The Sciences et Avenir site has teamed up with the French Neuro-Vascular Society (SFNV), which annually educates the general public on preventive measures to reduce the risk of stroke, the leading cause of death for women. Update on care, treatment and prevention with Serge Timsit, head of the neurology department of the University Hospital of Brest and president of the SFNV.
How many people have a stroke in France?
Serge Timsit: Almost 800,000 people. A quarter of them are under 65 and more than 500,000 have sequelae. Each year, 140,000 new people are affected and about 30,000 die. 85% of strokes are called “ischemic” (blood flow to or into the brain is interrupted by a clogged blood vessel) and 15% are “haemorrhagic” (rupture of a blood vessel causes hemorrhage in the brain).
How to react if you are a witness or suffer a stroke?
The first symptoms of a stroke are: paralysis, weakness or numbness of a part or half of the body; deformity of the mouth and difficulty speaking; loss of vision of an eye; disturbances of balance, coordination or walking; unusual atrophic headache.
If one or more of these signs suddenly appear, it is necessary to call the “15”. Indeed, the earlier the stroke is taken care of, the better it can be treated. “Time is brain”, we usually say between specialists. The patient is supported by an organized circuit coordinated with all health professionals until the arrival in a neurovascular unit where a dedicated team will take care of him. Developed over twenty years in France, neurovascular units have reduced stroke mortality by about 20%. There are currently 135 in France and Overseas.
What are the possible treatments for the patient?
There are two therapeutic approaches: since 2003, thrombolysis and since 2015, thrombectomy. The first is to administer an intramuscular or intra-arterial product that breaks down the blood clot. But thrombolysis must be performed within 4h30 after the first symptoms.
This technique makes it possible to avoid 1 handicap out of 7. The most recent thrombectomy is to suck directly into the clogged artery, via a microcatheter, the blood clot responsible for the stroke. The operation must be performed within 6 hours after the first signs of the stroke. This second technique avoids 1 disability out of 4. The ideal now is to develop drugs that allow to “stop the time” for the brains of patients in late care, that is to protect the time that thrombolysis and / or thrombectomy can be performed.
How to prevent the risk of stroke?
Studies show that 90% of stroke risks depend on these 10 modifiable risk factors:
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– High waist-to-hip ratio (obesity)
– The lack of physical activity
– Unfavorable diet (a non-Mediterranean diet, not varied)
– Too high cholesterol
– Psycho-social factors (stress, depression, life events)
– Cardiac causes (cardiac arrhythmias: atrial fibrillation or flutter, myocardial infarction, prosthetic valve, rheumatic fever)
– Excessive alcohol consumption (more than 14 drinks a week for women and 21 for men)