BE-FAST adds two critical early signs: sudden loss of Balance and sudden Eye/vision changes — both frequently missed in traditional FAST guidance. Any sudden neurological symptom = possible stroke = call 0422-2222222 immediately.
Complete Stroke Care at KG Hospital
From the moment an acute stroke patient arrives at KG Hospital to discharge and rehabilitation, every element of stroke care is available in-house — no transfers, no delays.
Mechanical thrombectomy is the most effective treatment for large vessel occlusion (LVO) ischaemic stroke — the most devastating subtype, where a large brain artery is completely blocked. A thin catheter is guided from the femoral artery (groin) through the aorta and into the blocked brain artery. The clot is removed using a stent retriever (which grabs and pulls the clot) or aspiration (which vacuums it out), restoring blood flow to the ischaemic brain territory.
The evidence is transformative: thrombectomy reduces severe disability by up to 50% in LVO stroke patients treated within the window. KG Hospital performs mechanical thrombectomy via the Biplanar Neuro Cath Lab (Siemens) — dual-plane cerebral angiography providing the highest-resolution real-time imaging of brain vessels during the procedure. This is available 24 hours a day, 7 days a week.
- Every 1 minute of untreated LVO stroke = 1.9 million neurons lost
- Every 1 hour of untreated LVO stroke = 120 million neurons lost (equivalent to 3.6 years of normal ageing)
- Thrombectomy up to 24 hours after onset in eligible patients with salvageable brain tissue (CT perfusion guided)
- KG Hospital Biplanar Cath Lab: 24/7 — no wait for a weekday or daylight hours
Intravenous thrombolysis (tPA — tissue plasminogen activator) is a clot-dissolving medication given through a vein within 4.5 hours of ischaemic stroke symptom onset in eligible patients. It works by activating plasminogen to form plasmin, which breaks down the fibrin clot blocking the brain artery. Alteplase (0.9 mg/kg IV) and the newer, simpler bolus agent Tenecteplase are both available at KG Hospital.
Door-to-needle time (the time from hospital arrival to tPA administration) is one of the most critical quality metrics in stroke care. Every 15-minute reduction in door-to-needle time produces meaningfully better outcomes. KG Hospital’s Code Stroke protocol is activated the moment a stroke patient calls or arrives — the stroke team, CT scan, and pharmacy are all mobilised simultaneously to minimise delays.
Haemorrhagic stroke accounts for approximately 15% of all strokes but causes disproportionate mortality and disability. It occurs when a blood vessel in or around the brain ruptures. The two main types are intracerebral haemorrhage (ICH) — bleeding directly into the brain tissue — and subarachnoid haemorrhage (SAH) — bleeding into the space surrounding the brain, most commonly from a ruptured aneurysm.
SAH characteristically presents with a sudden, severe “thunderclap” headache — patients describe it as the worst headache of their life, reaching maximum intensity within seconds. This is a neurosurgical emergency. KG Hospital’s integrated stroke-neurosurgery team manages both ICH and SAH, with the Biplanar Neuro Cath Lab available for endovascular aneurysm coiling and the neurosurgery theatre for open aneurysm clipping.
A TIA (transient ischaemic attack, “mini-stroke”) produces stroke symptoms that resolve completely — typically within minutes. It is critically important not to dismiss this as benign. A TIA is the brain’s final warning before a major stroke: 10–15% of TIA patients have a full stroke within 3 months, with the highest risk in the first 48–72 hours. Urgent evaluation and treatment dramatically reduces this risk.
KG Hospital evaluates all TIA patients urgently with brain MRI (DWI), carotid ultrasound or CT angiography, cardiac monitoring for atrial fibrillation (AF), and blood tests. The ABCD2 score guides admission vs outpatient management. AF-related TIA requires anticoagulation rather than antiplatelet therapy — making cardiac monitoring essential in every TIA.
Organised stroke unit care reduces stroke mortality and disability independent of thrombolysis or thrombectomy — making the Stroke Unit itself a treatment. KG Hospital’s dedicated Stroke Unit provides continuous cardiac and blood pressure monitoring, regular neurological assessment, and immediate availability of the stroke team for any deterioration. The adjacent dedicated Neuro ICU provides intensive care for patients with large infarcts, malignant MCA syndrome, post-thrombectomy care, and SAH management.
Multiple physiological parameters independently worsen stroke outcomes if uncontrolled: fever (each degree increases infarct size), hyperglycaemia (worsens penumbra injury), hypoxia (reduces oxygen delivery to ischaemic tissue), and hypotension (reduces cerebral perfusion pressure). The Stroke Unit’s systematic monitoring and treatment of these parameters is as important as the acute interventions.
The brain has remarkable plasticity — the ability to reorganise and form new neural connections in response to learning and experience. Stroke rehabilitation exploits this plasticity: structured, intensive therapy in the weeks and months after stroke drives the brain to reroute function around damaged areas. Early mobilisation (sitting up and walking within 24–48 hours where possible) is now established as beneficial, reducing complications and improving functional outcomes.
KG Hospital’s stroke rehabilitation begins in the Stroke Unit from day one. Physiotherapy, occupational therapy, and speech and language therapy are initiated before hospital discharge, with a structured outpatient rehabilitation programme available for continued recovery after discharge.
The Four Types of Stroke & Why They Matter
Stroke is not one condition — it is several. The treatment for each is different, which is why immediate CT imaging on arrival is essential before any treatment is given.
Ischaemic Stroke
A blood clot blocks a brain artery, cutting off blood supply to part of the brain. Treated with IV thrombolysis (within 4.5 hours) and/or mechanical thrombectomy for large vessel occlusion. Most preventable and most treatable type of stroke.
Haemorrhagic Stroke (ICH & SAH)
A blood vessel ruptures, bleeding into or around the brain. Intracerebral haemorrhage (ICH) usually from hypertension. Subarachnoid haemorrhage (SAH) usually from a ruptured aneurysm — presents as thunderclap headache. Treated with BP control, anticoagulation reversal, and neurosurgical intervention.
TIA (Transient Ischaemic Attack)
Stroke symptoms that resolve completely within 24 hours — usually within minutes. Do not ignore. 10–15% of TIA patients have a full stroke within 3 months — risk is highest in the first 48–72 hours. Urgent evaluation and treatment dramatically reduces this risk. Call 0422-2222222.
Stroke Mimics
Conditions that produce stroke-like symptoms but have different causes and treatments: severe migraine with aura, complex partial seizures (Todd’s palsy), hypoglycaemia, hypertensive encephalopathy, MS relapse, and brain tumour. CT brain and clinical assessment rapidly distinguish stroke from mimics.
