Clot-Busting Stroke Treatment in the Golden Hour – Bangalore Guide

Around 20% of stroke victims are between the ages of 20 and 55. Knowing the symptoms of a stroke and acting quickly can mean the difference between a life saved and a tragic outcome.

Stroke is the fifth leading cause of mortality in the United States, as well as the top cause of adult disability. According to the National Stroke Association, few people understand what a stroke is and how to spot it when it occurs.

Book a Consultation with our Stroke Specialists in Bangalore

stroke

What is a golden hour?

 When someone is having a stroke, what we call  “Golden Hour” can make all the difference in the world. The first  3.5 hours is crucial because stroke patients have a significantly better chance of surviving and avoiding long-term brain damage if they arrive at the hospital in right time and are treated with a clot bursting medicine known as TPA.

What is TPA?

 TPA is a thrombolytic medication, also known as a “Clot Burster.” This clot burster is used to break up the clot that is causing a blockage or disruption in the flow of blood to the brain and aids in the restoration of blood flow to the affected part of the brain. It is administered intravenously (IV).

Dr. Ganesh Veerabhadraiah

Consultant – Neurosurgeon, Neurointerventional Surgery, Spine Surgeon (Neuro)
23+ Years Experience Overall (17+ years as Neuro Specialist)

Available for Consultation: Jayanagar 9th Block & Kauvery Hospital, Electronic City 

Thrombolysis- A “clot burster” medicine

Ischaemic strokes are frequently treated with injections of alteplase, a medication that breaks blood clots and restores blood flow to the brain.

This application of “clot bursting” medication is known as thrombolysis.

Alteplase is most effective when administered as soon as possible after a stroke occurs – ideally within 4.5 hours.

It is not generally advised if more than 4.5 hours have passed, as it is unclear how effective it is after this period.

Before using alteplase, a brain scan must be performed to confirm the diagnosis of an ischemic stroke.clot burster

This is due to the fact that the medication has the potential to exacerbate the bleeding that happens in hemorrhagic strokes.

It is critical to seek therapy for Ischemic Stroke as soon as possible because we now have a clot burster called TPA (Tissue Plasminogen Activator). It’s an enzyme medicine that dissolves clots, and it may be given at only in  stroke-ready(comprehensive stroke care)hospital.

What tests are required?

A CT scan of the brain will be performed as soon as possible to evaluate whether you or a family member can be offered TPA. This is to determine whether the stroke can be improved by TPA. If the stroke was caused by bleeding into the brain, TPA can exacerbate the hemorrhage. You will not be able to obtain TPA if this is the case. A blood test will also be performed to ensure that you do not have a bleeding disorder.

If the CT scan reveals no brain bleeding, doctors can employ the clot-dissolving medication TPA if specific criteria are met. This will be discussed with you by the doctor.

Subsequently CT angiogram and  MRI scan will be performed to understand more about treatment aspect- like perfusion study.

Understanding TPA as a stroke treatment

The drug TPA is frequently used to treat ischemic strokes. It must be given to the patient within 4.5 hours after the commencement of the stroke, as permitted by the US Food and Drug Administration (FDA). There are various pros and cons to using tPA as an advanced stroke treatment in Bangalore, including the following:

Pros:

TPA can be very helpful in dissolving blood clots and increasing a patient’s chances of recovering after a stroke. At the very least, TPA may lessen the long-term repercussions of a stroke. However, the benefits of TPA are heavily dependent on when it is delivered.

Cons:

Doctor will explain everything in detail before they give blood thinners. RTPA has Bleeding risk

Summary:

Strokes are a medical emergency that requires immediate treatment.

The sooner a person receives care for a stroke, the less likely it is that permanent damage will occur.

Read more : brain stroke causes and symptoms what puts you at risk and how to spot the signs

Conclusion

Clot-busting medications like TPA (tissue plasminogen activator) have revolutionized stroke care, but timing is everything. Administering this treatment within the golden window (first 4.5 hours) can drastically reduce brain damage, prevent disability, and even save lives. The earlier the treatment, the better the outcome—making awareness and rapid action absolutely critical.

Recognizing stroke symptoms early and reaching a stroke-ready hospital immediately is the first and most important step toward recovery.

Need expert stroke care in Bangalore?

Book a consultation with Dr. Ganesh Veerabhadraiah, one of Bangalore’s top neurosurgeons.

About Author

Dr. Ganesh Veerabhadraiah

Dr. Ganesh Veerabhadraiah, leading neurosurgeon and neurologist in Bangalore, has over 20 years of expertise in managing back pain, migraines, headaches, neuro disorders, and spine problems. His clinical excellence and patient-first approach make him one of the most trusted neuro doctors in Bangalore.

