Most Advanced Treatment of various types of Brain and Neurological Disorders

The main line of treatment is with antiepileptic drugs, which are effective in controlling seizures in 70%-80% of patients with epilepsy. There are several antiepileptic medications. Since certain medications are much better for some seizures, the choice of the medication should be made by a physician who is familiar with these medications. If possible, the child should be evaluated in a center specializing in epilepsy. If this is not feasible, usually pediatric neurologists have training in epileptic disorders and are a good source for a referral.

When antiepileptic drugs fail to control the seizures, the patients may improve with surgical procedures.

Who is a candidate for epilepsy surgery?

Surgery is indicated in a small group of children.

It usually takes the failure of two or three antiepileptic medications before a child would be considered as a potential candidate for surgery. In general, this happens at least after two or three years of continuous treatment with medications. The failure might be due:

1.   to a resistance to the antiepileptic medications that are available,

2.   to the presence of intolerable side effects to the antiepileptic medication,

3.   or to a combination of both.

Since surgical procedures might be very effective in some children, once it is clear that the child's epileptic disorder is not responding to treatment with antiepileptic medications, surgery should be considered. Young age is not a contraindication for surgery, and there is no benefit in waiting for the child to be older. In fact, there is considerable evidence that the younger a child is at the time of surgery, the better his/her potential will be for good function after the surgery. There is a certain degree of plasticity in the brain that helps with the recovery of functions that can be damaged at the time of surgery. This plasticity is higher in younger than in older children.

Advanced Epilepsy Treatment Options Available at World Best Hospital in India

Best Neurosurgery Hospital in India | Neurosurgeon India : Stroke Patient from Nigeria

Till the time a person develops a second seizure, treatment for epilepsy will not begin. This is due to the reason that a person may have one seizure and never develops a second seizure. Medicines are successful in treating epilepsy. These medicines do not cure epilepsy, they prevent recurring of the seizures. These medicines changes the chemical or electrical transmissions in the brain in a particle way that decreases the chance of a seizure.

Vagus Nerve Stimulation (VNS) :

VNS therapy is recommended when medicines are unable to control epilepsy. During the surgical procedure, an electrical device is implanted underneath the skin. The lead of this device is wrapped around one of the nerves on the neck’s left side. This nerve is called as vagus nerve. This device continuously passes an electric dose to the nerve in order to stimulate it. This process reduces the severity and frequency of the seizures. If a person is feeling a warning seizure symptom then extra stimulation is given for preventing recurrence of the seizure.

Ketogenic Diet :  This is also considered as one of the treatment for epilepsy. Ketogenic diet is recommended for children as it involves eating a diet which is low in proteins and carbohydrates and high in fats. The chemical balance of the brain can be altered that also reduces the chance of having seizures. Ketogenic diet is not meant for adults as the diet can result in any other serious medical condition like heart disease, high blood pressure or strokes.

Advanced Surgical Procedures for Management of Epilepsy

Depending on the particular clinical situation, one of the following surgical procedures is chosen by the Medical team at our affiliate hospital. These operations either aim to resect the disease area of the brain, to disconnect it from other areas so as to relieve the seizures, or to lessen their impact.

• Anteromedial Temporal Lobectomy
• Selective Amygdalohippocampectomy
• Electrocorticography guided Resections
• Multiple Subpial transections
• Quadrantic Resections
• Multilobar Resections
• Functional Hemispherotomy
• Vagal Nerve stimulation
• Radiosurgery (selected cases)
  

  Services offered at our Network Hospitals for the treatment of various types of Brain and Neurological Disorders

  • Highly advanced surgeries for the patients with Vascular Malformations, Cerebral Aneurysms, Complex Craniofacial Malignancies andAcoustic Tumours
  • Diagnosis and Treatment of Cancerous Brain Tumours with complete range of treatment options that include surgery, radiosurgery , radiation therapy, chemotherapy and other cancer treatments
  • Deep Brain Stimulation ( DBS) for patients with Parkinson's Disease and tremors from other neurological conditions
  • Paediatric neurologists and neurosurgeons who specialize in the surgical management of a wide range of paediatric diseases including brain tumours, epilepsy, spinal bifida and hydrocephalus
  • Minimally Invasive Brian Surgeriesusing the most sophisticated 3-D image-guided technology
  
