As neurological disorders steadily rise across all age groups, Bengaluru is showing the way forward. The Brain Super Speciality Hospital, founded by neurosurgeon Dr N K Venkatramana, is setting a new benchmark in the way brain, spine, and mind-related conditions are treated—through a deeply integrated and holistic approach.
Why BRAINS
The hospital, aptly named BRAINS (Bangalore Regenerative Advanced Institute of Neurosciences), was born out of a growing need to address complex neurological challenges that span beyond traditional diagnosis and surgery. With life expectancy increasing and lifestyle diseases on the rise, brain-related conditions have become more prevalent—not just among the elderly, but also among younger adults and children. The COVID-19 pandemic further accelerated this trend, bringing about a surge in strokes among the young, along with a notable increase in cases of brain fog, epilepsy, autoimmune disorders, and degenerative diseases.
In a healthcare landscape where few centres are exclusively devoted to brain health, Brain Super Speciality Hospital stands out by offering a one-stop destination for comprehensive neurological care. The institution consolidates advanced diagnostics, surgical intervention, rehabilitation, critical care, and long-term follow-up under one roof. The aim is not only to treat diseases but to preserve function, enhance quality of life, and address the broader emotional and psychological needs of patients and families.
The hospital’s strength lies in its multidisciplinary approach. Highly skilled consultants work in close collaboration across departments, leveraging advanced technology and personalised treatment plans to manage complex cases. From pre-hospital emergency care to rehabilitation and social support, every stage of a patient’s journey is mapped out with precision and compassion.
The facility also emphasises the often-overlooked importance of brain wellness. This includes promoting emotional health, stress reduction, and lifestyle changes as vital components in preventing neurological decline. Brain wellness is seen as a continuum—rooted in good sleep, balanced nutrition, regular exercise, and a calm, focused mind. The hospital encourages practices like pranayama and yoga to support circulation, reduce stress, and improve neurological resilience.
In an age where neurological disorders are becoming a leading cause of disability, the Brain Super Speciality Hospital presents a forward-thinking model—one that combines clinical excellence with a vision for long-term wellness. By prioritising not just treatment but awareness, education, and preventive care, it is helping redefine how society approaches brain health in the 21st century.
Dr N K Venkatramana states that Brain Super Speciality Hospital in Bengaluru addresses ailments related to the brain. He explains that the idea for establishing the hospital arose due to increasing life expectancy and a corresponding rise in brain-related problems associated with age and other factors. He notes a significant increase in brain disorders, affecting both children and adults.
He mentions that there are few centres entirely dedicated to the brain. He emphasises the need to consider both the functionality and dysfunction of the brain, an organ susceptible to injury and degeneration for various reasons. This led to the concept of bringing all necessary facilities under one roof, offering integrated treatment for the brain, spine, and mind with advanced technology and ongoing research. He clarifies that BRAINS stands for Bangalore Regenerative Advanced Institute of Neurosciences, with the overarching aim of ensuring complete brain health to support the body and societal needs.
He highlights that a striking difference of Brain Super Speciality Hospital is his 35 years of experience in neurosciences. He adds that the hospital employs carefully selected technology aimed at achieving the best patient outcomes. Furthermore, he emphasises the availability of top-tier diagnostic facilities and highly skilled consultants. He also stresses the importance of teamwork, where collaborative expertise can effectively tackle complex neurological diseases.
According to Dr Venkatramana, the COVID-19 pandemic has specifically led to a rise in strokes among young individuals and conditions such as brain fog, epilepsy, degenerative issues, and autoimmune disorders. He points out that the brain is a crucial organ responsible for the entire body’s well-being. His vision was to create a model where comprehensive care for the brain, mind, and body complex could be provided to ensure overall health. He believes the expanding field of brain-related specialties necessitates focused attention.
Explaining that most neurological conditions are intricate, Dr Venkatramana says that a comprehensive service is required that extends beyond just medical, surgical, and critical care. He details that their approach includes a continuum of care, starting from emergency and pre-hospital care through critical care, rehabilitation, and all necessary support services, along with long-term follow-up. Moreover, he underscores the significance of advocacy, awareness, and education to ensure timely intervention and appropriate treatment for brain disorders, ultimately leading to better patient results and functional recovery.
Understanding Strokes
Dr Venkatramana describes a stroke as a sudden and severe event that can cause paralysis of limbs, speech difficulties, sensory loss, balance issues, or memory impairment, leading to temporary or permanent disability. He states that the primary cause is a sudden interruption of the brain’s blood supply, known as an ischaemic stroke, which is the common understanding of stroke.
