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Which Doctor Do I see For Possible Brain Stroke?

The short answer is a Neurologist!

But this is probably a bit of an oversimplification. In fact, your recovery from stroke will involve at least three different types of practitioners, starting with your primary care Doctor. Not only can it take from minutes to hours – stroke patients do not have this kind of time – to get hold of a neurologist, your primary care Doctor is also very well equipped to determine whether or not you are actually suffering a stroke attack. And if they feel that you indeed are suffering from something acute, they can always start the process of evaluating your symptom, and perform all the basic tests before referring you to a specialist, who would need those tests anyway.

Exams and Tests

The first test that your primary care Doctor can perform before he hands over your case to a specialist is the CT scan or an MRI to help confirm the presence of a bleeding in the brain and to determine the exact location thereof. The test will also help establish whether it’s an ischemic stroke or a hemorrhagic stroke. The additional test that your Doctor will typically recommend will include:

  • Electrocardiogram or ECG
  • Blood tests to check Complete blood count (CBC), Blood sugar, Electrolytes, Liver and kidney function, Prothrombin time and INR.

If your Doctor feels that you have a narrowing in the carotid artery, he may order below mentioned additional tests:

  • Carotid ultrasound/Doppler scan
  • Magnetic resonance angiogram (MRA)
  • CT angiogram and Carotid angiogram
  • Echocardiogram, or Holter monitoring, or Telemetry test to rule out heart-related complications

Identifying and Treating Stroke

While a Neurologist is on the way, your primary care Doctor will want to identify the type of stroke, its location, and the extent of damage that has been caused to the brain. He will also want to rule out other conditions and, to that end, he will:

  • Inquire about your symptoms, when they started, and any medical history
  • Check your level of consciousness, ability to move, coordination, and balance
  • Check for numbness or weakness in the body, and vision or speech impairment


Once your primary care Doctor has ascertained stroke, and the affected area of the brain, the next course of action will be a Thrombolytic Therapy, which is the procedure to dissolve the clots in blood vessels, thereby improving blood flow, and preventing damage to tissues and organs – in this case, the brain.The procedure might also involve removing the clot, or physically breaking it up. Since this procedure involves using a long catheter to deliver a clot-busting drug directly to the site of the blockage in the brain, your primary care Doctor will defer it to a trained Neurologist.

Your Neurologist will most likely use one of the below-mentioned drugs, also known as Thrombolytic Agents:

  • Eminase (anistreplase)
  • Retavase (reteplase)
  • Streptase (streptokinase, kabikinase)
  • t-PA (class of drugs that includes Activase)
  • TNKase (tenecteplase)
  • Abbokinase, Kinlytic (urokinase)

Stroke Rehabilitation

Once your primary care Doctor and Neurologist have worked together to remove the blood clot or the bleeding from the brain, a therapist will take over to ensure proper post-operative care, including stroke rehabilitation, the goal of which is to help you reacquire the skills that were lost because of the stroke. The actual length of this therapy will vary depending on the severity of the stroke and damage caused, but will typically last from few months to even years after the stroke.

The therapy will primarily focus on two areas:

  • Physical activities – These will include motor-skill exercises to help improve your muscle strength, mobility training to help stabilize and strengthen your body while you relearn to walk, constraint-induced therapy to reduce your dependency on the unaffected limb, and range-of-motion therapy to ease muscle tension and spasticity.
  • Cognitive and emotional activities– These will include therapy for cognitive disorders to help you with lost cognitive abilities such as memory and problem-solving, therapy for communication disorders to help you regain lost abilities in speaking and comprehension, and psychological evaluation to test your emotional adjustment and prescribe counseling or a support group.

So this will be the team of health professionals that will assist you in your journey to recovery from a stroke. However, it will all still depend on whether or not the patient reached a hospital within 3 to 4 hours of suffering the stroke. To that end, the importance of performing the B.E.F.A.S.T. test (Balance loss; Eye-sight impairment; Face drooping; Arm weakness; Speech difficulty; Time to act) on a person who is showing the symptoms of stroke, cannot be emphasized enough. If a loved one has failed the B.E.F.A.S.T. test, contact us at 8008104199 immediately to properly diagnose the issue and evaluate treatment options available to you!


