- At what age can you have a stroke?
- What is stroke?
- What are the causes ?
- What are the symptoms of stroke?
- What are the risk factors?
- How is stroke treated? How to react ?
- Rehabilitation after a stroke: how does it work?
- What is the prognosis and lifespan after a stroke?
- Stroke: how to avoid it?
At what age can you have a stroke?
Stroke can occur at any age. The average age of onset of a stroke is 74 years old, however 25% of patients are under 65 years old and 10% under 45 years old, according to Public Health France. Furthermore, in recent years the number of strokes affecting young people has increased in a significative way. This is how the rate of young patients hospitalized for stroke increases every year, especially between 35 and 64 years. In question: high blood pressure, diabetes, obesity, tobacco and alcohol, but also stress are all risk factors that affect the risk of stroke.
It even happens that infants and adolescents are victims of it and it is estimated that there would be between 500 and 1000 cases per year in France, according to the SFNV. It is also the leading cause of acquired disability in children.
What is stroke?
One cerebrovascular accident (CVA) also called stroke is a disturbance of the irrigation of the brain which can have two causes: an artery clogged by a clot or the rupture of an artery which will create a hematoma. “One in 5 French people will have a stroke in their lifetime and almost 1 in 4 women”, informs Pierre Amarenco, Head of the Neurology Department and of the Reception and Treatment Center for Stroke at Bichat Hospital (Paris), who insists that the majority of strokes could be avoided.
There are two types of stroke:
- L’ischemic stroke:
This is the most common type of stroke: 85% of strokes are of ischemic origin. This stroke occurs when an artery becomes clogged, preventing blood supply to part of the brain and preventing it from functioning properly.
Namely: when the artery is blocked temporarily (less than an hour in general), we speak of a transient ischemic stroke (TIA). This “mini stroke“can be the warning sign of a stroke in the days that follow. Even transient symptoms must therefore be consulted urgently.
- L’hemorrhagic stroke:
It accounts for 15% of strokes and occurs when a cerebral artery ruptures, creating a hematoma compressing the brain. It can be a cerebral hemorrhage or subarachnoid hemorrhage. Most often, subarachnoid hemorrhage follows a ruptured aneurysm (rupture of an arterial aneurysm).
What are the causes ?
“There are more than 150 causes of stroke, but four big main causes,” describes the neurologist:
- L’atherosclerosis,
- hypertensive small artery disease,
- embolisms of cardiac origin (myocardial infarction, heart valve disease, atrial fibrillation) which can promote clot formation,
- blood abnormalities that can cause clots to form.
What are the symptoms of stroke?
The stroke symptoms can be a paralysis, loss of strength on one side of the body, arm, leg or face, or all at the same time, a loss of speech, a difficulty in articulating, in getting out words or words that come in the place of other words or even a difficulty in getting out the words in his head.
“Stroke can also be signaled by vision problems such as loss of sight in one eye in its entirety, the carotid artery that supplies the brain supplying the eye first, balance disorders (all of a sudden, the person starts walking like a drunk, cannot stand up), hemibody sensitivity disorders (tingling in an arm, a leg, the face, or even the whole side)”, describes the neurologist.
Finally, an extremely sharp, unusual headache, usually very violent, can signal a stroke. “What characterizes the symptoms of a stroke is their sudden onset”, says Professor Amarenco.
What are the risk factors?
The risk factors are common to both types of stroke and to pathologies of vascular origin in general. They gather risk factors:
-non-preventable: age, sex (men are more at risk), heredity (more risk of having a stroke if a family member had a stroke before age 65), history of Stroke.
-avoidable: high blood pressure, diabetes, hypercholesterolemia, overweight, physical inactivity, smoking and cannabis, excessive alcohol consumption. “Stroke prevention is essential”, underlines the neurologist.
How is stroke treated? How to react ?
A stroke should be treated as soon as possible. You should call 15 or go to the nearest hospital. An MRI or CT scan is performed to make the diagnosis and see if it is a cerebral infarction or a cerebral hemorrhage.
“The treatment of revascularization must be carried out within 3 hours ideally, within 6 hours following the stroke at the latest”, informs Professor Pierre Amarenco. This treatment of thrombolysis administered intravenously aims to unclog the artery blocked by a clot.
“If this is not enough, we can do a treatment of thrombectomy“, says the neurologist. This consists of introducing a catheter into the femoral artery under imaging control and raising it up into the carotid artery and then into the cerebral artery in order to remove the clot. “Care in a neuro-vascular unit makes it possible to reduce mortality by 30%, in particular thanks to the interest shown in swallowing disorders (responsible for pneumonia) and causes 60% more patients to return home”, again informs Professor Amarenco.
A check-up is done to find the cause and/or risk factors and treat them (for example diabetes, hypercholesterolemia, tobacco or cannabis poisoning, high blood pressure, etc.)
Rehabilitation after a stroke: how does it work?
Some people have to go reeducation center weeks or even months after a stroke. “They benefit from motor and language rehabilitation. Invisible disabilities such as memory problems, concentration problems, character changes must also be taken care of by stroke specialists”, explains Prof. Pierre Amarenco.
What is the prognosis and lifespan after a stroke?
150,000 people are victims of a stroke in France each year, of which more than 110,000 are hospitalized and 30,000 die. “It’s the leading cause of death among women”, warns Professor Amarenco. However, it should be noted that the mortality rate has decreased significantly
More than 500,000 French people live with sequelae following a stroke. This pathology represents the leading national cause of acquired disability in adults. “Overall, the risk of recurrence of a stroke is between 1 and 8% per year depending on the cause., indicates the neurologist, but this risk is reduced by 80% with the treatments of the cause”, he reassures.
Stroke: how to avoid it?
The primary prevention (if you haven’t had a stroke) can prevent the majority of strokes. It is based first of all on a healthy lifestyle: balanced diet, regular physical activity, all avoiding overweight, no smoking or cannabis consumption, alcohol consumption.
You should also have your blood pressure and blood cholesterol levels checked and, if necessary, treated for high blood pressure or hypercholesterolemia.
Namely: this healthy lifestyle also helps you if you still have a stroke. “People who have had a stroke and who practiced physical activity have a 50% lower risk of disability”, emphasizes Professor Amarenco.
“We can reduce this risk of stroke by 80% with simple measures”, says the neurologist whose Association Vaincre l’AVC has set itself the goal of reducing strokes by 80% by 2030.
The secondary prevention (if you have already had a stroke) is also essential. It includes the same rules as primary prevention. “Physical activity is a major point”, says Professor Pierre Amarenco who asks his patients to do 30 minutes on an exercise bike every morning before showering. In addition to hygiene rules, good compliance with treatments is essential.
Sources:
- Interview with Pr Amarenco, President of the Vaincre l’AVC Fund, Head of the Neurology Department and of the Reception and Treatment Center for Stroke at Bichat Hospital (Paris).
You can calculate your risk of stroke on this site and receive personalized advice to avoid it
- Cerebrovascular accident (CVA) booklet, Saint-Maurice Hospitals
- Brochure Better understand what a stroke is, Franceavc
- French Neurovascular Society.
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