Stroke is the second leading cause of death and a primary cause of long-term adult disability globally. In India, stroke affects approximately 1.8 million people annually, with the burden falling significantly on younger working-age adults compared to Western populations. The speed and quality of neurological care in the first hours after a stroke directly determines how much brain function is preserved and how fully a patient can recover. For international patients and their families seeking expert stroke management and post-stroke rehabilitation, the Institute of Neurosciences at SIMS Hospital, Chennai brings together a team of experienced neurologists, a neurovascular interventional specialist, and a rehabilitation infrastructure ranked among the top five neurosciences centres in India by both Times of India and India Today for seven consecutive years.
This guide explains what stroke treatment involves at every stage, introduces the neurologists at SIMS Hospital Chennai who lead this care, and covers what international patients can expect from stroke management and recovery.
Understanding Stroke: Why the Neurologist's Response in the First Hours Is Decisive
Stroke occurs when blood supply to part of the brain is interrupted, either by a blood clot blocking an artery (ischaemic stroke, 85 percent of cases) or by a blood vessel rupturing and bleeding into the brain (haemorrhagic stroke, 15 percent of cases). Brain cells begin dying within minutes of losing their blood supply. The window for effective intervention is measured in hours.
The Two Types and Their Treatment Pathways
Ischaemic stroke caused by a blood clot is treated by restoring blood flow as rapidly as possible. The two primary interventions are:
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IV thrombolysis (tPA): An intravenous clot-dissolving drug effective within 4.5 hours of symptom onset
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Mechanical thrombectomy: A catheter-based procedure that physically removes the clot from a large cerebral artery. Effective up to 24 hours from symptom onset in selected patients when advanced perfusion imaging confirms salvageable brain tissue
Haemorrhagic stroke caused by vessel rupture is managed by controlling bleeding, reducing intracranial pressure, reversing any anticoagulant medication, and in some cases performing neurosurgical evacuation of the haematoma or endovascular treatment of the underlying aneurysm or AVM.
What "Time Is Brain" Means Clinically
Every minute of delayed treatment in ischaemic stroke results in the death of approximately 1.9 million neurons. The phrase "time is brain" is not a slogan it quantifies the cost of delay in terms that directly translate into the disability a patient will carry for the rest of their life. A stroke centre with 24-hour CT imaging, rapid tPA protocol, and mechanical thrombectomy capability is the only appropriate destination for acute stroke management.
The Neurologists at SIMS Hospital Chennai: Who They Are and What They Manage
The Institute of Neurosciences at SIMS Hospital, Vadapalani, Chennai operates a multi-specialist neurology team that covers the full spectrum of stroke care from acute intervention through long-term rehabilitation and secondary prevention.
Dr. Rithesh R. Nair: Senior Consultant, Neurology and Neurovascular Interventional Specialist
Dr. Rithesh R. Nair is the neurovascular interventional specialist at the Institute of Neurosciences, with more than 23 years of clinical experience. He completed his MBBS at Calicut Medical College in 1998, MD in General Medicine at Coimbatore Medical College in 2002, and DM in Neurology at Bombay Hospital in 2008. He has performed over 1,000 neurological treatment procedures.
His specific clinical expertise covers neurovascular disorders including stroke management, aneurysm coiling, AVM embolisation, and movement disorders. For ischaemic stroke specifically, his interventional training positions him as the SIMS specialist for mechanical thrombectomy, the most time-sensitive and technically demanding acute stroke intervention available.
He is actively associated with the Indian Association of Neurology, Indian Medical Association, Calicut Neuro Society, Bangalore Neurological Society, and Karnataka Neurological Association.
For international patients who have suffered a large vessel occlusion stroke, Dr. Nair's neurovascular interventional training is the critical clinical capability that makes SIMS Hospital a genuine acute stroke centre rather than a stabilisation facility.
Dr. Prabash Prabhakaran: Senior Consultant Neurologist
Dr. Prabash Prabhakaran is a Senior Consultant Neurologist at SIMS Hospital Chennai with extensive experience in diagnosing and managing complex neurological disorders. He has specific expertise in stroke care, epilepsy, movement disorders, neuromuscular diseases, and comprehensive brain and nerve care for adults. Recognised as one of the best neurologists in Chennai, he is known for precise diagnosis, evidence-based treatment protocols, and a compassionate, patient-centred approach to long-term neurological care.
His breadth of expertise makes him the appropriate neurologist for patients whose stroke is associated with other neurological conditions including seizures, movement disorders, or neuromuscular complications, as well as for patients who present with recurrent strokes requiring comprehensive secondary prevention evaluation.
Dr. Vivek Iyer: Senior Consultant Neurologist
Dr. Vivek Iyer is a senior neurologist at SIMS Hospital with over 15 years of practice. He completed his MBBS at Maharashtra University of Health Sciences in 2007, MD in General Medicine in 2010, and DM in Neurology from KEM Hospital Mumbai in 2014, one of India's most prestigious neurology postgraduate programmes. He is actively associated with the Indian Association of Neurology, Indian Epilepsy Association, and Movement Disorder Society.
Dr. Iyer specialises in epilepsy and movement disorders alongside general neurology. His specific expertise in pre-surgical evaluation for refractory epilepsy and intraoperative electrocorticography positions him as the SIMS neurologist for patients with post-stroke epilepsy, a complication that affects five to fifteen percent of stroke survivors and requires expert management to prevent further neurological deterioration.
