EMERGENCY:If someone is having a stroke RIGHT NOW: Face drooping, Arm weakness, Speech problems, Time to call —call040-46324365immediately — 24 hours, 7 days— 24/7
Ischemic Stroke: A Brain Emergency — The Faster the Treatment, the More Brain Is Saved
Ischemic stroke occurs when a blood clot blocks a vessel supplying the brain, cutting off oxygen and causing rapid brain cell death. Immediate treatment with clot-busting thrombolysis or mechanical thrombectomy can significantly reduce disability and save life. At KIMS Neuroscience, Hyderabad, 24/7 stroke emergency care ensures rapid diagnosis and treatment within the critical time window.
An ischemic stroke occurs when a blood clot blocks an artery supplying the brain, cutting off oxygen and glucose to downstream neurons. Every minute of untreated ischemic stroke kills approximately 1.9 million brain cells. It is the most common type of stroke, accounting for 70–80% of all strokes in India. Two time-critical treatments reverse the damage: IV thrombolysis (alteplase) within 4.5 hours, and mechanical thrombectomy (surgical clot removal) up to 24 hours in selected patients. Both are available 24 hours a day at KIMS Neuroscience Hyderabad. Call 040-46324365 immediately. Do not wait.
- What it is
- Blocked brain artery cuts off blood supply. Brain cells die at 1.9 million per minute. Immediate treatment is essential.
- Recognise FAST
- F — Face drooping · A — Arm weakness (one arm drifts) · S — Speech slurred or confused · T — Time: call 040-46324365 immediately if any one sign is present.
- Treatment Window 1
- IV thrombolysis (alteplase or tenecteplase) — within 4.5 hours of symptom onset. Best outcomes if given within 90 minutes.
- Treatment Window 2
- Mechanical thrombectomy — stent retriever removes the clot directly. Up to 24 hours in selected patients. 24/7 at KIMS.
- India-specific fact
- 24% of Indian stroke patients are under 50. Stroke incidence has risen >100% in India over 40 years. Working-age adults in Hyderabad are at significant risk.
- After stroke
- Every stroke patient at KIMS has cause-finding investigation before discharge and leaves with a secondary prevention plan. The first stroke is the warning. Preventing the second is the goal.
- Emergency
- 040-46324365 immediately (24/7) · Do not give aspirin first · Do not wait to see if symptoms improve
| Fact | Details |
|---|---|
| What it is | Blocked brain artery (arterial thrombosis or embolism) — 70–80% of all strokes in India |
| Time is brain | 1.9 million brain cells die per minute untreated · Brain loses 3.6 years of normal ageing per hour without treatment |
| IV Thrombolysis | Alteplase or tenecteplase (tPA variants) · Given within 4.5 hours of onset · Available 24/7 at KIMS · Best outcomes within 90 minutes · Tenecteplase: single IV bolus, preferred when thrombectomy follows |
| Mechanical Thrombectomy | Stent retriever removes clot from blocked major artery · Up to 24 hours in selected patients · Biplane neurointerventional suite at KIMS, 24/7 |
| Young Indian adults | 24% of Indian stroke patients under 50 · Extended investigation protocol at KIMS for all patients under 50 |
| Secondary prevention | Dual antiplatelet therapy (duration by mechanism: short-course for minor stroke/TIA; up to 90 days for large artery atherosclerosis/ICAD) · Anticoagulation for AF · BP target <130/80 · High-intensity statin · Carotid endarterectomy if stenosis found |
| Emergency | 040-46324365 · 24/7 · Stroke team activates on call before patient arrives |
A blocked blood vessel cutting off blood supply to part of the brain
YES — call 040-46324365 immediately. Every minute counts.
IV thrombolysis (alteplase or tenecteplase) within 4.5 hours of symptom onset Mechanical thrombectomy up to 24 hours in selected patients
Blood clot blocking a brain artery from the heart from a carotid artery or forming in the artery itself
Anyone with hypertension diabetes or tobacco use and 1 in 4 Indian stroke patients is under 50
040 46324365
About This Condition
What Is an Ischemic Stroke?
An ischemic stroke happens when a blood vessel supplying the brain becomes blocked. Blood and with it oxygen and glucose cannot reach the brain cells downstream of the blockage. Without a blood supply brain cells begin to die. The longer the blockage continues the more brain tissue is permanently lost.