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Parkinson's Disease - Symptoms, Diagnosis, Treatment of Parkinson Disease in India

Parkinson's disease is a chronic, degenerative neurological disorder that affects one in 100 people over age 60. While the average age at onset is 60, some people are diagnosed at 40 or younger. There is no objective test, or biomarker, for Parkinson's disease, so the rate of misdiagnosis can be relatively high, especially when the diagnosis is made by a non-specialist. Estimates of the number of people living with the disease therefore vary, but recent research indicates that at least one million people in the United States, and more than five million worldwide, have Parkinson's disease.

Parkinson's disease was first characterized extensively by an English doctor, James Parkinson, in 1817. Today, we understand Parkinson's disease to be a disorder of the central nervous system that results from the loss of cells in various parts of the brain, including a region called the substantia nigra. The substantia nigra cells produce dopamine, a chemical messenger responsible for transmitting signals within the brain that allow for coordination of movement. Loss of dopamine causes neurons to fire without normal control, leaving patients less able to direct or control their movement. Parkinson's disease is one of several diseases categorized by clinicians as movement disorders.

The exact cause of Parkinson's disease is unknown, although research points to a combination of genetic and environmental factors. If a continuum existed, with exclusively genetic causes at one end and exclusively environmental causes at the other, different Parkinson’s patients would likely fall at many different places along that continuum.

In the past 10 years, researchers have identified a number of rare instances where Parkinson's disease appears to be caused by a single genetic mutation. In these cases, the mutated gene is passed from generation to generation, resulting in a great number of Parkinson's disease cases within an extended family. On the opposite end of the continuum, in the early 1980s, a group of heroin users in California took drugs from a batch contaminated with a substance called MPTP. After ingesting this chemical, the drug users were stricken with a form of Parkinson's disease that was primarily, if not exclusively, "environmental" in origin.

For most Parkinson's patients, the cause lies somewhere in the middle. While many Parkinson’s patients report one or more family members with the disease, it is not always clear that one or several genes are the cause. Similarly, while some patients suspect that exposure to one or another chemical or environmental toxin caused their Parkinson’s disease, this also cannot be conclusively proved. Scientists currently believe that in the majority of cases, genetic and environmental factors interact to cause Parkinson's disease. Research into this subject continues aggressively every day. Unfortunately, however, it is generally impossible to determine what specifically caused an individual's Parkinson’s disease.

The causes of Parkinson’s disease are unknown, there is no scientifically validated preventive course to reduce the risk of its onset. The single biggest risk factor for Parkinson’s disease is advancing age. Men have a somewhat higher risk than women.

That being said, a number of studies have highlighted factors that are associated with either greater or lesser risk of Parkinson's disease. For example, smoking and caffeine consumption have been associated with lower rates of Parkinson's disease, while head injury and pesticide exposure have been associated with higher risk. While such studies do not definitively link these factors with Parkinson's disease one way or another, they highlight areas where further research may guide us to risk-prevention or treatment strategies.

The cardinal symptoms of Parkinson's disease are resting tremor, slowness of movement (bradykinesia) and rigidity. Many people also experience balance problems (postural instability). These symptoms, which often appear gradually and with increasing severity over time, are usually what first bring patients to a neurologist for help. Typically, symptoms begin on one side of the body and migrate over time to the other side.

There is no objective test (such as a blood test, brain scan or EEG) to make a definitive diagnosis of Parkinson’s disease. Instead, a doctor takes a careful medical history and performs a thorough neurological examination, looking in particular for two or more of the cardinal signs to be present. Frequently, the doctor will also look for responsiveness to Parkinson's disease medications as further evidence that Parkinson's is the correct diagnosis. (However, starting on medication right away can limit your ability to participate in clinical trials that urgently need newly-diagnosed Parkinson’s patients.)