Treatments Options For Brain Stroke

When a stroke attack occurs, the brain tissues begin to die due to a lack of oxygen, and sooner the medical intervention is provided, the more brain tissues can be saved. Read more


Causes And Symptoms Of A Brain Stroke

As we know, when the blood supply to the brain is interrupted, the brain is deprived of oxygen and other nutrients, causing the brain cells to die, and this is what we call a Stroke.

In most cases, the stroke affects the Middle Cerebral Artery(MCA) area of the brain, with tissue-death being observed in two general regions – the Superficial Divisions and the Lenticulostriate Branches.

Now that we have seen what is a Stroke, and what areas of the brain it can affect, let’s take a closer look at the causes and symptoms of the stroke.

Stroke is more likely to affect the elderly and those who have a positive familial history. But these circumstantial risk factors are not the only ones – stroke can also affect overweight people, people who have a sedentary lifestyle, people who have poor dietary preferences, people who drink and smoke heavily, and people who are addicted to the use of illicit drugs.

In addition, there are also a whole bunch of other non-circumstantial, non-controllable (but manageable) risk factors that can cause a stroke. These risk factors include:

  • Hypertension, or blood pressure of 140/90 mm Hg or above
  • Diabetes and high blood cholesterol of 240 milligrams per deciliter (mg/dL) or over
  • A congenital defect, or a head trauma
  • Medical conditions including moyamoya disease, venous angiomas, or a vein of Galen malformation
  • Certain drugs and medical conditions result in blood clotting

In addition, a Hormone Replacement Therapy (HRT) may also increase the risk in those who already have carotid artery disease. That said, specific causes can vary for different types of strokes. For example, the Ischemic stroke is caused either by a blood clot stopping the blood flow in the arteries that lead to the brain or by fatty deposits, which narrow the arteries and thus significantly reduce the amount of blood that reaches the brain. On the other hand, Hemorrhagic strokes are caused when an artery ruptures in the brain, thus creating pressure on brain cells and damaging them. This rupture can be the result of a high blood pressure, a weakness of the arterial wall, the side-effect of a blood-thinning medication, or even a trauma. And yet another, albeit rare, cause of stroke is vasculitis, which is a condition in which the blood vessels become inflamed, thus restricting the blood flow to parts of the brain.

Now, to understand the symptoms of a stroke! Except for an ITA, which almost always leads to a major episode of stroke within a year, a stroke often appears without a warning and does so suddenly. Key symptoms include:

  • a severe and sudden headache
  • paralysis of one side (hemiplegia) or weakness on one side (hemiparesis)
  • confusion, difficulty communicating, including slurred speech
  • nausea and vomiting with altered consciousness>
  • loss of vision (half or full), or balance, or coordination

Additionally, in the medium to longer term, patients might also experience the following symptoms, the severity of which may vary from patient to patient:

  • complete or partial loss of bladder or bowel control
  • depression, and trouble controlling or expressing emotions
  • progressive pain in the extremities

Also, different types of strokes affect the brain differently. For example, a stroke affecting the left side of the brain would affect speech and comprehension, whereas a stroke affecting the right side would weaken the face, the arm, the leg, or a combination of the three. It should also be noted that a right brain stroke would make the left side of the body weak, and vice-versa.

Again, the importance of performing the F.A.S.T. test (Face drooping; Arm weakness; Speech difficulty; Time to act) on a person who is showing the symptoms mentioned above, cannot be emphasized enough. If a loved one is high on the risk factors or has failed the F.A.S.T. test, contact us at 8008104199 immediately to properly diagnose the issue and evaluate treatment options available to you!


Symptoms of the Nervous System Disorders

A very complex and highly specialized interconnection of the human body’s internal circuitry, the nervous system is like the body’s multimeter to the outside world, in the sense that it controls:

  • The body’s sense of sight, hearing, taste, smell, and sensations
  • The body’s ability to perform movement, balance, and coordination
  • The mind’s ability to think, reason, be conscious, and have thoughts, memories, and language

Divided into three parts – viz the brain, the spinal cord, and the nerve cells – the nervous system also regulates a whole range of voluntary and involuntary vital actions, such as blood flow and blood pressure. Given their enormity, they are prone to a host of problems, the symptoms of which might manifest all of sudden, posing a life-threatening situation or they might develop over a long period, all the while causing slow deterioration in one or a group of certain brain functions. Also, the symptoms can be mild or severe, transient or permanent, physiological or psychological, but never nonexistent, and when they do manifest, they will be in one of the following forms:

