Who treats brain and nerve conditions in India, what neurointerventional procedures are, and how stroke teams work together.
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Brain and nerve care in India is delivered by teams. Neurologists diagnose and manage conditions of the brain, spinal cord, nerves and muscles. Neurointerventional specialists treat diseases of the brain's blood vessels from inside the vessels, through a thin tube (catheter) usually passed from the wrist or groin. In stroke, both work together, and minutes matter.
The specialists
1
Neurology
A neurologist is a doctor who specialises in the brain, spinal cord, nerves and muscles. In India this usually means a DM or DNB in Neurology after an MD in Medicine.
Diagnoses the cause of symptoms such as weakness, seizures, headache, memory loss, tremor or numbness
Leads emergency stroke care in many hospitals, including deciding on clot-busting medicine
Manages long-term conditions such as epilepsy, Parkinson disease, multiple sclerosis and dementia
Works with rehabilitation teams on recovery
2
Vascular neurology (stroke neurology)
Vascular neurologists focus on stroke and diseases of the brain's blood vessels: emergency treatment, finding the cause, and preventing another stroke.
Runs the stroke pathway from arrival to discharge
Looks for causes such as narrowed arteries, heart rhythm problems or clotting disorders
Sets up prevention: blood pressure, diabetes, cholesterol, lifestyle and medicines
3
Neurointerventional care
Neurointerventional specialists (also called interventional neuroradiologists or endovascular neurosurgeons) treat blood-vessel problems of the brain and spine using catheters and X-ray guidance, without open surgery.
Removes large clots in stroke (mechanical thrombectomy)
Treats brain aneurysms and abnormal vessel connections from inside the vessel
Opens narrowed arteries in the neck or brain when appropriate
Needs a hospital with a catheter lab (cath lab), anaesthesia and intensive care, available around the clock for stroke
How stroke care fits together
1
Recognise
Spot the signs with the KneeTie… Go Run Go test and call 112.
2
Scan
At hospital, an urgent CT or MRI shows whether it is a clot or a bleed.
3
Treat
Clot-busting medicine and, for some patients, thrombectomy.
4
Transfer
If the first hospital has no cath lab, some patients are moved to one that does.
A catheter is guided to the blocked brain artery and the clot is pulled out or suctioned away.
Used for
Ischaemic stroke caused by a blockage in a large brain artery. Brain scans help decide who can benefit; earlier treatment generally gives better results.