Stroke Treatment Guide: The Golden Hour Rule, Risk Factors

Every minute of a stroke kills brain cells and the first 60 minutes decide recovery!
The Golden Hour in stroke management began in trauma care and the stroke teams use this term to push speed. It means the first 60 minutes after symptoms begin. Treatment within this window is most effective by maximizing the chance to restore blood flow and save threatened brain tissue.

Many patients still qualify after the first hour for up to 4.5 hours for clot-busting medicine and 6-24 hours for clot removal. In short, stroke is a brain attack. It happens due to a blocked artery or bleeding in the brain that needs urgent treatment. Seconds matter because a saved brain means saved speech, movement and memory. At PSRI Hospital, our 24×7 pathway, rapid imaging and trained team make those seconds count.

Read on to see exactly what to do, what raises risk and how treatment works.

Golden Hour in Stroke Management: Operational Pathway

Here is exactly what to do and what will happen, step by step.

Step 1: Spot the Warning Signs

• Use FAST Assessment, face droop, arm weakness, speech trouble and time to act.
• Note the exact time the person was last normal. This “last-known-well” time guides treatment.

 

Step 2: Call an Ambulance, Not a Car

• Dial the PSRI local emergency number +91 84 84 84 84 17.
• The ambulance team starts checks on the way and alerts our hospital so we are ready when you arrive.

 

Step 3: On Arrival: Go Straight for CT Scan

• We move you directly to a CT scan. This shows if it is a clot or a bleed.
• If a large clot is suspected we may add a dye CT (angiography) or blood-flow scans (perfusion).
• An MRI may be done when it changes the decision. Special MRI pictures like DWI help us see fresh injuries.

 

Step 4: Decide and Treat Within Minutes

• If scans show a clot we give a clot-busting injection when you are eligible.
• If a large artery is blocked we may do a mechanical thrombectomy to remove the clot through a thin tube.
• If scans show a bleed we lower blood pressure, reverse blood thinners if needed and call neurosurgery early.
• Do not take aspirin before the scan. Aspirin can worsen a bleed.

 

Step 5: The Time Goals We Work Toward

• Door-to-CT: Start the CT scan within minutes of reaching the hospital.
• Door-to-needle: Give clot-busting medicine within 60 minutes. We aim for 30-45 minutes.
• Door-to-groin: Start thrombectomy as soon as you qualify without delay.

 

Step 6: If a Transfer Is Needed

• When a transfer to a thrombectomy suite is required we keep door-in-door-out time short so no minute is lost.

 

Bottom line: Call an ambulance, come now and let us scan first. Fast imaging leads to the right treatment at the right time.

What Are the Risk Factors of Brain Stroke

Clinical Risks You Can Change

• Hypertension and High Blood Pressure Management.
• High Blood Sugar Levels.
• High Blood Fat and High Cholesterol.
• Obesity Risk Assessment using Waist-to-Hip Ratio.
• Smoking and Tobacco Use.

 

Heart and Vessel Drivers

• Irregular or Abnormal Heartbeats.
• Cardiac Disease, Heart Conditions, hardening of blood vessels.
• Clogged or Narrowed Arteries due to cholesterol buildup.
• Blockage in Neck Arteries that supply blood to the brain.
• Blockage in heart arteries that can cause chest pain or heart attack.
• Heart valve problems that affect blood flow inside the heart.
• A small hole in the heart that didn’t close after birth.
• Infection of the inner lining.

 

Lifestyle And Mind-Body Factors

• Physically inactive lifestyle.
• Unhealthy Food Patterns.
• Alcohol Consumption and Frequent Drinking.
• Harmful or Addictive Drug Use.
• Sleep Disorders.
• Psychosocial Stress, Depression and Mental Health Issues.

 

Risks You Cannot Change (Still Worth Screening)

• Health risks that increase with age.
• Differences in health risks for men and women.
• Health risks linked to your background or community.
• Illnesses that run in your family.
• Inherited tendency to develop certain diseases
• Age-Related Risk, Gender/Sex Risk Stratification, Race/Ethnicity Classification.
• Family History Documentation, Genetic Predisposition, Genetic Risk Assessment.

 

If one or more points apply to you, book a stroke-risk review today at PSRI, best neuro hospital in Delhi. Small changes now prevent big problems later.

Treatment of Stroke

Step-by-step view of how treatment works:

Rule One: Scan First, Then Treat

• Treatment depends on what the scan shows.
• We do a CT scan first to tell the clot from bleeding.
• This single step protects you and guides every next move.

 

If Scans Show A Clot

1) Clot-Busting Injection

• We give a fast IV medicine that dissolves the clot.
• It may be tPA (Tissue Plasminogen Activator) or single-bolus tenecteplase (tNK).
• This is reperfusion therapy which reopens the blocked artery and restores flow.
• We check the time since symptoms began and your scan pattern.
• This timing check is our treatment window analysis. It helps include the right patients, fast and safely.

 

2) Clot Removal Procedure (Mechanical Thrombectomy).