  • Numbness, tingling, weakness, or loss of mobility in certain body parts
  • Lack of focus, reduced light sensitivity, double vision, tunnel vision, or loss of vision
  • Incoherentor illegible speech, confusion, and change in level of consciousness
  • Sudden onset of a severe headache, nausea, and vomiting
  • Dizziness, unsteadiness, or loss of balance and equilibrium
  • Seizures and abnormal body movements, such as twitching

In addition to these, there might also be certain behavioral changes that might not seem like an indicator of anything serious, but might actually be due to an underlying cause. These can include:

  • You find it difficult or impossible to move certain parts of your body
  • You can’t put weight on one leg as you have pain running down that leg
  • You find it hard to coordinate your movements, making you clumsier than before
  • You seem to be having to run to the bathroom too frequently and for no apparent reason
  • You get intense headaches that come and go frequently, but without any pattern

These symptoms will depend on the specific area of the nervous system that has been impacted and the underlying cause and the nature of these symptoms can provide clues as to the site of the issue. These sites can be divided into categories – Lower Level Sites, which include muscle, motor-end plates, peripheral nerves, spinal nerve roots, etc; and Higher level Sites, which include brainstem, cerebellum, thalamus etc. Below are the typical symptoms of issues in these specific areas:

  • Lower-level sites
    • Weakness in a specific set of muscles: Depending on the set of muscles impacted, the symptoms will be noticed when climbing stairs, getting up from a chair, lifting something, or even chewing the food.
    • Fatigue and weakness in motor end plate: This happens when the motor nerve impulses are unable to properly connect with the muscle end plate at the neuromuscular junction.
    • Weakness and muscle atrophy: This happens when there is sensory nerve damage, and might cause numbness, tingling, shooting or burning pains, hyperesthesia, and an absence of reflex activity.
    • Abnormal posture, abnormal deep and plantar reflexes: Caused by damage to the spinal cord, and often results in pain, temperature, and loss of scratch sensations.
  • Higher-level sites
    • Loss or reduced activity of cranial nerve functions: Caused by damage to the brainstem, this can also be life threatening, since many critical functions, such as consciousness, respiration, and blood pressure, are controlled from there
    • Difficulty in maintaining an upright posture: Caused by damage to the cerebellum, this can also be accompanied by other symptoms such as jerky movements of the eyes at rest, ataxia of the limbs, and even a severe tremor
    • Loss of sensation on the opposite sides of the body: This is typically caused by a lesion in the thalamus, and might be accompanied by extreme pain. Other related symptoms can include disorders of eye movement and speech impairment.
    • Loss of ability to perform purposeful actions: Damage to the various parts of the cerebral hemisphere can result in a loss of different day-to-day abilities, including something as complex as foresight, planning, and comprehension; or something as simple as the ability to put on clothes.

Unfortunately, the symptoms of a nervous system disorder might resemble the symptoms of other medical conditions or problems, making it difficult for family members to realize the gravity of the affliction. If you or a loved one has these symptoms, call us at 8008104199 immediately to properly diagnose the issue and evaluate treatment options available to you!


Symptoms that Alert a Woman who is having a Heart Attack

Most people think of heart attacks and other heart-related diseases as men’s problem. It’s a myth!

In fact, in age group 55+, women have greater chances of suffering a heart attack than have men, and death within first 5 years of suffering a heart attack is as much as 11 percent more likely in women than in men. Why, then, the misconception?One possible reason is that since symptoms of heart attack in men and women are different, most women don’t realize that they are suffering a heart attack. Below are the major symptoms that women experience when they suffer a heart attack:

Chest Pain or Discomfort

The chest pain is the quintessential symptom of a heart attack among both, men and women. However, the way it manifests, and the specific region in which it is experienced may vary among men and women. Women are more likely to feel an uncomfortable pressure, squeezing, fullness or pain in the center of the chest, which may last for a few minutes, or are recurrent in nature.Unlike men who predominantly feel the pain on the left side or center-left, women can feel the pain anywhere in the chest, not just on the left side.

Pain in Arms, Back, Neck, or Jaw

Most men will experience pain that is concentrated on the left side of the chest, whereas women can feel pain in other areas as well, which results in them not realizing the severity of the situation. That said, the pain is usually intense enough to go unnoticed – if you are asleep, it will often wake you up. Cardiologists even go to the extent of advising women to report any out of the ordinary sensation in their body from waist up.