Deep Brain Stimulation, Parkinson Surgery, Tremor, Dystonia, OCD Treatment at World's Best Hospital in India

Indian doctors with training in brain conditions (neurologists), brain surgeons (neurosurgeons), doctors with training in mental conditions (psychiatrists), pain specialists, specialized programming nurses and other specialists use an integrated team approach to treating people who have deep brain stimulation. Indian specialists have successfully used deep brain stimulation to treat hundreds of people who have essential tremor, Parkinson's disease and dystonia. Recently, doctors have used DBS to treat people who have cluster headaches, Tourette syndrome, epilepsy and chronic pain that hasn't responded to other treatment.

Neuro specialists in India use computer-assisted brain surgery, intraoperative MRI and awake brain surgery during deep brain stimulation.

Indian Neurologists are ranked among the Best surgeons for neurology and neurosurgery worldwide. Because the brain can shift slightly during surgery, there is the possibility that the electrodes can become displaced or dislodged. This may cause more profound complications such as personality changes, but electrode misplacement is relatively easy to identify using CT.

After 2–4 weeks, there is a follow-up to remove sutures, turn on the neurostimulator and program it.

What is Deep Brain Stimulation ?

Deep brain stimulation surgery technique involves implanting electrodes inside the deep nuclei of brain called as subthalamus under local anesthesia. These electrodes are then connected to IPG (Pacemaker) implanted underneath the skin below the clavicle through the connecting leads under general anesthesia. To perform any kind of activity, the patient has to switch on the device with the help of a patient programmer. This stimulates the deep brain nuclei, which results in improvement of all the symptoms of Parkinson disease.

With the progress of disease the parameters of stimulation are changed over a period of time so that patients can remain symptom free for long period. The patient himself can change the stimulation parameters with the help of patient programmer. Normally the life of the pacemaker is five years and after that a new pacemaker replaces it. The electrodes remain in position for life long.Rechargeble Pace makers are now available that can be recharged at home.The life of these pace makers are 15-20 years.The stimulation of subthalamic nucleus through this device leads to improvement in all the symptoms of advanced Parkinson disease.

DBS uses a surgically implanted medical device, similar to a cardiac pacemaker, to deliver electrical stimulation to precisely targeted areas within the brain. Stimulation of these areas blocks the signals that cause the disabling motor symptoms of Parkinson's disease. The electrical stimulation can be noninvasively adjusted to maximize treatment benefits. As a result, many individuals may achieve greater control over their body movements.

DBS System consists of three implanted components :

• »
• Lead – A lead consists of four thin coiled insulated wires with four electrodes at the lead tip. The lead is implanted in the brain.
• »
• Extension – An extension connects to the lead and is threaded under the skin from the head, down the neck and into the upper chest.
• »
• Neurostimulator – The neurostimulator connects to the extension. This small, sealed device, similar to a cardiac pacemaker, contains a battery and electronics. The neurostimulator is usually implanted beneath the skin in the chest below the collarbone (depending on the patient, a surgeon may implant the neurostimulator in the abdomen). Sometimes called a "brain pacemaker," it produces the electrical pulses needed for stimulation. These electrical pulses are delivered through the extension and lead to the targeted areas in the brain. The pulses can be adjusted wirelessly to check or change the neurostimulator settings.

The doctor may advise few antibiotics to prevent infection. The patient may need to visit the doctor several times after the surgery to adjust the stimulation with the help of programming. The doctor may prescribe a detailed medication plan to the patient. The patient should take some precautions after the surgery and follow the instructions given by the doctors. He/she should take care of the incisions and the surgical region on the head, by keeping it dry and covered. Heavy physical activities and lifting heavy weights should be avoided for few weeks after the surgery. Regular follow-up with the treating doctor should be done.

Deep Brain Stimulation Surgery Advantage:

• »
• In this surgery we do not injure the brain so it is relatively risk free.
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• Completely reversible and programmable
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• Parkinson medications are reduced which results in improvement of drug related side effects.
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• There is improvement of quality of life in both off and on stage of the disease.

What are the different types of surgery for Parkinson's disease? - Parkinson Surgery, Tremor, Dystonia, OCD Treatment at World Best Hospital in India

When should one consider surgical therapy? 
 
