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New procedure to avoid brain damage in stroke patients introduced at AKUH

<p><span style="font-family: helvetica;">Patients suffering from stroke will now have less brain damage following the introduction of mechanical thrombectomy treatment, a new less invasive procedure that can remove a blood clot from the brain. The Aga Khan University Hospital in Nairobi is currently the only hospital offering this procedure in East and Central Africa. Strokes are a leading cause of long-lasting injury, disability, and death.  </span></p><p><span style="font-family: helvetica;">The technique allows the neurosurgeon to access the brain using a catheter inserted through the femoral artery in the groin to remove the clot. This is more effective in restoring blood flow to the brain than using blood thinner medication.</span></p><p><span style="font-family: helvetica;">Approximately 16,000 stroke cases occur each year in Kenya, of which 80 per cent are ischaemic. Most of these strokes are caused by a blockage in blood flow which causes lack of blood flow to portions of the brain causing damage to one, or more areas of the brain.</span></p><p><span style="font-family: helvetica;">Dr Edwin Mogere, a Neurosurgeon at Aga Khan University Hospital and the first Kenyan doctor to perform the procedure in the country, explained, &quot;When a patient has a blockage that interferes with blood flow to the brain, he is suffering from an ischaemic stroke as opposed to the hemorrhagic stroke where there is bleeding into the brain.&quot;</span></p><p><span style="font-family: helvetica;">&quot;Because blood is not flowing to the brain, the cells begin to die and depending on the area affected, a person may lose the ability to move one side of the body, to speak, to see normally, or a number of other body functions. A person&#39;s long term outcome depends upon how much the brain is damaged and how quickly treatment begins.&quot;</span></p><p><span style="font-family: helvetica;">&quot;For people who have an ischaemic stroke, the goal of treatment is to restore blood flow to the affected area of the brain as quickly as possible, which means within the first six hours after the stroke begins. The window for performing this procedure is 12 hours after which it will be of no benefit as the brain will have suffered irreversible damage&quot;</span></p><p><span style="font-family: helvetica;">&quot;The first six hours are crucial. If the patient is rushed to our hospital immediately after seeing the first symptoms of stroke, we are able to quickly determine the kind of stroke he is experiencing and decide if he can benefit from this procedure. Time is of essence because the faster the clot is removed, the sooner the patient can begin to recover normal brain functions.</span></p><p><span style="font-family: helvetica;">Emphasizing on the importance of acting quickly in the event of a stroke, Dr Mogere gives an example of a recent case of a 72 year old female patient who recently benefited from the procedure and is now recovering well.</span></p><p><span style="font-family: helvetica;">The lady woke up at 4.00 am to go to the toilet and returned to bed. But when her husband woke her up at 6.00 am, he noticed that she was unable to speak and was weak on the right side of her body. He suspected that she could have suffered a stroke between 4.00 am and 6.00 am and rushed her to the Aga Khan University Hospital&#39;s Accident and Emergency Unit.</span></p><p><span style="font-family: helvetica;">The ambulance arrived at 8.00 am and after a quick review she was taken for a CT scan which confirmed that she had a blockage in one of the large arteries in the brain. A CT Angiogram was also conducted to establish the location of the clot. In less than one hour after her arrival at the hospital, she was taken to the hospital&#39;s interventional suite (also known as Cathlab) and prepared for surgery.</span></p><p><span style="font-family: helvetica;">Explaining the procedure, Dr Mogere said, &quot;The procedure involves placing a sheath in the femoral artery in the groin through which a catheter is inserted. A special mesh is then pushed through the catheter then expanded to attach itself to the clot and the surgeon gently pulls out the clot. This takes about 30 to 45 minutes. An angiogram is carried out immediately to confirm that blood flow has been restored.&quot;</span></p><p><span style="font-family: helvetica;">&quot;Within hours of the removal of the clot, there was improvement as the right side of her body started recovering function. She was discharged after one week with medication and she is progressing well. She is now recovering her speech and is walking with a stick aid. We were able to stop further brain damage because we managed to perform the procedure within six hours of the initiation of the stroke. Many other patients are referred to us too late to benefit from this procedure.&quot;</span></p><p><span style="font-family: helvetica;">&quot;It is therefore very important to recognise stroke-related symptoms as quickly as possible to enable us time to save the patient. Common symptoms  include a sudden numbness, or weakness on any limb, facial drooping, difficulty in speaking, or understanding speech, sudden difficulty walking, dizziness, loss of balance, or coordination, trouble seeing with one or both eyes, severe headache and drowsiness.&quot;</span></p><p><span style="font-family: helvetica;">Dr Mogere concluded, &quot;This procedure if carried out within 12 hours at maximum, successfully restores functions to the affected areas and is cost-effective, with a shorter stay in hospital. If a patient suffers a stroke, do not waste time, they require immediate care in a hospital that can coordinate emergency services, with a neurologist, intensive care services, and brain and vascular imaging with CT, or MRI scans.&quot;</span></p>

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