At Neurowellness Brain & Spine Clinic in Jayanagar and Kavery Hospital Electronic City, Dr. Ganesh provides comprehensive treatments ranging from minimally invasive spine surgery to advanced neurological care. As a respected back pain specialist and migraine doctor, he continues to deliver reliable outcomes for patients.

👉 Connect with Dr. Ganesh on LinkedIn

FAQs

1. What is the golden hour in stroke treatment?

The golden hour is the first 60 minutes after stroke symptoms start. Quick treatment during this time with clot-busting medication can save brain cells and improve recovery.

2. Which clot-busting medication is used for stroke?

The most common clot-busting drug is tPA (tissue plasminogen activator), which helps dissolve blood clots and restore blood flow to the brain.

3. Can all stroke patients receive clot-busting treatment?

No. Eligibility depends on the type of stroke, time since symptoms began, and the patient’s medical history. A CT scan is done to confirm suitability.

4. Why is the golden hour important in stroke care?

Because “time is brain.” Each minute of delay causes brain damage. Treatment within the golden hour can reduce disability and save lives.

5. Where can I find stroke specialists in Bangalore?

You can consult experienced neurosurgeons and stroke specialists in Bangalore at Neurowellness Brain & Spine Clinic, led by Dr. Ganesh Veerabhadraiah.

What you should know about Blood thinners used in stroke?

What you should know about common blood thinners used in brain stroke?

Medications that thin the blood can help you avoid a stroke caused by a clot (ischaemic stroke). This drug may be prescribed to you after a stroke or a transient ischemic attack (TIA) to help you avoid another stroke. If you have a health condition like heart trouble or a blood-clotting illness that could lead to a stroke, you may need blood-thinning medicine.

This medical information can assist you in discussing your options with your doctor. If you have any medication-related questions, you should consult your doctor, as a guide can only provide broad information.

Dr. Ganesh Veerabhadraiah

Consultant – Neurosurgeon, Neurointerventional Surgery, Spine Surgeon (Neuro)
23+ Years Experience Overall (17+ years as Neuro Specialist)

Available for Consultation: Jayanagar 9th Block & Kauvery Hospital, Electronic City 

What are blood-thinning medications?

Blood thinners like double edged sword. If their action is less blood clots , if too much action it can cause bleed in the brain. They function in different ways to prevent blood clots from developing. They alter the function of several blood cells and proteins.

This information pertains to a stroke-prevention drug.

Why are they used?

One of the most important methods to lower your risk of stroke is to take this medicine. If you’ve already had a stroke or have a health condition that puts you at risk of having one, it can help.

A stroke caused by a bleed.

Approximately 15% of strokes are caused by bleeding in or around the brain. A hemorrhagic stroke is a medical term for this. Blood-thinning medications can either increase or worsen the risk of this type of bleeding.

what are the Common blood thinners and their side effects-

Acetylsalicylic acid (aspirin): Aspirin has been used for a long time. It inhibits platelet aggregation, which means it prevents tiny cells from clumping together.

Although aspirin can help prevent secondary strokes, it is not advised as a preventative medication since the risks of bleeding and other side effects exceed the benefits for persons who have never had a stroke. Aspirin should only be used in extremely particular circumstances and under the care of a doctor, according to new guidelines.

Bleeding is a common side effect

Coumadin (warfarin): It is a blood thinner that blocks vitamin K’s action, which is required for healthy blood coagulation.

Coumadin is often prescribed for individuals with cardiac abnormalities that could lead to stroke, such as heart valve replacement, to assist avoid recurrent stroke.

Because an overdose of Coumadin can cause significant bleeding anywhere in the body, its action must be closely monitored with a blood test called the International Normalized Ratio (INR). Coumadin patients must be cautious since falls can result in significant, life-threatening bleeding.

Clopidogrel (Plavix): It is a blood thinner that affects platelet function. It is frequently used for stroke prevention, but it has a number of adverse effects, including bleeding, a low white blood cell count, and a rare condition known as thrombotic thrombocytopenic purpura, which is characterized by microscopic blood clots.

Aggrenox (aspirin and dipyridamole): It reduces the risk of stroke by combining aspirin with dipyridamole, a blood thinner that slows platelet activity by blocking enzymes associated with platelets. Bleeding, bruising, and headaches are all possible side effects.

Pradaxa (dabigatran): It is a blood thinner that prevents blood clotting by inhibiting the enzyme thrombin. This medicine has been shown to lower the risk of stroke in people with atrial fibrillation, but it can also induce bleeding and interfere with wound healing.

