Brain Stroke Symptoms & Treatment —
Everything You Need to Know

A brain stroke kills approximately 1.9 million brain cells every minute it goes untreated. In India, stroke is the third leading cause of death and the number one cause of long-term disability. Yet most strokes are treatable — if recognised quickly and treated within the critical window. This article explains how to recognise a stroke, what happens inside the brain, and what modern treatment can do.

1. The FAST Test — Recognise a Stroke in Seconds

The FAST test is the simplest and most effective way to recognise a stroke. It stands for:

If a person shows even ONE of the FAST signs, treat it as a stroke until proven otherwise. Do not wait for symptoms to pass or improve — this is a common and fatal mistake.

2. Ischaemic vs Haemorrhagic Stroke

There are two fundamentally different types of stroke, and they require completely different treatment:

Feature	Ischaemic Stroke (80%)	Haemorrhagic Stroke (20%)
Cause	Blood clot blocking an artery to the brain	Blood vessel bursting, causing bleeding in/around the brain
Main treatment	Thrombolysis (clot-busting drug) or thrombectomy	Blood pressure control, reversal of blood thinners, possibly neurosurgery
Blood thinners	May be used after initial treatment	Contraindicated — would worsen bleeding
Surgery	Rarely needed (mechanical thrombectomy for large clots)	May be needed to evacuate blood clot or repair burst vessel
On CT scan	Initially may appear normal or show early ischaemic changes	Shows bright white area (blood) immediately

This is why an emergency CT brain scan is the very first investigation when a stroke patient arrives — it tells us immediately which type of stroke it is, and which treatment to use.

3. Other Stroke Symptoms to Know

Beyond FAST, stroke can also cause:

4. The Golden Window for Stroke Treatment

Time is the most critical factor in stroke treatment:

• Within 4.5 hours of symptom onset: IV thrombolysis (clot-dissolving injection) can be given for ischaemic stroke, with the best results when given within 90 minutes.
• Within 6–24 hours in selected patients: Mechanical thrombectomy (removing the clot using a catheter through the blood vessel) may be possible for large artery blockages.
• After 24 hours: The window for most acute treatments closes, but stroke management — blood pressure control, antiplatelet/anticoagulant therapy, and rehabilitation — continues.

The phrase "time is brain" is literally true. A 90-minute delay in giving thrombolysis reduces its effectiveness by 50%.

5. How Stroke is Treated at Charak Hospital, Lucknow

When a stroke patient arrives at Charak Hospital's Emergency & Trauma unit, the following happens immediately:

1. Immediate assessment — vital signs, neurological exam, blood tests
2. Emergency CT brain scan — performed within minutes to identify stroke type
3. IV thrombolysis — administered for eligible ischaemic stroke patients within the golden window
4. ICU or HDU admission — for continuous neurological monitoring, blood pressure management
5. Neurosurgical intervention — for haemorrhagic stroke patients requiring clot evacuation or aneurysm repair
6. Rehabilitation — physiotherapy begins as early as Day 2 post-stabilisation

6. Who Is at Risk of Stroke?

The most important stroke risk factors — almost all of which are controllable with medical treatment and lifestyle changes:

• Hypertension (high blood pressure) — the single biggest risk factor for stroke
• Atrial fibrillation — an irregular heart rhythm that promotes clot formation
• Diabetes — damages blood vessels over time
• High cholesterol — builds up plaque in arteries
• Smoking — doubles stroke risk
• Obesity and sedentary lifestyle
• Previous stroke or TIA — significantly raises risk of a further stroke
• Carotid artery disease — narrowing of the arteries in the neck
• Age above 55

7. TIA — The Warning Stroke You Cannot Ignore

A Transient Ischaemic Attack (TIA), or 'mini-stroke', has identical symptoms to a stroke but they resolve within 24 hours (usually within 1 hour). Many people make the dangerous mistake of ignoring a TIA because "it got better."

A TIA is a medical emergency. Studies show that 10–15% of people who have a TIA will have a full stroke within 3 months — and half of these occur within 48 hours of the TIA. Urgent investigation and treatment can prevent the major stroke.

8. Recovery & Rehabilitation After Stroke

Recovery after stroke depends on which part of the brain was affected and how quickly treatment was received. Rehabilitation at Charak Hospital includes:

• Physiotherapy — rebuilding strength, coordination, and balance
• Speech therapy coordination — for patients with speech or swallowing difficulties
• Occupational therapy — relearning daily activities (dressing, feeding, writing)
• Secondary prevention — antiplatelet drugs, blood pressure control, anticoagulation for AF

The brain has a remarkable ability to rewire itself (neuroplasticity) — consistent rehabilitation, especially in the first 3–6 months, produces the greatest recovery.