For patients with early Parkinson's disease, levodopa (sinemet) and other antiparkinsonian medications are usually effective for maintaining a good quality of life. As the disorder progresses, however, medications can produce disabling side effects. Many patients on long-term levodopa develop troublesome dyskinesias, excessive movements that often cause the limbs and body to writhe or jump. In addition, their dose of levodopa no longer lasts as long as it once did. This may lead to "on-off fluctuations," a condition in which the ability to move changes unpredictably between a mobile ("on"), state when medication seem to work, and an immobile ("off") state in which little effect of medication is apparent and normal movement is very difficult. When patients no longer have an acceptable quality of life due to these shortcomings of medical therapy, surgical treatment should be considered. 
 
What are the different types of surgery for Parkinson's disease? 
 
There are several different types of surgery for Parkinson's disease. The first surgical procedures developed were the ablative, or brain lesioning, procedures. Examples of lesioning surgery include thalamotomy and pallidotomy. Lesioning surgery involves the precisely controlled destruction, using a heat probe, of a small region of brain tissue that is abnormally active. It produces a permanent effect on the brain. In general, it is not safe to perform lesioning on both sides of the brain. 
 We continue to perform some lesioning surgeries for patients who desire it, although in our practice lesioning has been largely replaced by deep brain stimulation (DBS). DBS surgery involves placing a thin metal electrode (about the diameter of a piece of spaghetti) into one of several possible brain targets and attaching it to a computerized pulse generator, which is implanted under the skin in the chest (much like a heart pacemaker). All parts of the stimulator system are internal; there are no wires coming out through the skin. To achieve maximal relief of symptoms, the stimulation can be adjusted during a routine office visit by a physician or nurse using a programming computer held next to the skin over the pulse generator. Unlike lesioning, DBS does not destroy brain tissue. Instead, it reversibly alters the abnormal function of the brain tissue in the region of the stimulating electrode.

 
Many patients inquire about the "restorative" therapies, a category of procedures which includes transplantation of fetal cells or stem cells, growth factor infusion, or gene therapy. These procedures attempt to correct the basic chemical defect of Parkinson's disease by increasing the production of dopamine in the brain. In the future, restorative therapies will hopefully emerge as effective and possibly curative interventions for Parkinson's disease. Growth factor therapy for Parkinson’s disease (using brain injection of modified viruses to deliver the growth factor) is an experimental therapy recently studied in a phase II clinical trial at UCSF and seven other centers. 
 
What are the possible brain targets for DBS?
 
There are now four possible target sites in the brain that may be selected for placement of stimulating electrodes: the internal segment of the globus pallidus (GPi), the subthalamic nucleus (STN), the pedunculopontine nucleus (PPN), and a subdivision of the thalamus referred to as Vim (ventro-intermediate nucleus). These structures are small clusters of nerve cells that play critical roles in the control of movement. Thalamic (Vim) stimulation is only effective for tremor, not for the other symptoms of PD. Stimulation of the globus pallidus or subthalamic nucleus, in contrast, may benefit not only tremor but also other parkinsonian symptoms such as rigidity (muscle stiffness), bradykinesia (slow movement), gait problems, and dyskinesias.

How does DBS work? 
 
DBS does not act directly on dopamine producing cells and does not affect brain dopamine levels. Instead, it compensates for one of the major secondary effects of dopamine loss, the excessive and abnormally patterned electrical discharge in the GPi or the STN. The exact mechanism by which the constant frequency stimulation pulse affects nearby brain cells has not been determined. 
 
How is the surgery performed?
 
There are several available surgical methods. In the most common method, implantation of the brain electrode is performed with the patient awake, using only local anesthetic and occasional sedation. The basic surgical method is called stereotaxis, a method useful for approaching deep brain targets though a small skull opening. For stereotactic surgery, a rigid frame is attached to the patient's head just before surgery, after the skin is anesthetized with local anesthetic. A brain imaging study (MRI or CT) is obtained with the frame in place. The images of the brain and frame are used to calculate the position of the desired brain target and guide instruments to that target with minimal trauma to the brain. After frame placement, MRI/CT, and calculation of the target coordinates on a computer, the patient is taken to the operating room. At that point an intravenous sedative is given, a Foley catheter is placed in the bladder, the stereotactic frame is rigidly fixed to the operating table, a patch of hair on top of the head is shaved, and the scalp is washed. After giving local anesthetic to the scalp to make it completely numb, an incision is made on top of the head behind the hairline and a small opening (1.5 centimeters, about the size of a nickel) is made in the skull. At this point, all intravenous sedatives are turned off so that the patient becomes fully awake. 
 