Eliquis (apixaban): It is a blood thinner that works by preventing thrombin from being activated. It’s been approved to prevent strokes in people who have atrial fibrillation that isn’t caused by a heart valve condition.  It raises the risk of bleeding, just like other blood thinners.

Xarelto (rivaroxaban): It is a blood thinner that works by interfering with two separate phases in the clotting cascade to prevent blot clot formation. Xarelto is licensed for stroke prevention in adults with atrial fibrillation and only needs to be taken once a day.  It can cause bruising and bleeding, just like other blood thinners.

Why are blood thinners used in stroke?

Following a transient ischemic attack (TIA) or an ischemic stroke, many patients are offered anticoagulants or antiplatelet medicines to avoid blood clots. The two most typically recommended blood thinners for stroke patients are antiplatelet and anticoagulation medicines. These drugs work by interfering with the blood’s natural clotting ability. Platelets are small cells that travel through our bloodstream. The ordinary individual may bleed a little after a cut, but due to the aforementioned platelets attaching to one another, the rate of bloodletting will slow down rather rapidly.

Clotting is defined as the phenomenon of platelets adhering to one another. Antiplatelets (also known as platelet aggregation inhibitors) disrupt the clotting process, reducing the likelihood of potentially hazardous blood clots developing. Aspirin, dipyridamole, clopidogrel, or one of the above combined with aspirin, a headache drug with antiplatelet qualities, are some of the most common antiplatelet pharmaceuticals now available.

Risks:

Stroke survivors who are at risk of deadly blood clots are frequently taken blood thinners. Unfortunately, the blood thinners used to avoid such clots might raise the risk of brain bleeding, which can lead to hemorrhagic stroke. In addition, several common blood thinners may interact with other over-the-counter drugs, vitamins, and prescriptions, lowering their effectiveness and potentially causing hazardous adverse effects.

Summary:

Blood thinners like double edged sword  are among the most basic drugs, yet they also present some of the most challenging choices in stroke treatment. While they have been shown to decrease stroke, the danger of bleeding can create difficulties ranging from poor wound healing to tiny areas of bruising to life-threatening hemorrhage.

The decision about whether or not to take a blood thinner should be made in cooperation with your doctor, who will assess your stroke risk as well as your bleeding risk.

Neurowellness provide high quality Advanced Stroke treatment in Bangalore at affordable cost in comparison with the other medical treatment options world wide.

Concerned about stroke recovery or managing medications? Book your consultation today with our expert neurosurgeon.

FAQs

1. When are blood thinners prescribed after a stroke?

Blood thinners are typically prescribed after an ischemic stroke to prevent blood clots. A neurologist will assess your condition and decide the right timing and dosage.

2. What are the risks of taking blood thinners after a stroke?

Risks may include bleeding complications, especially in people with uncontrolled hypertension or a history of internal bleeding. Regular monitoring is essential.

3. Can I stop blood thinners once I recover from stroke symptoms?

You should never stop blood thinners without medical guidance. Your doctor will determine the duration based on your recovery and risk profile.

Minimally Invasive MCA Stenting: Pin-Hole Brain Surgery in Bangalore

Successful MCA Stenting for TIA in a 46-Year-Old Patient: A Case Study

A 46-year-old gentleman from North Karnataka presented with complaints of left-sided weakness and difficulty speaking for 10 days prior to his arrival at 1224, G-Floor, 26th Main, 9th block, Jayanagar, Opp to Ragiguddada Anjaneyaswamy Temple Arch, Bangalore, Karnataka 560069. On examination, he was conscious, alert, and oriented, with no noticeable motor or sensory deficits. Further investigation led to a diagnosis of a Transient Ischemic Attack (TIA), a condition often referred to as a mini-stroke. Here’s an in-depth look into his diagnosis, treatment, and recovery process.

MRI
Minimally invasive pin hole surgery

Initial Diagnosis

The patient underwent an MRI brain stroke protocol, which revealed watershed infarcts in the right middle cerebral artery (MCA) territory with high-grade stenosis of the MCA. To further evaluate the extent of the problem, a Digital Subtraction Angiogram (DSA) was performed, showing more than 95% focal stenosis, with significantly reduced blood flow into the distal branches of the M2 and M3 segments of the MCA.

This high-grade stenosis posed a significant risk of a major stroke, prompting the team to plan for MCA stenting after carefully explaining the benefits and risks to the patient.

What is MCA Stenting?

The Middle Cerebral Artery (MCA) is one of the major blood vessels supplying the brain. Stenting is a minimally invasive procedure that involves placing a small tube called a stent inside the narrowed artery to restore proper blood flow.