Time is the most critical factor in stroke. Every minute of untreated ischemic stroke approximately 1.9 million brain cells die. Every hour without treatment the brain loses the equivalent of 3.6 years of normal ageing. This is not a figure to contemplate at leisure. It is the reason why stroke is treated as the most time critical emergency in all of neurology and why the emergency number 04046324365 at KIMS Neuroscience Hyderabad must be called the moment stroke symptoms are recognised.
Ischemic strokes account for 70 to 80 percent of all strokes in India they are by far the most common type. The remaining strokes are haemorrhagic caused by bleeding rather than blockage and are covered on our separate Haemorrhagic Stroke and Subarachnoid Haemorrhage pages.
India’s stroke burden is severe and worsening. Over the past four decades stroke incidence has fallen by 42 percent in high income countries while rising by more than 100 percent in low and middle income countries including India. And critically approximately 24 percent of stroke patients in India are under 50 years of age this is not a disease only of the elderly. Working age adults parents of young children and people in the peak of their productive lives are being struck down in Hyderabad and across Telangana every day.
At KIMS Neuroscience Secunderabad we provide 24 hour emergency stroke care including intravenous thrombolysis clot dissolving medication and mechanical thrombectomy surgical clot removal available every hour of every day. The stroke team is activated the moment a patient arrives.
Book Emergency Stroke Care
Stroke is a medical emergency. Contact our stroke team 24 hours a day.
040-46324365International enquiries: neuroscience@kimshospitals.comRecognise a Stroke — The FAST Signs
The single most important thing anyone can know about stroke is how to recognise it immediately.
F Face drooping
Ask the person to smile. Does one side of the face droop or appear uneven? Is there a facial asymmetry that was not there before? Facial weakness typically on one side is one of the most visible signs of stroke.
A Arm weakness
Ask the person to raise both arms to shoulder height and hold them there for 10 seconds. Does one arm drift downward or feel weak? Inability to raise one arm or weakness on one side of the body is a classic stroke sign.
S Speech problems
Ask the person to say a simple sentence The sky is blue today. Is the speech slurred? Are the words confused or jumbled? Is the person unable to speak or unable to understand what you are saying? Any sudden change in speech slurring word finding difficulty confusion is a stroke warning.
T Time to call
If any one of these three signs is present call emergency services immediately. In Hyderabad 04046324365 KIMS Neuroscience Emergency 24 hours.
Additional signs that can indicate stroke
• Sudden severe headache the worst headache of my life with no apparent cause this may indicate subarachnoid haemorrhage a different type of stroke covered separately
• Sudden vision loss or double vision in one or both eyes
• Sudden loss of balance or coordination
• Sudden numbness or tingling on one side of the face arm or leg
• Sudden confusion or difficulty understanding speech
What NOT to do if you suspect a stroke
• Do not wait to see if the symptoms improve they may temporarily a TIA but even if symptoms resolve the person has had a warning event and must be seen urgently
• Do not give food or water swallowing may be impaired after stroke and aspiration is a risk
• Do not drive to hospital unless there is genuinely no other option call emergency services and tell them stroke is suspected so the team can be ready
• Do not delay by searching the internet call first
What Causes Ischemic Stroke?
The blockage in an ischemic stroke is almost always a blood clot. Understanding where the clot came from guides both the immediate treatment and the long term prevention strategy.
Cardioembolic stroke clot from the heart
A blood clot forms in the heart typically in the left atrial appendage in patients with atrial fibrillation AF and travels through the circulation to the brain where it lodges in a cerebral artery. Atrial fibrillation is one of the most important preventable causes of stroke in India. A person with untreated AF has a 5 fold higher risk of stroke. When AF related stroke is diagnosed at KIMS the cardiology team is involved immediately because preventing the next stroke requires anticoagulation and managing the AF.
Large artery atherosclerosis clot from a diseased artery
Fatty plaques build up inside the walls of large arteries the carotid arteries in the neck or the cerebral arteries within the skull. When a plaque ruptures a clot forms on its surface and either blocks the artery at that point or breaks off and travels to a smaller downstream artery. Hypertension diabetes and tobacco use are the dominant drivers. Carotid artery disease is the most important surgically treatable cause of stroke if significant narrowing is found in the carotid artery intervention carotid endarterectomy or stenting dramatically reduces future stroke risk.