Stomach Pain

Most people will not associate stomach pain with a heart attack, often attributing it to the flu, heartburn, or an ulcer in the stomach. But women may experience severe abdominal pressure when they are suffering a heart attack. The pressure can be intense enough for it to be likened with an elephant sitting on your stomach; although I can’t imagine how anyone can have an elephant sit on their stomach, and live to describe the pain.

Difficulty in Breathing

A difficulty in breathing that occurs for no apparent reason is one of the surest signs of an episode of the heart attack. A heart attack occurs when the supply of oxygen-rich blood to the heart muscle is disrupted due to blockages in the coronary arteries, and it is this disruption in the supply of oxygenated blood that causes breathlessness, dizziness, and loss of consciousness. If you’re also having one or more of the other symptoms, call for help immediately.


Women suffering a heart attack may also sweat profusely for no apparent reason, which is often out of character for them. Typically a cold sweat, this will often feel more like sweating from nervousness than from exercising or spending time in the heat. This condition is medically known as diaphoresis and is caused due to the over-activation of the sympathetic nervous system, which in turn is actuated by release of hormones due to sharp pain, increase blood pressure, elevated and heartbeat.

Fatigue, Tunnel Vision, and Anxiety

In case you did not know, these are also the symptoms of a migraine, and for someone getting a heart attack with no other telltale sign (as is likely in case of women), it’s very easy to confuse the two.

While genetics is one of the most common risk factors, looking out for lead indicators such as blood pressure, diabetes, smoking, sedentary lifestyle, unhealthy diet, stress and weight issues can predict most heart diseases. Also, for most women, the symptoms of heart attack will start manifesting in the milder form much before a major episode occurs, giving plenty of advance warning to mitigate, or even avoid altogether, the impact of an unfortunate eventuality.

If you or a loved one is experiencing these symptoms, call us today on  0861-6680 100, 8008 104 199 or write to us at  info@simhapurihospitals.com  to take action!


brain tumor symptoms and treatment

What Is a Tumor?

Tumor is a mass of tissue that is formed by accumulation of abnormal cells. Normally, the cells grow old or get damaged, they die, and new cells take their place. Tumor cells will grow even though the body does not need them, and unlike normal old cells, they don’t die. As this process goes on, the tumor continues to grow as more and more cells are added to the mass.

Primary brain tumors may emerge from various cells that to make up the brain and the central nervous system are named for the kind of cell in which they form in the first. The common types of adult brain tumors are gliomas as in astrocytic tumors. These tumors might form from astrocytes and also the other types of glial cells, which helps the cells to keep nerves healthy.

There are two main types of tumors: –

  • Benign tumors
  • Malignant or cancerous tumors.

Benign tumors:-

A benign tumor is not a cancerous tumor. Unlike this cancer tumors, a non cancerous tumor are unable to spread throughout the body. A non malignant tumor gets serious, they are to be pressed on the primary nerve, a main artery, or compresses brain matter. Benign tumors will respond well for the treatment and the prognosis is usually favorable.

Most Common Types of Benign Tumors

  • Adenomas (epithelial tissue that covers the organs and glands)
  • Meningiomas (brain and spinal cord)
  • Fibromas or fibroids (connective tissue of any organ – most commonly found in the uterus)
  • Papillomas (skin, breast, cervix, and mucus membranes)
  • Lipomas (fat cells)
  • Nevi (moles)
  • Myomas (muscle tissue)
  • Hemangiomas (blood vessels and skin)
  • Neuromas (nerves)
  • Osteochondromas (bones)

It Depends on the location and size of a benign tumor, treatment might not be necessary. Then the doctors will monitor it, and track the patient symptoms and do tests at specific intervals.

Benign tumors are surrounded by a protective “sac”  mechanism that performed by the immune system  that segregates it from the rest of the body and enables it to be easily removed.

Malignant Tumor:-

Malignant tumors are formed in abnormal cells are highly unstable and also they travel through the blood stream, circulatory system and lymphatic system. Malignant cells don’t have the chemical adhesion molecules to anchor them to the original growth site that benign tumors possess.

Many of the suspected causes of cancer are widely accepted by the medical community while others are not. Obesity, smoking, alcohol consumption, poor diet, environmental pollution, heavy metal exposure and household toxins are some of the culprits that might leads to the  cancer in the body.

