) is given intravenously. After this, a CT angiogram is performed to check whether there is a block of a small vessel or a large vessel. If there is a block of a large vessel, the patient is shifted immediately to the Cath Lab where neurological intervention is done and the clot is cleared immediately. The patient is then moved to the Neuro ICU where they are monitored for progress.

Neuro emergencies beyond a stroke

  • After stroke, head injuries are the next common type of neuro emergencies, followed by seizures. In the event of a trauma — road traffic accident or otherwise — resulting in head injury, the hospital’s trauma protocol is put into effect. In any major trauma, the Neurosciences team, the Orthopaedic team and the General Surgery team are all called in to assess the patient. A pan CT is performed which will tell all the teams, in just a few minutes, where the problems lie. Is there a head injury, is there a cervical spine injury, is there an abdominal injury? From this understanding, a treatment plan is put together.
  • When a patient who has had a seizure is brought in, the most important step is to stabilise the patient in the ER. Once the patient is stable, a CT scan is done and then the patient is shifted to the Neuro ICU. Based on the cause of the seizures, it is decided whether the neurologists need to be involved or the neurosurgeons. The reason a CT scan is preferred over an MRI for the first imaging is because a CT scan is faster. Once the patient is stabilised in the Neuro ICU, an MRI can be done to understand more about the patient’s condition.
  • At MGM Healthcare, an integrated and comprehensive approach between and within specialties ensures that our doctors work together as a well-oiled machine for the benefit of the patient.

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