Stroke affects more than 110,000 people a year in France. Stroke can be fatal and cause serious sequelae if not treated in time. Here are the symptoms that should alert you.
More and more patients are having strokes. No less than 110,000 people are hospitalized for strokes each year in France. To ensure rapid treatment and limit the consequences of strokes, it is necessary to know how to recognize the symptoms immediately. Doctor Anne Ferrier, neurologist, manages the neurovascular unit of Clermont-Ferrand University Hospital. On World Stroke Day, October 29, we asked her about the symptoms of stroke. It indicates: “There are no warning signs. When the first signs come, they come very suddenly, without warning.” Here’s what you need to know about strokes.
- Sudden loss of strength in an arm, leg or the whole side, called hemiplegia
- The corner of the mouth that falls
- Sudden loss of vision in one eye: completely black vision
- The sudden loss of speech: the impossibility of speaking, the impossibility of answering the questions we are asked, an incomprehensible language…
If you notice any of these symptoms in yourself or in a third party, you must immediately contact the SAMU, explains Doctor Ferrier: “ Above all, don’t say “I’ll wait to see what happens”, because it can get worse during this time. It is necessary to do the 15 immediately even if the symptoms return to order. If, for example, you notice paralysis of an arm or a leg, even if it lasted a minute and after that there is nothing left, you still have to call 15.” The patient comes across a medical regulation assistant who will ask him questions, in particular about his background and the treatments he is taking: “Then, the regulating doctor or the medical regulation assistant will trigger a transport: it can be an ambulance or firefighters who come to pick up the patient. The big advantage of calling 15 more than 18, for example, is that the medical dispatcher will warn all the hospital teams where the patient will arrive. He will prevent emergencies, he will warn the radiologists to do a scan or an MRI quickly and the neurologists of course”. explains Anne Ferrier.
For doctors, the challenge will be to very quickly differentiate between the 2 types of stroke: “In 80% of cases it is an ischemic stroke or a heart attack. It’s exactly the same mechanism as in the heart, it’s an artery that gets blocked by a clot. In 20% of cases, it can be a hemorrhage, a bleeding intracerebral artery. The medical team therefore performs a CT scan or an MRI to be able to determine what type of stroke it is and thus adapt the treatment that “will be totally different one way or the other”specifies the neurologist.
Dr. Ferrier explains: “There is no treatment today that you can administer to stop the bleeding. The only treatment is to control the blood pressure, to make sure that the tension does not increase too much”.
Much progress has been made, according to Dr. Anne Ferrier: “Treatment is done either by a drug infusion, intravenously, what is called thrombolysis. It is a drug that will destroy the clot. When the clot is large or on a large artery, this is associated with a mechanical gesture. It’s called mechanical thrombectomy and it allows, passing through the interior of the vessels, to remove the clot.
Anne Ferrier alert: in the event of a stroke, every minute counts. “It is estimated that 2 million neurons are lost per minute when an artery becomes clogged. Obviously, it is necessary to go as quickly as possible to limit the size of the cerebral area affected and to be able to intervene quickly to restore the flow or, in the context of a haemorrhage, to try to stop the bleeding.
“Anyone can have a stroke, even the youngest. But there are people for whom the risk is higher, it is those who have cardiovascular risk factors”explains Dr. Ferrier.
Here are the most common risk factors:
- High blood pressure: do not exceed 14/9
- The tobacco
- Heavy alcohol consumption
- The association of sedentary lifestyle, overweight and/or lack of physical activity
- heart arrhythmia
Late treatment presents a risk of death: “Mortality is 10% in the first month”, explains the neurologist. It also warns of a risk of disability: “More than half of patients will have sequelae from a stroke, but for some, it will be sequelae that are not motor sequelae. You can also have an invisible handicap, that is to say, significant fatigue, problems concentrating… On the other hand, you can have a heavier handicap, in particular physical, with for example the persistence of paralysis or a hemiplegia which greatly limits autonomy. The sequelae will depend on the size and the area that is affected in the brain.
Prevention involves screening and treating risk factors, according to Dr. Ferrier: “We know that half of the people who have hypertension do not know it and, among those who know it and who have the treatment, there are still half who are not well balanced. The management of hypertension is a big issue.” Public Health France advises to ccontrol one’s blood pressureanger healthilycontrol your cholesterol5 years old and have a physical activity.
The incidence of strokes is only increasing, in particular due to the aging of the population. The Clermont-Ferrand University Hospital department receives just over 700 patients each year. In Auvergne, there are approximately 3,500 strokes per year.