Dr. Shubha Subramanian: Senior Consultant Neurologist
Dr. Shubha Subramanian brings over 15 years of clinical expertise to the SIMS neurology team. She completed her MBBS at PSG Institute of Medical Sciences, Coimbatore, MD in General Medicine at Sree Balaji Medical College, Chennai, and DM in Neurology at Madras Medical College. She manages stroke, epilepsy, dementia, movement disorders, and neuromuscular diseases. She is skilled in lumbar puncture, EMG, EEG, and Botox injections, and is an active member of the SIMS Deep Brain Stimulation team.
As the founder of the neurology department at Dr. Rela Institute, she brings particular expertise in liver-related neurological complications, which is clinically relevant for stroke patients with concurrent hepatic disease or those on anticoagulation for hepatic conditions.
Her role in the DBS team reinforces the integrated nature of the SIMS neurology programme neurologists at SIMS Hospital Chennai are not siloed by subspecialty but participate in the full interdisciplinary clinical programme.
Stroke Treatment at SIMS Hospital: From Acute Intervention to Rehabilitation
The stroke pathway at the Institute of Neurosciences covers every phase of care, from the moment of acute presentation through the months of recovery.
Acute Phase: The First 24 Hours
On arrival with stroke symptoms, SIMS Hospital's stroke protocol activates a rapid assessment pathway including emergency CT brain imaging, CT angiography for vessel assessment, and perfusion imaging to identify salvageable brain tissue. This imaging is available 24 hours a day.
For eligible ischaemic stroke patients within 4.5 hours of symptom onset, IV tPA is administered immediately. For patients with large vessel occlusion (a blocked major cerebral artery), Dr. Rithesh R. Nair performs mechanical thrombectomy using catheter-based techniques to physically remove the clot and restore arterial blood flow. For haemorrhagic stroke patients with underlying aneurysms or AVMs, the same endovascular infrastructure used for elective neurovascular procedures, including coil embolisation and flow diversion, is available as emergency treatment.
For more on the endovascular capabilities at SIMS, read: No Open Surgery Required: Advanced Endovascular Options for Brain Aneurysms
Subacute Phase: Days Two to Fourteen
Once the acute intervention is complete and the patient is stabilised in the stroke unit, the focus shifts to:
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Identifying the underlying cause of the stroke (cardioembolic, large vessel atherosclerotic, small vessel disease, or cryptogenic)
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Initiating secondary prevention therapy appropriate to the stroke mechanism (antiplatelet agents, anticoagulation for atrial fibrillation, statin therapy, blood pressure control)
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Beginning early mobilisation with the physiotherapy team to reduce complications of immobility including DVT, pressure injuries, and pneumonia
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Initiating speech and language therapy for patients with aphasia or dysphagia
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Neuropsychological assessment for patients with cognitive changes
Rehabilitation Phase: Weeks to Months
Post-stroke rehabilitation at SIMS Hospital integrates physiotherapy, occupational therapy, speech therapy, and neuropsychological rehabilitation under the supervision of the neurology team. The rehabilitation programme is designed to maximise neurological recovery by taking advantage of neuroplasticity, the brain's ability to rewire function to surviving neurons in the months following stroke.
For international patients who return home after their acute care and subacute rehabilitation at SIMS, the team provides a written rehabilitation programme for continuation with a local physiotherapist and speech therapist at home, alongside clear neurological follow-up documentation for the patient's local neurologist.
Why International Patients Choose SIMS Hospital for Stroke Care
The Institute of Neurosciences at SIMS Hospital has been ranked among the Top 5 Neurosciences centres in India by Times of India and India Today for seven consecutive years, performing 900 or more neurosurgeries and neurological interventions annually. For international patients from Nigeria, Bangladesh, Kenya, the UAE, and South Asia, three specific factors make SIMS Hospital the practical choice.
Complete Neurovascular Capability Under One Roof
The combination of neurovascular interventional neurology (Dr. Rithesh R. Nair), comprehensive stroke neurology (Dr. Prabash Prabhakaran, Dr. Shubha Subramanian, Dr. Vivek Iyer), neurosurgery (Dr. K. R. Suresh Bapu and Dr. Vijay Sankaran), and dedicated neurorehabilitation means that every phase of stroke management and recovery is available within the same institutional programme. International patients do not need to transfer between facilities as care needs evolve.
Cost That Makes Access Realistic
Stroke treatment at SIMS Hospital costs significantly less than equivalent care in the USA, UK, or UAE. IV tPA administration costs a fraction of Western figures. Mechanical thrombectomy is available at India's private centres at approximately Rs. 3,00,000 to Rs. 6,00,000 (USD 3,600 to USD 7,200), compared to USD 20,000 to USD 50,000 in the USA. Inpatient stroke rehabilitation in India costs Rs. 50,000 to Rs. 1,50,000 per week (USD 600 to USD 1,800), versus USD 10,000 to USD 20,000 per week in Western rehabilitation centres.
How Karetrip Connects International Patients to SIMS Hospital's Neurology Team
For acute stroke, Karetrip's role is to ensure international patients who are stable post-acute reach the right continuing care and rehabilitation programme. For patients seeking post-stroke rehabilitation, second opinions on stroke aetiology, or evaluation of recurrent TIA, Karetrip coordinates the full patient journey including pre-travel neurological record review, consultation scheduling with the appropriate SIMS neurologist based on the clinical presentation, medical visa support, accommodation near SIMS Hospital in Vadapalani, and discharge documentation for neurological follow-up at home.
Chat with our Medical care assistant, RUA, for quick guidance and support and take the first step toward connecting with the neurologists at SIMS Hospital Chennai for expert stroke management and recovery care.
Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. Stroke is a medical emergency requiring immediate hospital treatment. If you or someone with you shows signs of stroke, call emergency services immediately.