Critical Review of Thrombo-embolic And Hemorrhagic Stroke In Ayurveda WSR To the Disease Kaphanubandhi and Pittanubandhi Pakshaghata

Background: Stroke remains one of the leading causes of mortality and long-term disability worldwide, with ischemic (thromboembolic) and hemorrhagic subtypes constituting the principal pathological entities. Ayurveda, the ancient Indian system of medicine, provides a remarkably comprehensive framework for understanding cerebrovascular disease through the concept of Pakshaghata (hemiplegia), particularly its subtypes — Kaphanubandhi Vataj Pakshaghata, corresponding to thromboembolic stroke, and Pittanubandhi Vataj Pakshaghata, corresponding to hemorrhagic stroke. Classical texts of Charaka, Sushruta, Madhava Nidana, and their commentators describe aetiology, pathogenesis, clinical features, prognosis, and management with precision that parallels modern biomedical understanding. Objectives: This literature review aims to systematically analyse and compare classical Ayurvedic descriptions of Pakshaghata with contemporary biomedical knowledge of thromboembolic and hemorrhagic stroke, identify conceptual convergences and divergences, and highlight the integrative research potential of this domain. Methods: A comprehensive review of primary classical Ayurvedic texts (Charaka Samhita, Sushruta Samhita, Madhava Nidana, Chakradatta) was conducted alongside peer-reviewed biomedical literature published between 2015 and 2024 sourced from PubMed, Scopus, AYUSH Research Portal, and Google Scholar using terms including "Pakshaghata", "stroke Ayurveda", "ischemic stroke pathophysiology", and "hemorrhagic stroke management". Results and Discussion: The Ayurvedic concept of Marag Avaranjanya Vataprakopa (obstructive vitiation of Vata) aligns with the pathophysiology of atherosclerosis-induced thromboembolic stroke, while Dhatukshayajanya Vataprakopa (deficiency state vitiation of Vata) correlates with the vasculopathic mechanisms underlying hemorrhagic stroke. Dietary and lifestyle factors described in classical texts show strong concordance with modern risk factors, including dyslipidemia, hypertension, diabetes, and obesity. The prognostic framework of Sadhya-Asadhyata (prognosis) correlates with clinical outcomes assessed by contemporary severity scoring systems. Conclusion: Ayurveda offers a structured, clinically relevant, and evidence-informed framework for understanding cerebrovascular accidents. Integrative approaches combining Ayurvedic diagnostics and therapeutics with modern neurological management hold significant promise for improving patient outcomes.