Clarifying that brain stroke is linked to the brain’s blood supply and vessels, sharing similar risk factors with heart attacks, Dr Venkatramana suggests that managing these risk factors can effectively control, prevent, and treat both conditions. He introduces the term “brain attack” to encompass four conditions: ischaemic stroke (sudden loss of blood supply due to blockage), brain haemorrhage (rupture of a brain blood vessel causing bleeding, often due to hypertension), subarachnoid haemorrhage (rupture of an aneurysm around the brain, causing severe “thunderbolt” headache and potential unconsciousness), and cerebral venous thrombosis (blockage of veins draining blood from the brain, potentially caused by dehydration, hormonal pills, or post-delivery conditions). He notes that cerebral venous thrombosis can present with stroke-like symptoms, seizures, paralysis, and behavioural changes.
He explains that by categorising these conditions as a “brain attack,” they aim to emphasise the urgency of seeking immediate emergency treatment within the “golden hours.” He stresses that prompt diagnosis and effective treatment during this period can significantly improve outcomes and reduce disability. He points out that, unfortunately, brain attack is currently the leading cause of disability worldwide.
Early Signs of Stroke
Dr Venkatramana indicates that many individuals experience warning signs before a major stroke, known as Transient Ischaemic Attacks (TIAs). These can manifest as sudden vision loss or blurring, loss of half of the visual field with subsequent recovery, temporary sensory loss on one side of the body, sudden arm or leg weakness with recovery, or Transient Global Amnesia, characterised by sudden memory loss and confusion followed by gradual recovery. He notes that these symptoms usually last only a few hours, with complete recovery typically within a day.
According to Dr Venkatramana, a TIA is a clear warning sign of a potential future stroke. However, he laments that many people ignore these signs due to a lack of awareness or by attributing them to other causes like improper diet, lack of sleep, or tiredness, thus delaying necessary medical examination. He contrasts this with the more obvious symptoms of a full stroke, such as sudden paralysis, vision loss, imbalance, or difficulty walking. He also points out that haemorrhagic strokes typically present with a severe headache.
He notes that while brain haemorrhages, both subarachnoid and intracerebral, are usually accompanied by severe headaches prompting medical attention, ischaemic strokes can be silent and often occur during sleep, with the individual only realising the paralysis in the morning. He expresses concern that because these ischaemic strokes are painless, people often disregard them and fail to reach the hospital within the critical golden hours.
Strokes Across Age Groups
Dr Venkatramana states that while stroke is commonly associated with older individuals due to age-related changes in blood vessels (narrowing and cholesterol deposits), it can occur at any age. He attributes this partly to India’s high rates of diabetes and hypertension, which are prevalent across all age groups.
Highlights the surprising impact of COVID-19, Dr Venkatramana notes the virus’s affinity for cerebral blood vessels. Consequently, many younger individuals with a history of COVID-19 are now experiencing strokes and heart attacks. He emphasises that sudden strokes in young people have become increasingly common, and even children are susceptible. He mentions specific conditions in children, such as moyamoya disease, vasculitis, and autoimmune disorders, which can lead to stroke.
Additionally, he points out that developmentally abnormal blood vessels and systemic conditions like uncontrolled diabetes, hypertension, kidney disease, and blood disorders such as polycythaemia can also cause strokes. He stresses that stroke is not solely a blood-related issue and requires a comprehensive understanding of various contributing factors.
He advocates for early investigation of any warning signs to systematically identify and address these underlying conditions. He explains that their stroke centre is designed to evaluate and investigate all age groups based on specific criteria to determine risk factors. He cautions against the misconception that a single stroke is an isolated event, particularly in younger individuals who face a higher risk of recurrent strokes over their longer lifespan. He underscores the importance of thorough evaluation and long-term management of underlying conditions in addition to acute stroke treatment, which is a primary goal of the stroke centre at Brains Hospital.
Steps to Take During Strokes
Dr Venkatramana advises that when a stroke occurs, even if the patient remains conscious (as is often the case, except in brain haemorrhage), they should immediately alert their family and doctor, especially if they notice an inability to move a limb during the night or early morning. The family, upon observing any signs such as facial drooping, speech difficulties, loss of balance, limb weakness or numbness, or vision problems, should act swiftly.