Small vessel disease lacunar stroke
Small perforating arteries deep in the brain become diseased thickened narrowed and blocked due to long standing high blood pressure and diabetes. The resulting strokes are typically small but can cause significant disability depending on their location. Prevention is entirely through rigorous blood pressure and blood sugar control.
Cryptogenic stroke cause unclear
In approximately 25 to 30 percent of ischemic strokes no clear cause is found after standard investigation. This is called cryptogenic stroke. Further investigation including prolonged cardiac monitoring to detect intermittent AF patent foramen ovale PFO assessment and comprehensive haematological screening may reveal the cause in some of these patients.
Risk factors for ischemic stroke in India
The dominant risk factors differ somewhat from Western populations. Hypertension is the leading risk factor across all Indian stroke registries affecting 40 to 75 percent of first ever stroke patients. Diabetes tobacco use both smoking and chewing and poorly controlled lipids follow. In younger patients the 24 percent of Indian stroke patients under 50 additional causes including cardiac conditions hypercoagulable states blood clotting disorders and drug use must be investigated.
Treatment
Emergency Treatment The KIMS Stroke Protocol
When a patient arrives at KIMS Neuroscience with suspected ischemic stroke a pre established rapid response protocol activates immediately.
Step 1 Immediate assessment and imaging target within 25 minutes of arrival
CT brain scan performed immediately to confirm ischemic stroke and exclude haemorrhage critical thrombolytic medication cannot be given if there is bleeding. CT angiography maps the cerebral arteries to identify the site of the blockage and assess whether mechanical thrombectomy is possible. Blood tests glucose full blood count coagulation screen required before thrombolysis.
Step 2 IV Thrombolysis clot dissolving medication
Alteplase (tissue plasminogen activator, tPA) and tenecteplase (TNK, a modified tPA given as a single IV bolus) are the two thrombolytic agents used at KIMS to dissolve the clot causing stroke. Tenecteplase at 0.25 mg/kg (maximum 25mg) IV bolus is particularly advantageous when mechanical thrombectomy follows, enabling faster transfer to the interventional suite. It is the most time critical treatment in all emergency medicine.
The window: IV thrombolysis must be given within 4.5 hours of symptom onset. Patients who can receive it within 90 minutes of symptom onset have the best outcomes. Every 15 minute delay in giving thrombolysis reduces the chance of a good outcome by a meaningful margin.
The benefit: For every 100 patients who receive tPA within the window approximately 10 to 15 additional patients achieve independence who would otherwise have remained dependent.
Who can receive it: Patients within the 4.5 hour window with ischemic stroke confirmed on CT without contraindications recent surgery bleeding disorder or haemorrhage on imaging. The decision is made immediately by the stroke team at KIMS.
At KIMS thrombolysis is available 24 hours a day 7 days a week. There is no time of day or night at which it is unavailable.
Step 3 Mechanical Thrombectomy surgical clot removal
For strokes caused by blockage of a large artery the middle cerebral artery the internal carotid artery the basilar artery mechanical thrombectomy is the most powerful treatment available. A microcatheter is guided through the femoral artery in the groin through the aorta and into the blocked cerebral artery. A stent retriever device is deployed to capture and remove the clot restoring blood flow. When performed by an experienced cerebrovascular neurosurgeon in the right time window the results can be extraordinary patients who arrived unable to move one side of their body or unable to speak walk out of hospital days later.
The window: Up to 6 hours from symptom onset in standard cases. Up to 24 hours in selected patients with imaging showing a large area of at risk but not yet infarcted brain tissue perfusion mismatch imaging.
The outcomes: In major clinical trials mechanical thrombectomy approximately doubled the rate of functional independence at 3 months compared to medical treatment alone for large vessel occlusion strokes.
At KIMS Neuroscience The KIMS Neuroscience cerebrovascular team perform mechanical thrombectomy with a biplane neurointerventional suite available around the clock. This capability available continuously in Secunderabad is what differentiates a comprehensive stroke centre from a facility that can only provide thrombolysis.
Step 4 Stroke Unit Care
After acute treatment patients are managed in the KIMS Neuro ICU and Stroke Unit. Continuous cardiac monitoring detects atrial fibrillation. Blood pressure glucose and temperature are optimised. Early physiotherapy speech therapy and swallowing assessment begin within 24 to 48 hours of admission. Every patient has a cause finding investigation before discharge.
