Stroke Accounts for 40% of NIMHANS Neurology Emergencies; Hubballi Link Brings Care Closer to Home

Stroke patients make up nearly 40% of those seeking emergency neurological care at the National Institute of Mental Health and Neurosciences (NIMHANS) in Bengaluru, with about 705 such cases reported every month. Of the roughly 1,700 patients who attend the institute's neurological casualty services each month, 705 are stroke patients, according to Girish B. Kulkarni, professor of Neurology and head of the stroke unit at NIMHANS.

To extend specialised stroke treatment to northern Karnataka, NIMHANS has adopted a hub-and-spoke model linking it with the Karnataka Institute of Medical Sciences and Research Institute (KMCRI) in Hubballi. Under the arrangement, NIMHANS serves as the central specialised centre while KMCRI develops its capacity to evaluate and treat acute stroke patients in the region. Teleconsultation and structured coordination between the two institutions allow doctors to assess patients and begin appropriate treatment without waiting for a transfer to Bengaluru.

The initiative is aimed at ensuring that patients receive prompt assessment and care closer to home, particularly during the critical first few hours after a stroke. KMCRI manages around 100 to 120 stroke patients a month under the collaborative model, with coordinated treatment protocols helping doctors make time-sensitive decisions. World Stroke Day is observed on October 29.

Dr. Kulkarni said early recognition of symptoms, rapid transportation to a hospital equipped to treat stroke, and timely treatment were essential to improving outcomes. "This year's theme, 'Every Minute Counts', highlights the importance of recognising stroke symptoms early and ensuring that patients reach hospitals that are equipped to provide appropriate treatment without delay," he said.

At NIMHANS, the institute administers intravenous thrombolysis to around five to eight patients and performs about five to nine endovascular thrombectomies every month. Amruth, professor and head of the Department of Neurology at KMCRI, said the Hubballi centre was managing an average of 100 to 120 stroke cases a month. "Through structured coordination and teleconsultation mechanisms with NIMHANS, patients arriving at our centre receive immediate medical management and targeted interventions," he said.

The model is particularly relevant for patients in northern Karnataka, for whom travelling to Bengaluru during a medical emergency can consume valuable time. Stroke treatment is highly time-sensitive, and delays in diagnosis and intervention can increase the risk of death or long-term disability.

The KMCRI spoke centre has begun evaluating stroke patients and providing intravenous thrombolysis. A dual-plane digital subtraction angiography (DSA) machine has also been installed at the centre, and endovascular thrombectomy services are expected to be introduced soon, Dr. Amruth said.

Thrombolysis involves administering clot-dissolving medication to eligible patients with an ischaemic stroke, which occurs when a blood vessel supplying the brain is blocked. Endovascular thrombectomy is a procedure in which doctors remove a clot from a blocked blood vessel using specialised equipment. Dr. Kulkarni said the choice of treatment depends on the type of stroke, imaging findings, the time since the onset of symptoms and the patient's clinical condition.

On public awareness, Dr. Kulkarni said it was the first step in reducing delays in stroke treatment. He said the acronym BE FAST can help people recognise the signs: B for sudden loss of balance, E for eye or vision disturbances, F for facial drooping, A for arm weakness and S for speech difficulties. The final letter, T, underscores the need to seek timely medical help and act immediately.

According to the doctors, the sudden onset of any of these symptoms should prompt immediate medical attention. Patients should not wait to see whether the symptoms improve, nor attempt to manage them at home. Reaching a hospital that can assess and treat stroke without delay remains the most important step, they said.