To maximize the precision of the surgery, we employ a "brain mapping" procedure in which fine microelectrodes are used to record brain cell activity in the region of the intended target to confirm that it is correct, or to make very fine adjustments of 1 or 2 millimeters in the intended brain target if the initial target is not exactly correct. The brain mapping produces no sensation for the patients, but the patient must be calm, cooperative, and silent during the mapping or else the procedure must be stopped. The brain's electrical signals are played on an audio monitor so that the surgical team can hear the signals and assess their pattern. The electronic equipment is fairly noisy, and the members of the surgical team often discuss the signals being obtained so as to be sure to interpret them correctly. Since each person's brain is different, the time it takes for the mapping varies from about 30 minutes to up to 2 hours for each side of the brain. The neurological status of the patient (such as strength, vision, and improvement of motor function) is monitored frequently during the operation, by the surgeon or by the neurologist. 
 
When the correct target site is confirmed with the microelectrode, the permanent DBS electrode is inserted and tested for about 20 minutes. The testing does not focus on relief of parkinsonian signs but rather on unwanted stimulation-induced side effects. This is because the beneficial effects of stimulation may take hours or days to develop, whereas any unwanted effects will be present immediately. For the testing, we deliberately turn the device up to a higher intensity than is normally used, in order to deliberately produce unwanted stimulation-induced side effects (such as tingling in the arm or leg, difficulty speaking, a pulling sensation in the tongue or face, or flashing lights). The sensations produced at high intensities of stimulation during this testing are experienced as strange but not painful. We thus confirm that the stimulation intensity needed to produce such effects is higher than the intensity normally used during long-term function of the device. 
 
Once the permanent DBS electrode is inserted and tested, intravenous sedation is resumed to make the patient sleepy, the electrode is anchored to the skull with a plastic cap, and the scalp is closed with sutures. The stereotactic headframe is removed. The patient then receives a general anesthetic to be completely asleep for the placement of the pulse generator in the chest and the tunneling of the connector wire between the brain electrode and the pulse generator unit. This part of the procedure takes about 40 minutes. 

Deep Brain Stimulation, Parkinson Surgery, Tremor, Dystonia, OCD Treatment at World Best Hospital in India

Indian doctors with training in brain conditions (neurologists), brain surgeons (neurosurgeons), doctors with training in mental conditions (psychiatrists), pain specialists, specialized programming nurses and other specialists use an integrated team approach to treating people who have deep brain stimulation. Indian specialists have successfully used deep brain stimulation to treat hundreds of people who have essential tremor, Parkinson's disease and dystonia. Recently, doctors have used DBS to treat people who have cluster headaches, Tourette syndrome, epilepsy and chronic pain that hasn't responded to other treatment.

Neuro specialists in India use computer-assisted brain surgery, intraoperative MRI and awake brain surgery during deep brain stimulation.

Indian Neurologists are ranked among the Best surgeons for neurology and neurosurgery worldwide. Because the brain can shift slightly during surgery, there is the possibility that the electrodes can become displaced or dislodged. This may cause more profound complications such as personality changes, but electrode misplacement is relatively easy to identify using CT.

After 2–4 weeks, there is a follow-up to remove sutures, turn on the neurostimulator and program it.

For more information visit:          http://www.medworldindia.com       
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Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors.

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Indian hospitals to offer low-cost neurosurgery in India

Neurosurgery in India is a very good option for abroad patients seeking low cost and safe surgical treatment for the correction of their disorders. Medical tourism in India provides very good assistance to international patients for their comfortable treatment in India. For neurosurgery, patients must find surgeons who are appropriately trained. Another factor to consider is cost and reimbursement. And finally, patients need to be aware that like any new medical technology, this surgery carries with it a certain level of unknown technical risks. SinceNeurosurgery  in india it is still a relatively new procedure in India with a certain level of risks. The cost of Neurosurgery in India is very less compared to that of its cost in other developed countries. Most advanced surgery hospitals for Neurosurgery  in India are in most prominent cities of India.