Most Common Types of Malignant Tumors:-

  • Sarcomas (connective tissues such as muscle, tendon, fat, and cartilage)
  • Carcinomas (organs and gland tissue such as the breast, cervix, prostate, lung, and thyroid)

Malignant tumors might not have the symptoms initially but at the first indication it has something that not be right or it may be the detection of a painless lump. These types of tumors are   “elastic,” which will enables them to grow fairly large before they detected.

If they grow and begin to press against the organs, blood vessels and nerves, pain and general soreness at the site it may occur.

Pre-Cancerous Tumors:-

Precancerous tumors fall between benign and malignant. These types of growths may have the markers that to be malignant but they are not yet apparent. These are not to be characterized as malignant unless irrepressible cell growth ensues.


The more you know about prevention, the better you  can guard against all tumor growth in the body. Boosting the  body’s immune system through diet, exercise and healthy lifestyle choices are of defense.


Neurological Disorders And Symptoms

Neurological disorders are the group of diseases that affect the brain, the spine and the various nerves that connect them both. While there are more than 600 types of neurological diseases that are recognized by the medical world, there are some that are really common and occur more frequently.

1. Alzheimer’s

The most common neurological disorder is definitely Alzheimer’s, with a large number of senior citizens being diagnosed with the same each year, all over the world. Also known as AD, Alzheimer’s disease is a type of neuro degenerative disease, which means that while it starts off slow, the condition really worsens with time. While the time it takes to move from the first stage to the really bad one can vary from person to person, the average life expectancy after the diagnosis is about 3 to 9 years.


  • Short term memory loss, or problems in remembering regular things
  • Difficulty in speaking
  • Sudden mood swings
  • Unable to remember places or directions
  • Starting something but forgetting to complete the same
  • Not able to take care of self

2. Migraine

While you may not think of migraine as a neurological disease, it is a very common condition that affects a lot of people, and almost three times the number of women as men. Migraine is a condition where you feel a throbbing in one part of the head or extreme pain and pulsing. It is a type of extreme sensitivity towards loud noises and harsh lights that can cause severe headaches along with other symptoms. In many cases, patients are able to understand when a migraine is about to begin, as there is almost always a difficulty in vision. It mostly affects one part of the head and can last from an hour to as long as 72 hours!


  • Light or severe sensitivity to light
  • Nausea
  • Throbbing pain in one part of the head or at the temples
  • Difficulty in vision
  • Vision going black
  • Seeing blurry or seeing lines in vision
  • Severe sensitivity to smell or sound

3. Parkinson’s Disease

Parkinson’s Disease, also known as PD, falls under a group of diseases that are known as motor system disorders. It is a type of disorder where the symptoms take time to show up, and slowly progress from start to getting worse. Genetic build as well as certain environmental causes are thought to increase the chances of getting affected with PD. Those who have a family member who has suffered PD are also at a higher risk.


  • Dementia and forgetfulness
  • Problems with sleep
  • Anxiety
  • Depression
  • Emotional upheaval and sudden mood swings
  • Problem in walking
  • Mild or severe shaking of the hands, tremors
  • Sensory issues

4. Epilepsy

Another very common condition that afflicts a lot of people is epilepsy, which leads to epileptic seizures. The seizures can be for a little while, or take a long time to subside. While the cause is unknown, it can sometimes be caused after an injury to the brain, after a stroke, some form of infection to the brain or some form of birth defect. The seizures can repeat often or in some cases be a one or twice affair.


  • Fainting
  • Sudden tremors especially in the hands and legs
  • Sudden confusion for short term
  • Staring at a fixed spot and not realizing
  • Not aware of immediate environment or situation

5. Brain Tumor

Brain tumor is a type of growth that in the brain cells which goes out of control and grows at a random pace. While there is no known cause why a brain tumor happens, it is also very difficult to understand who is at risk. While almost half of the brain cancer cases are not cancerous, they can be removed with the help of surgery. Removing the tumor can help the patient lead a better life and also improve life expectancy.


  • New occurrence of headaches or difference in the type of headaches experienced till date
  • Increase in the severity of headaches
  • Nausea or vomiting without any explained reason
  • Problems in vision, blurry vision, temporary loss of vision
  • Gradual problem in movement or sensation
  • Problems with speech
  • Problems with balancing

While the above symptoms may not necessarily mean you have the condition, make sure you consult a doctor and get an assessment done, especially if you experience more than one of the above symptoms.