As far as I know if you have a blood clot stroke and you are given clot busting drugs in the first four hours since the start of the stroke you will recover pretty well. A couple of questions. What if the Thai hospital does not have a CT or does not want to use it, will they still administer the clot busting drugs? Are the clot busting drugs SOP for stroke victims in Thailand? Any advice on getting ready to have a stroke in Thailand? I stopped drinking and smoking.

There are 2 types of stroke, one is due to a blot clot which deprives the affected part of the brain of oxygen, and the other is due to a blood vessel bursting causing hemorrhage in the brain.

The clot-busting drugs are only useful for the first type and would be very dangerous in the second as they would aggravate the bleeding. So the physician must know which type it is before making the decision to use these drugs. Also, as these drugs are contraindicated in people with histories of bleeding disoreder or on anti-coagulant medication, the physician must know the patient's medical history with reasonable certainty to safely administer the drugs. these limitations plus the 4 hour window are why this treatment is nto more often employed.

The drugs are available but not all hospitals have neurologists skilled in their use. Being sure to go to one that is and also having your medical history on file there (in case you are unable to speak) or that someone who would accompany you has that information readily at hand would be important.

Among the private hospitals, I know that Bangkok Hospital (Bangkok branch) does this and i would expect, but am not sure, that Bumrungrad and Samitivej also do. BH's neuro dept is quite good.

Among the govt hospitals, Chula or Siriraj and be sure to go in via the ER.

As for preventing a stroke:

- keep BP in normal range, if you have hypertension, make sure it is properly controlled.

-regular check-ups of your lipid profile and appropriate measures if LDL choledterol and/or triglycerides are elevated. Narrowing and hardening of the cerebral arteries predisposes to stroke from both causes.

-- seek prompt attention from a skilled neurologist if you develop, even very temporarily, such symptoms as loss of or impaired movement or sensation on one side of the body, slurred speech, temporary loss of consciousness etc. Sometimes full strokes are preceded by a series of transient ischemic attacks (TIAs, also known as "mini-strokes") and people sometimes make the mistake of not acting on them since they quickly resolve on their own.

Thanks for the information Shery.

I have had two episodes of blood clots-one to lungs and one to abdomen both caused by 20 hour flights from the U.S. In both cases Bumrungrad handled the emergency very effectively,about 6-8 days in hospital resolving clots.

Lefty