The large number of neurosurgeries in India enables Indian hospitals to offer low-cost neurosurgery in India. Further, cost of neurosurgery in India is amongst the lowest in the world.

The neurosurgeries performed at hospitals in India include the following

• ·         Surgery of the Skull Base
• ·         Micro Vascular Surgery
• ·         Brain Surgery for Epilepsy
• ·         Interventional Neuroradiology
• ·         Neurological Endoscopy
• ·         Non-Invasive Stereotactic Radiosurgery
• ·         Craniotomy
• ·         Surgery for DBS (Deep Brain Stimulation)
• ·         Spine Decompression Surgery
• ·         Spine Decompression with Fusion
• ·         Laminectomy
• ·         Spine Disc Replacement
• ·         Scoliosis Surgery
• ·         Endoscopic Discectomy
• ·         Spina Bifida

Neurosurgeons in India gravitate towards super specialisation in focus areas such as interventional neuroradiology, skull base surgeries, paediatric neurosurgery, etc. Unlike in the past when orthopaedic surgeons used to perform some spine surgeries, spine surgeries are now performed at leading hospitals in India exclusively by surgeons specially trained in spine surgery.

Success rates of Neurosurgery in India very often exceed international standards. Further, neurosurgery cost in India, is amongst the lowest in the world.

Cost of Neurosurgery in India

The cost of neurosurgery in India is truly economical. Some examples:

·         Neurosurgery cost in India for the removal of Pituitary Gland Tumour : Cost of Neurosurgery in India for the excision of pituitary tumour will involve an expenditure of US dollars three thousand to six thousand. The comparable cost of neurosurgery in the USA would be approximately 5 times as much.

·         Neurosurgery cost in India for Lumbar Spine Fusion: Cost of Neurosurgery in India for this procedure will be approximately US dollars 5000. The comparable cost of neurosurgery in the USA would be US dollars 20,000 at least

·         

Neurosurgery cost in India for spine decompression: Cost of Neurosurgery in India for this procedure would be between US dollars 6000; the cost of neurosurgery in the USA would be at least four times as much

Leading neurosurgery hospitals in India rank amongst the finest in the world. They combine the best of human resources in terms of highly qualified neurosurgeons, neurologists, interventional radiologists, interventional neuroradiologists and the best of material resources in terms of hospital infrastructure and medical equipment.

Why should you choose to get Neurology & Endovascular Neurosurgery in India?

Neurosurgery in India's top hospitals is extremely successful on account of the world class operation theatres and cutting edge technology that is available to neurosurgeons in India. For example:

·        

Indian doctors are known all over the world for their skill and knowledge and have the experience of studying and working at the best neuron surgery hospitals in the world.

·         Most advanced Technology Infrastructure - Blood Bank with 24 hour apharesis facility, advanced laboratory and microbiology (infection control) support, advanced cardiology, DSA and interventional radiology, portable and colour ultra-sonology, Liver Fibro-scan, 64 slice CT scanner, 3 T MRI, PET-CT and nephrology (including 24 hour dialysis and CVVHD).

·         Neurosurgery Hospitals in India are equipped with the latest and high end technology.

·         Cost of epilepsy surgery in India at best brain surgery hospitals in India is very low as compared to the cost at best hospitals in America or UK with the same level of care and services.

Treatment of brain and spine disorders are becoming less invasive with the advent of better imaging and interventional technologies. Interventional neuroradiologists in India now offer a wide range of minimally invasive neurosurgeries through angioplasty, placement of stents, treatment of vascular tumors, large aneurysm, embolization for resolution of arteriovenous malformations, etc

Rehabilitation care at hospitals for neurosurgery in India:

In the aftermath of complex neurosurgery, several patients will require intense physical and neuro rehabilitation. Leading hospitals for neurosurgery in Indiahave specialised equipment as well as rehabilitation specialists. Rehabilitation post neurosurgery is targeted in the following areas:

• ·        Functional Therapy
• ·         Mobility of Patients
• ·         Enhanced Movement Therapy
  
  
  
  

  
  

  
  

  
  

  
  

  
  

  For more information visit:          http://www.medworldindia.com      
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Tips for Your Best Stroke Recovery : Rehabilitation is a crucial component of care following a stroke

Survivors have an increased risk for long-term disability and face challenges completing daily activities.