Strongly advising against a “wait and see” approach involving offering food or juice, Dr Venkatramana, instead, urges immediate transport to the hospital. He notes that while earlier recommendations focused on a three-and-a-half-hour window for thrombolysis, this has fortunately been extended to six hours and, in some recent guidelines, up to 24 hours, which is a significant benefit. However, he reiterates that earlier intervention leads to better outcomes, as the clot is softer and more easily dissolved, resulting in quicker recovery.
He recommends that even a suspicion of stroke should prompt an immediate visit to a hospital with stroke facilities. He acknowledges the limited number of such facilities currently available but states that promoting the concept of “brain attack” aims to increase their prevalence. He emphasises that stroke is a highly preventable condition and that identifying risk factors through comprehensive health checks, especially for those over 25 and certainly after 40, is crucial for prevention.
Dr Venkatramana identifies obesity, a sedentary lifestyle, excessive smoking and alcohol consumption, lack of exercise, and drug abuse as significant risk factors for stroke. He also includes uncontrolled diabetes, hypertension, and emotional stress. A more recent factor he highlights is snoring, indicating that individuals who snore heavily during sleep are at a higher risk of both stroke and heart attack. He clarifies that contrary to the common perception of snoring as sound sleep, it can be unhealthy and warrants investigation through a sleep study to check for obstructive sleep apnoea, which can lead to dangerously low oxygen levels in the brain and trigger a stroke. He advises that such individuals should be closely monitored and evaluated to mitigate their risk.
Emotional Health and Strokes
Explaining that emotional well-being, characterised by happiness, good social connections, relaxation, and enjoyment, contributes to healthy blood sugar levels, blood pressure, and immune function, Dr Venkatramana points out that, conversely, high stress levels lead to frequent release of adrenaline and steroids (stress hormones) in the body. These hormones, triggered by anger and stress, can increase heart rate, strain the heart and blood vessels, alter cholesterol and coagulation mechanisms, and increase platelet count, thereby raising the risk of blood clots. He points out that these clots can lead to brain attacks (strokes) or heart attacks, a connection often underestimated.
Dr Venkatramana contrasts this with individuals who maintain a happy, mentally and emotionally healthy lifestyle, are socially active, and remain calm and easygoing. He clarifies that this doesn’t preclude work but implies a more relaxed approach. He suggests that inner peace fosters ease with others, leading to an inherent happiness that stimulates the vagus nerve. Increased vagal tone relaxes blood vessels, improves blood flow, regulates heart rate, calms the mind, enhances work efficiency and immunity, and maintains healthy coagulation. Consequently, the body’s organs are less stressed due to reduced stress hormone release, promoting good sleep and overall well-being, making such individuals less prone to strokes, although underlying conditions still require attention.
He stresses that while emotional wellness is not the sole determinant of stroke risk, it is a major contributing factor, especially in today’s world with its unhealthy competition, declining interpersonal relationships, increasing individualism and stress in various aspects of life. He notes the growing reliance on medications even for sleep, compounded by poor lifestyle choices like inadequate sleep and diet, junk food consumption, and lack of exercise, all exacerbating emotional health issues and consequently increasing disease risk.
When asked for a single word to summarise lifestyle, brain wellness, and happiness, Dr Venkatramana responds that a healthy life is invariably a happy one and vice versa, leading to a different experience of energy and overall well-being. He believes that happiness, despite its difficulty, is crucial for bodily functions, regardless of circumstances.
Dr Venkatramana defines brain wellness as a systematic practice involving regular sleep schedules, proper nutrition, adequate rest, and consistent exercise, coupled with an orderly and planned approach to work, enabling effective brain function without excessive stress. He emphasises that brain wellness encompasses emotional health, as the brain and mind are interconnected. Maintaining a positive, effective, focused, and relaxed state is key to brain wellness. Regarding lifestyle, he reiterates avoiding damaging habits like smoking and excessive alcohol, favouring a vegetarian diet, and engaging in regular exercise. He specifically mentions pranayama for its benefits in blood circulation, stress reduction, mental calmness, improved brain circulation, and lower blood pressure, and yoga as a proven practice. He advocates for a good lifestyle with proper sleep, quality food, and avoiding unnecessary stressors, which he terms “mindedness” in his book, emphasising awareness of one’s actions, speech, and thoughts.
Dr Venkatramana concludes that constant awareness, focus, happiness, and the enjoyment of relaxing activities like music are beneficial, while excessive indulgence in anything is detrimental. He advocates for balance in all aspects of life, including eating, sleeping, and working, as crucial for brain wellness.
