Advances Stroke Prevention

MGM Healthcare takes a giant step in stroke prevention, having successfully performed about 100 brain bypass surgeries on adults who have experienced mild strokes or presented with early warning signs. The procedure has helped prevent ischemic strokes in about 95% of patients, marking a significant milestone in the hospital’s efforts to improve patient outcomes. A stroke is a medical emergency that occurs when brain cells begin to die due to an inadequate supply of oxygen and nutrients. It occurs when a blood vessel in the brain ruptures or blood flow to a part of the brain is interrupted. It can affect an individual’s movement, speech, vision, memory, and ability to perform day-to-day activities. Brain bypass surgery is recommended for a carefully selected group of patients with compromised blood flow to the brain due to major vessel blockages or inadequate collateral circulation. These patients undergo a comprehensive evaluation, including MRI-based cross-circulation assessment, perfusion studies, and a Diamox challenge test to assess the brain’s blood flow reserve. Surgery is considered only for patients who demonstrate a Type 3 response to the Diamox challenge, indicating severely impaired cerebrovascular reserve. These patients are at a higher risk of recurrent stroke despite medical management, making careful evaluation for surgical intervention essential. The surgical team at the hospital, headed by Dr. Roopesh Kumar, Director of Neurosurgery, has performed superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery on these patients. This procedure involves redirecting blood flow by connecting an artery from the scalp to a blood vessel inside the brain to restore blood flow. The surgery has been performed on patients ranging in age from 28 to 72 years, with majority of cases falling within the 40–60 age group. Patients are advised to undergo a brain MRI with perfusion imaging, along with angiography of the brain and neck, to assess cerebral blood flow and identify any abnormalities in the blood vessels if they experience symptoms such as slurred speech, weakness in the limbs, persistent headaches, and seizures. In his comments, Dr. Roopesh Kumar said, “When it comes to stroke, prevention can make all the difference. Brain bypass surgery has traditionally been performed in patients with Moyamoya disease, but its potential in preventing ischemic stroke in carefully selected high-risk patients is equally significant. The idea is to intervene before a stroke occurs, rather than wait for the brain to suffer irreversible damage. In our experience, more than 95% of patients who underwent this procedure remained stroke-free during the observed follow-up period. While earlier studies questioned the role of bypass surgery in stroke prevention, subsequent research, including studies from Japan, has renewed interest in its benefits for select patients. The key is to identify those at high risk, assess them thoroughly, and intervene at the right time. In stroke care, the right intervention at the right time can make a life-changing difference.”