Rehabilitation is a crucial component of care following a stroke. At top stroke centers some form of rehabilitation begins virtually immediately after a patient is admitted to the hospital — to get them on the right path to the best possible outcomes.

However, there are several things patients can do to ensure they are maximizing their recovery starting the second they suspect a stroke. Here are 10 tips:

1. Seek urgent care immediately.

It is absolutely critical to seek emergent care when a stroke is suspected. Patients who arrive at the emergency department within 3 hours of their first symptoms tend to have less disability months after a stroke than those who received delayed care.  A stroke alert prompts a team of experts from our center to come to a patient’s bedside within minutes to confirm or rule out a stroke, allowing treatment and rehabilitation to begin as soon as possible.

If you’re worried about clogging the emergency room or just want to wait things out, you could be delaying life-saving care.

2. Keep your medical information handy.

A stroke can affect parts of the brain responsible for cognition and communication, leaving a patient unable to tell a doctor their medical history. That can be worrisome, because some stroke treatments can’t’ be given with other medications.

I urge people to carry with them a patient health profile that lists their medical conditions and any medications they’re taking. This piece of paper carried in your wallet might contain vital information that doctors can use to ensure you’re on your way to an optimal recovery.

3. Choose a top care center for your rehabilitation.

Whenever possible, you want a patient to be involved in acute inpatient rehabilitation following a stroke. Data suggest the more acute, intensive rehabilitation you get after a stroke, the better the outcomes.

4. Eat well.

A healthy and consistent diet is crucial when recovering from a stroke, from the hospital bed to your outpatient care at home.

One reason food choice is important is because patients in early stages of recovery may experience weakness or incoordination of the swallowing muscles. A care team might recommend soft foods or thicker liquids, because swallowing problems can lead to fluid aspiration which might lead to pneumonia.

Also, certain medications may interact with certain foods, so a rehabilitation specialist can direct you to the best choices.

5. Compliance is key.

I tell my patients if you don’t remember anything in the weeks you’ve been here as an inpatient, the one thing I want you to remember is to see your primary care doctor for regular follow-ups and checkups. Your primary care doctor is essential to your recovery from a stroke, and can make sure your medication needs and health issues are being attended to properly.

Some people may be in denial after a stroke and instead avoid their doctors. But poor compliance with physicians and medications may have got them into these health problems in the first place.

6. Exercise, but within your limits.

Safe levels of physical activity as prescribed by a physical or occupational therapist can go a long way when rehabilitating from a stroke.

What’s important though is you don’t overdo it. People may be excited by improvements in their ability to exercise, but falls are a very real risk following a stroke. That’s why it’s important to stick to your prescribed routine.

7. Limit stress.

I urge patients to keep their lives as stress-free as possible after a stroke. This is not meant to imply that leading a stressed life in some way contributed to their stroke in the first place, but keeping your life more balanced without undue psychological pressures is associated with better outcomes.

8. Stay positive.

It’s very common to have a negative attitude after a serious illness, and some patients experience depression after a stroke — sometimes weeks or months later. However, it is absolutely critical to keep a realistic or positive attitude during rehabilitation to maximize results. Psychologists, psychiatrists and other therapists, who are part of your care team, may recommend therapy and/or medication.

9. Do your homework.

For every stroke patient, treatment at a rehabilitation center eventually comes to an end. When you continue onto the outpatient setting, it is essential you do any homework — otherwise known as a home exercise program — assigned to you by one of your rehabilitation care specialists.

I can’t tell you how many times a patient comes back with a family member or partner to report they’re not getting better, only for a loved one to point out they’re not following their assignments.

It’s never fun to have a stroke or disabling illness, but even if it feels like it’s a grind, do whatever you can to stay up-to-date with your homework.

10. Stay vigilant.

Patients following a stroke face an increased risk of second stroke compared with the general population. Your brain helps you recover from a stroke by asking the unaffected brain regions to do double duty, which means a second stroke can cause far more dangerous effects.

If heaven forbid something gets worse again or you suspect you’re having another stroke, seek out medical attention immediately.