Investigations After Stroke at KIMS
Understanding why the stroke happened is not optional. It is the foundation of preventing the next one.
Every patient admitted to KIMS Neuroscience after ischemic stroke receives:
Brain imaging
MRI brain with DWI diffusion weighted imaging the most sensitive test for identifying the area of infarction even in the first hours. MRA or CT angiography of the cerebral and carotid arteries to identify large vessel disease dissection or occlusion.
Cardiac assessment
12 lead ECG on admission. 24 hour or 72 hour Holter monitoring to detect intermittent atrial fibrillation. Echocardiogram to look for cardiac sources of clot left atrial thrombus patent foramen ovale valvular disease reduced ejection fraction.
Carotid artery assessment
Carotid Doppler ultrasound to measure the degree of narrowing stenosis of the internal carotid arteries. CT or MR angiography for detailed assessment. If significant stenosis is found carotid endarterectomy or carotid artery stenting is discussed urgently the first two weeks after a stroke or TIA are the highest risk period for a second often more severe stroke.
Blood tests
Fasting lipid profile and HbA1c. Full blood count and coagulation screen. In younger patients thrombophilia screen protein C protein S antithrombin III antiphospholipid antibodies homocysteine and vasculitis screen. Haemoglobin electrophoresis if sickle cell disease is a possibility.
Secondary Prevention Preventing the Next Stroke
The first stroke is a warning that the vascular system is vulnerable. Without systematic secondary prevention the risk of a recurrent stroke is highest in the first 90 days particularly the first week. Recurrent strokes are often more severe than the first.
Antiplatelet therapy
For non-cardioembolic ischaemic stroke, aspirin combined with clopidogrel (dual antiplatelet therapy) is used in the high-risk period following stroke or TIA, then single antiplatelet therapy long-term. The duration of dual antiplatelet therapy is determined by stroke mechanism. For minor ischaemic stroke and TIA, short-course dual antiplatelet therapy is used. For large artery atherosclerosis — including intracranial artery disease (ICAD) — dual antiplatelet therapy is continued for up to 90 days, following the evidence from the SAMMPRIS trial and subsequent studies demonstrating sustained benefit in this specific mechanism. KIMS individualises antiplatelet duration to the identified stroke mechanism.
Anticoagulation
For cardioembolic stroke caused by atrial fibrillation anticoagulation with a direct oral anticoagulant apixaban rivaroxaban or dabigatran or warfarin. This is among the most powerful secondary prevention interventions available reducing AF related stroke recurrence by approximately 64 percent.
Blood pressure control
Hypertension is the dominant modifiable risk factor. Target blood pressure after stroke below 130 by 80 mmHg. Achieving this consistently with medication and lifestyle change is the single most important long term intervention for most Indian stroke patients.
Lipid lowering therapy
High intensity statin therapy atorvastatin 40 to 80 mg reduces recurrent stroke risk in atherosclerotic stroke. Target LDL below 1.4 mmol per L 55 mg per dL for high risk patients.
Carotid intervention
If significant carotid artery stenosis 70 to 99 percent narrowing is found on the symptomatic side carotid endarterectomy surgical cleaning of the artery or carotid artery stenting is recommended urgently ideally within 2 weeks of the stroke or TIA. KIMS Neuroscience performs both procedures.
Lifestyle modification
Complete tobacco cessation this is non negotiable. Regular physical activity. Dietary modification particularly sodium reduction for blood pressure management. Diabetes management with target HbA1c below 7 percent.
Stroke Rehabilitation at KIMS
Recovery from stroke is an active process not a passive one. The brain has the capacity to reorganise to reroute functions around the damaged area through a process called neuroplasticity. This reorganisation is maximised by early intensive goal directed rehabilitation. The first few months after stroke are the period of greatest neuroplasticity and therefore the most important time for rehabilitation input.
At KIMS Neuroscience the rehabilitation programme begins within 24 to 48 hours of stroke onset and is tailored to each patient's deficits
Physiotherapy
Restoring mobility strength and coordination. Early mobilisation getting patients sitting standing and walking as soon as safely possible significantly improves functional outcomes. Balance training and falls prevention.