• If a large artery is blocked we remove the clot through a thin tube from the groin or wrist.
• This is called mechanical thrombectomy and is an endovascular intervention.
• The step is blood clot extraction under imaging guidance.
• Many patients benefit up to 6 hours after onset.
• With the right scan pattern selected patients benefit even 6-24 hours after onset.

 

If Scans Show A Bleed (Hemorrhagic Stroke)

• We lower blood pressure quickly and safely.
• If you are on blood thinners we reverse their effect when needed.
• A neurosurgeon or interventional specialist decides if repair or pressure relief is required.
• In the ICU we focus on neuroprotection: stable oxygen, sugar, temperature and fluids.

 

Medicines Around The Acute Phase

• Antiplatelet therapy (for example, aspirin) starts only after a scan excludes a bleed.
• Anticoagulation therapy (blood thinners) is used when there is a rhythm or valve problem, such as atrial fibrillation, at the right time and dose.
• Every plan is individual with safety-first.

 

If You Arrive Late: Do Not Lose Hope

• You may still qualify for clot-busting injection up to 4.5 hours if you meet safety rules.
• You may qualify for mechanical thrombectomy up to 6-24 hours if scans show brain tissue we can still save.
• Come in immediately. The scan will tell us what else is possible.

 

Safety Checks We Do Before Any Treatment

• Confirm clot vs bleed on imaging.
• Review blood pressure, sugars, medicines and allergies.
• Check for recent surgery, bleeding risks or other red flags.
• These checks make treatment both fast and safe.

 

Bottom line: Scan first, decide fast and treat what the scan shows. That is how we save the brain and help in recovery.

After the Emergency: Recovery, Prevention and Relapse Protection

In the ICU/Stroke Unit

• We check swallow, speech and movement as soon as you are stable.
• We prevent fever, high sugar and infections.
• We set your medicine plan and explain it to your family.

 

Early Rehabilitation

• Physiotherapy starts with safe moves, then standing and walking.
• Occupational Therapy helps with daily tasks like dressing and bathing.
• Speech Therapy supports speech, language and safe swallowing.

 

Your 90-Day Plan

• Blood Pressure, Sugar and Cholesterol: Keep them in target with medicines and follow-ups.
• Heart Rhythm Checks: Screen for atrial fibrillation (AF) when advised.
• Right Medicines: Antiplatelet or anticoagulant as your doctor prescribes.
• Habits: Quit tobacco, limit alcohol, eat balanced meals, sleep 7–8 hours and move daily.
• Mind and Mood: Manage stress, seek help for low mood or anxiety.

 

Why PSRI Hospital Is the Best Hospital in Delhi for Golden-Hour Stroke Care

Speed That Saves

• Direct-to-CT on arrival so we know clot or bleed in minutes.
• Door-to-needle for clot-busting medicine within 60 minutes, we aim for 30-45.
• Door-to-groin for thrombectomy without delay when you qualify.

 

One Team, One Plan

• Emergency doctors, stroke neurologists, CT scan and radiology, pharmacy, interventional neuroradiology, anesthesia, ICU and rehab work together.
• You meet a single, coordinated plan from emergency to recovery.

 

Complete Imaging on Site

• Non-contrast CT scan, CT-angiography, perfusion scans, MRI and DWI are available round the clock.
• The right scan guides the right treatment at the right time.

 

Clear Protocols That Hold

• Stroke center checklists keep steps parallel, not slow and serial.
• Clean handovers and fast transfers protect every minute if another suite is needed.

 

Note on Our Digital Edge

• Your electronic records help us see allergies, medicines and past illnesses instantly.
• Our systems pull key details from reports and scans so doctors decide faster and document clearly.
• The result is no delay, safe treatment and strong follow-up.

 

Bottom line: PSRI Hospital combines speed, a trained team, full imaging and reliable processes. That is why many families trust us as the best hospital in Delhi for time-critical stroke care.

Reach PSRI Emergency Department Immediately for Expert Stroke Care

The golden hour in stroke management is a signal to start fast, not a deadline to stop care. If you notice stroke signs, visit us as soon as possible . Let us scan, decide and act. At PSRI Hospital, a 24×7 team, on-site CT/MRI and clear stroke protocols help you get the right treatment immediately.

Take Your Next Step Now

• Emergency: Suspect stroke? Call PSRI Hospital Emergency now. Do not drive yourself.
• Prevention: Worried about risk? Book a PSRI stroke-risk screening today at the best neuro hospital in Delhi.

 

FAQs

1. What Should I Do In The First Five Minutes?

Ans. Call EMS. Note the last-known-well time. Keep the person NPO. Bring a medicine list. We will take you straight to CT.

 

2. Can I Still Be Treated If I Woke Up With Symptoms Or Crossed One Hour?
Ans. Yes, Scans may show tissue we can still save. 

 

3. Is CT Scan Enough Or Do I Need MRI?
Ans. CT comes first to rule out bleeding fast. MRI and perfusion scans are added when they change treatment.

 

4. Should I Give Aspirin At Home?
Ans. Do not start aspirin until a scan excludes a bleed.

 

5. How Soon Does Rehab Start?
Ans. Rehab starts in the hospital. Most patients begin safe movement, swallow care and speech practice early, then continue as an outpatient.