Unlike traditional brain surgery, MCA stenting doesn’t require opening the skull (craniotomy). Instead, thin wires and catheters, as small as a strand of hair, are inserted through a blood vessel in the thigh. These wires are guided all the way to the narrowed brain artery, where the stent is placed to open up the blocked area.

Procedure Overview

The patient was taken to the catheterization (Cath) lab for the procedure. A right femoral puncture was made to insert the guide wires and a micro-catheter. Using these tools, the team successfully reached the right MCA and placed a 2.25mm x 8mm stent in the brain vessel. The patient tolerated the procedure well, with no complications during or after the stenting.

Stenting
Brain Stroke

Post-Operative Results and Recovery

A post-operative CT scan showed no signs of bleeding or stroke. The patient experienced no complications and was able to walk the next day. He was discharged two days later, in good condition.

Stenting

Understanding Transient Ischemic Attacks (TIA)

A Transient Ischemic Attack (TIA), also called a mini-stroke, is a temporary blockage of blood flow to the brain. Unlike a major stroke, the symptoms of a TIA usually resolve within 24 hours. However, it is crucial to identify the underlying cause, as a TIA is often a warning sign of a more serious stroke.

Symptoms of TIA

ㆍWeakness in the face or limbs, typically on one side
ㆍDifficulty speaking or understanding speech
Dizziness or loss of balance
Temporary vision disturbances
Numbness or tingling sensations

CT scan

Diagnosing TIA

A variety of diagnostic tools are used to confirm a TIA and identify the cause:

ㆍDuplex scan
ㆍCT scan of the brain
MRI of the brain
MRA angiogram
Echocardiogram (ECHO)
Perfusion brain scan
DSA (Digital Subtraction Angiogram)

Importance of Early Detection and Treatment

TIAs are a critical warning sign, predicting a higher risk of a major stroke. Studies show that about 15% of people who experience a TIA will suffer a major stroke within three months. The risk increases to 30-40% within one year if left untreated. Therefore, prompt diagnosis and treatment are essential to prevent a future stroke.

CT scan

Preventive Treatments for Stroke

Several interventional procedures are available to prevent strokes in high-risk individuals, such as those who have experienced a TIA:

ㆍMCA Stenting: This is the procedure that was performed in this case to treat severe stenosis and restore blood flow to the brain.

ㆍCarotid Artery Stenting: This procedure is used to treat blockages in the carotid arteries in the neck, which supply blood to the brain.

ㆍMechanical Thrombectomy: This is an emergency treatment used to remove large blood clots during an acute stroke.

These minimally invasive procedures can dramatically reduce the risk of a major stroke, especially in patients with a history of TIA.

Conclusion

In this case, the timely diagnosis of MCA stenosis and the successful MCA stenting procedure helped prevent a major stroke for the 46-year-old patient. With the growing availability of advanced interventional treatments, it is possible to reduce the risk of life-threatening strokes in patients with conditions like TIA.

For those at risk, early medical intervention can make all the difference in ensuring a full recovery. If you experience symptoms of a mini-stroke, it’s essential to seek medical attention promptly.

This surgery was performed, Consultant Neurosurgeon specializing in brain and spine surgery.

Advanced MCA Stenting in Bangalore

“Minimally invasive pin-hole brain surgery can save lives after stroke. Consult Dr. Ganesh Veerabhadraiah at Neurowellness today.”

FAQs

1. What is MCA stenting?

MCA stenting is a minimally invasive brain procedure to open narrowed arteries and restore blood flow after a stroke.

2. Is MCA stenting safe?

Yes, when performed by skilled neurosurgeons, MCA stenting is a safe and effective way to prevent further strokes.

3. How long is recovery after MCA stenting?

Most patients recover within a few days in the hospital and can resume normal activities within weeks.

4. Who needs MCA stenting?

Patients with blocked middle cerebral arteries at high risk of stroke are recommended for MCA stenting.

5. Where can I get MCA stenting in Bangalore?

Neurowellness Brain & Spine Clinic offers advanced MCA stenting with minimally invasive techniques.

About Author

Dr. Ganesh Veerabhadraiah

Dr. Ganesh Veerabhadraiah, leading neurosurgeon and neurologist in Bangalore, has over 20 years of expertise in managing back pain, migraines, headaches, neuro disorders, and spine problems. His clinical excellence and patient-first approach make him one of the most trusted neuro doctors in Bangalore.

At Neurowellness Brain & Spine Clinic in Jayanagar and Kavery Hospital Electronic City, Dr. Ganesh provides comprehensive treatments ranging from minimally invasive spine surgery to advanced neurological care. As a respected back pain specialist and migraine doctor, he continues to deliver reliable outcomes for patients.

👉 Connect with Dr. Ganesh on LinkedIn

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