Occupational therapy
Retraining the practical skills of daily living dressing eating washing writing. Adaptive equipment and home modification recommendations. Return to work planning for working age patients.
Speech and language therapy
Assessment of swallowing safety aspiration pneumonia is a leading cause of death after stroke. Communication rehabilitation for patients with dysphasia language impairment or dysarthria speech impairment.
Neuropsychology
Post stroke depression occurs in approximately 30 percent of stroke survivors and is one of the strongest predictors of poor long term recovery. Cognitive rehabilitation for post stroke cognitive impairment.
Repetitive Transcranial Magnetic Stimulation (rTMS) — now available at KIMS
KIMS Neuroscience now offers repetitive Transcranial Magnetic Stimulation (rTMS) as part of the post-stroke rehabilitation programme — a non-invasive brain stimulation technique that directly targets the neuroplasticity mechanisms underlying stroke recovery. rTMS uses brief, targeted magnetic pulses delivered through a coil placed on the scalp to modulate the excitability of specific cortical areas, promoting the rewiring of brain circuits disrupted by stroke.
For motor recovery: Following stroke, the motor cortex of the affected hemisphere is often underactive, while the contralesional (unaffected) hemisphere can become relatively overactive and actually inhibits recovery. High-frequency rTMS applied to the affected motor cortex increases its excitability and promotes motor learning. Low-frequency (inhibitory) rTMS applied to the contralesional motor cortex reduces its inhibitory influence on the affected hemisphere. Both approaches, used alongside physiotherapy and occupational therapy, have been shown in multiple randomised trials and meta-analyses to enhance upper limb motor recovery beyond what physiotherapy alone achieves.
For post-stroke aphasia: Language recovery after stroke is driven by reorganisation of language circuits, often involving recruitment of right-hemisphere language-capable regions. Low-frequency (inhibitory) rTMS targeting Broca's area homologue in the right hemisphere has demonstrated improvements in naming accuracy and language fluency in patients with post-stroke aphasia, when combined with speech and language therapy.
How rTMS is delivered at KIMS: The rTMS course consists of multiple sessions (typically 10–20) delivered in the outpatient or rehabilitation setting. Each session lasts approximately 20–30 minutes. rTMS is delivered alongside — and timed to enhance — physiotherapy and speech therapy sessions on the same day. It is non-invasive, does not require sedation or anaesthesia, and is well-tolerated by most stroke patients.
Who is eligible: rTMS for stroke rehabilitation is considered for patients with residual upper limb motor impairment or aphasia after stroke who have not achieved a functional plateau with conventional rehabilitation alone. It is most effective in the sub-acute to chronic stages of stroke recovery (weeks to months after stroke). Eligibility assessment is performed by the KIMS stroke neurology team. Contraindications include implanted metal devices in or near the head, cochlear implants, pacemakers, and active epilepsy.
If you or a family member has residual weakness, hand impairment, or language difficulty after a stroke and you want to explore whether rTMS is an option at KIMS, call 040-44885000 to arrange a post-stroke rehabilitation assessment. No referral required.
Stroke in Young Adults A Growing Crisis in India
One in four stroke patients in India is under 50. Many are in their 30s and 40s with young children active careers and decades of productive life ahead. This is not a small clinical footnote. It is one of the most important public health realities in India today.
The causes of stroke in younger patients differ from the elderly. Alongside conventional risk factors hypertension diabetes tobacco young stroke patients require investigation for cardioembolic causes patent foramen ovale arterial dissection a tear in the arterial wall sometimes triggered by head or neck movement hypercoagulable states drug use migrainous infarction and rare vasculitic conditions.
At KIMS Neuroscience every young stroke patient under 50 receives an extended investigation protocol that goes beyond the standard assessment because finding the cause in young patients is both more achievable and more consequential for decades of prevention ahead.
Related Conditions
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FAQs
Frequently Asked Questions
EMERGENCY:if someone is having a stroke RIGHT NOW —call040-46324365immediately — 24 hours, 7 days— 24/7
Stroke doesn't wait — and neither do we.
KIMS Neuroscience provides Hyderabad's most comprehensive 24-hour stroke service emergency thrombolysis, mechanical thrombectomy, dedicated Neuro ICU, and a complete secondary prevention programme. If you have had a stroke or TIA, if a family member is at risk, or if you want a stroke risk assessment we are available.
neuroscience@kimshospitals.com