Wednesday, August 31, 2016

Alternative and Complimentary treatments for Stroke

Stroke is one of the leading causes of disability and death in India and across the world. Correct identification and treatment within the 'golden hour' using clot busting medicines and/or clot removal techniques can reverse or limit the disability caused by acute stroke. Stroke prevention focusses on life-style modification, healthy diet, exercise and elimination/control of risk factors.

A number of alternative therapies/treatments have been suggested in literature for prevention of stroke. However, there is NO EVIDENCE that any of these helps in the prevention or treatment of stroke.

Herbal Medicines for Stroke

1. Ginkgo Biloba (Marathi - Ginko, Jinko)

Ginkgo biloba is used both to prevent and treat stroke. It helps to prevent blood clots from developing and increases blood flow to the brain. This herb has also been shown to inhibit free-radical formation. Ginkgo is widely used in Europe to treat complications of stroke, including memory and balance problems, vertigo and disturbed thought processes. 

2. Garlic (Marathi/Hindi - Lasun)

Garlic helps prevent ischemic stroke in three ways:
  • Garlic reduces blood pressure
  • Garlic lowers cholesterol levels
  • Garlic is an anticoagulant.
Garlic is the best anti-clotting herb. It contains nine anticoagulant compounds. It is a major herb for heart attack prevention because of its blood-thinning effect and its ability to help control high blood pressure. These same effects also help prevent ischemic stroke

3. Ginger (Zingiber officinale) (Marathi - Ala; Hindi - Adrak)

Ginger is a cardiac tonic, as it decreases cholesterol and helps poor circulation. Ginger prevents blood from clotting excessively.

 4. Turmeric (Cucurma longa) (Marathi - Halad; Hindi - Haldi)

Many studies show that the compound curcumin, which is found in turmeric, helps prevent the formation of blood clots. 

5. Carrot (Marathi/Hindi - Gajar)

In a Harvard study of 87,245 female nurses, consumption of carrots (and to a lesser extent, spinach) significantly reduced stroke risk. Carrots are rich in beta-carotene and other carotenoids. Other studies show that people can reduce their risk of stroke by as much as 54 percent if they eat lots of fruits and veggies that are rich in beta-carotene and vitamins C and E.

6. Pigweed (Amaranthus) (Marathi - Cavaḷī; Hindi - Chaulaee)

A six-year Harvard study of more than 40,000 health professionals showed that compared with those who consumed the least calcium, those who got the most had just one-third the risk of succumbing to heart attack. Pigweed is an excellent plant source of calcium

7. Spinach (Marathi/Hindi - Paalak)

Studies at Tufts University in Boston and the University of Alabama in Birmingham have demonstrated that folate can help prevent both heart disease and stroke. Compared with people who consumed little folate, those who ingested the most were only half as likely to show narrowing of the carotid artery, the artery that leads to the brain.Spinach, cabbage, endive, asparagus, papaya, okra and pigweed have folate.

8. English pea (Pisum sativum), Scurfy pea (Psoralea corylifolia) (Marathi/Hindi - Matar)

Nearly all legumes contain genistein, a cancer-preventive nutrient. In addition to guarding against cancer, genistein also appears to have a significant anti-clotting effect. So, it may also help prevent ischemic stroke and heart attack.

9. Willow (Marathi - Bĕṭa; Hindi - Vilo)

Willow bark is herbal aspirin, and a low-dose aspirin has been shown in several studies to reduce the risk of ischemic stroke by about 18 percent. (Low-dose aspirin also cuts heart attack risk by about 40 percent in men and 25 percent in women.)

10. Pineapple (Marathi/Hindi- Anaanaas)

Pineapple contains an enzyme known as bromelain that is best known for its ability to break down proteins. It's a key ingredient in meat tenderizers. But bromelain also has an anti-clotting action that might help prevent ischemic stroke and heart attack.

11. Bilberry (Vaccinium myrtillus) (Marathi/Hindi - bBooberee)

Bilberries, blueberries and huckleberries contain compounds known as anthocyanidins. European studies show that these compounds help prevent blood clots and also break down plaque deposits lining the arteries. 

12. Evening primrose

Evening primrose oil is rich in gamma-linolenic acid (GLA), which has potent anti-clotting and blood pressure­lowering actions. It is believed to be useful in the prevention of stroke and heart disease. Borage oil is also rich in GLA.

13. Astragalus (Hindi - Kitara)

Astragalus improves tissue oxygenation.

14. Calamus (Marathi - Vēkhaṇḍa; Hindi - Bach)

Calamus helps restore brain tissue damaged by stroke.

15. Cayenne Pepper (Hindi/Marathi - Laal Mirch)

Cayenne pepper improves circulation and heart function without raising blood pressure. 

16. Green Tea

Green tea may act as one of the most potent free-radical scavengers to protect against the peroxidation of lipids, a contributing factor in atherosclerosis.

17. Hawthorn (Hindi/Marathi - Nagaphani)

Hawthorn has been reported to prevent or slow the progression of arteriosclerosis.

18. Horsetail (Hindi - Ashwa Pucchha)

The silica in horsetail maintains the elastic connective tissue of the arteries. It promotes arterial impermeability to harmful lipids, preventing deposits.

19. Kava kava (Marathi/Hindi -Kŏphī)

Kava kava helps to protect the brain against oxygen deprivation. Do not use kava kava if you are pregnant or nursing, if you have Parkinson's disease, or if you are taking a prescription medication for depression or anxiety.

20. Pine-bark and Grape-seed Extract

Pine-bark and grape-seed extract are high in proanthocyanidins (also known as OPCs) that increase the structural strength of weakened blood vessels. 

For more scientific information on each of these herbs, please refer to the official website of the National Center for Complementary and Integrative Health (

Saturday, August 6, 2016

Flow Diversion for Brain Aneurysms - Patient Guide

What is Flow Diversion?

It is a forma of treatment of brain aneurysms wherein a stent like device is placed in the portion of the artery from which the aneurysm arises. The flow diverter decreases the flow of blood within the aneurysm to the extent that the aneurysm is occluded.

How effective is Flow Diversion?

Results from many studies have shown that flow diversion is a safe and effective treatment for aneurysms, more so for unruptured aneurysms. Flow diversion removes the need to enter the aneurysm during surgery, which is the most dangerous part of endovascular treatment of aneurysms, according to medical experts. The risk of rupturing during surgery is greatly diminished by not placing a device inside the aneurysm.

What are the drawbacks of Flow Diversion treatment for brain aneurysms?

  1. The aneurysm does not close immediately, thus, there is a small risk of rupture until the aneurysm closes
  2. One has to be on blood thinner medications for 1-2 years or more
  3. The treatment is expensive in India (as compared to simple coiling or surgical clipping)

What questions should I ask my doctor if he/she recommends flow diversion to treat my brain aneurysm?

First of all, not all aneurysms can be treated by Flow Diversion treatment. Ans, there is a considerable number of aneurysms that can be treated by surgical clipping or simple coiling. Following factors need to be considered while choosing flow diversion treatment for an aneurysm

  1. Can the patient be on two blood thinners for 1-2 years (patients at risk of bleeding do not tolerate blood thinners well)
  2. Can the aneurysm be treated effectively by surgical clipping or simple coiling?
  3. Has the aneurysm ruptured or not?
What are the available Flow Diverting Devices in Indian market?
  1. Pipeline Embolization Device (eV3, Medtronic)
  2. Silk (Balt Extrusion, Montmorency, France)
  3. Surpass (Stryker)
  4. FRED (Microvention)