Stroke: Everything You Need To Know In 5 Questions

Stroke, or cerebrovascular accident, affects approximately 120,000 people in France each year. Half of the patients affected are left with a varying degree of disability, such as hemiplegia, while a quarter of them recover without any aftereffects. Strokes are currently the third leading cause of death in France and the leading cause of disability in adults. Here is everything you need to know about strokes in 5 questions.

1- What is a stroke?

A stroke or CVA is a sudden neurological deficit caused by a rapid interruption of blood flow to the brain.

When this problem occurs, the brain is partially deprived of oxygen and glucose, leading to a "cerebral attack." This attack can manifest as a loss of consciousness, partial or complete cessation of brain functions, or even cause the sudden death of the patient.

2- What are the possible causes of a stroke?

Contrary to what one might imagine, this type of stroke is common and occurs every 4 minutes in France, according to the Foundation for Stroke Research. The leading cause of physical disability in adults, it can strike anyone at any age.

There are 2 types of strokes based on their cause:
• Ischemic strokes related to a clot in a cerebral artery or an artery supplying the brain (carotid or vertebral artery).
• Hemorrhagic strokes caused by the rupture of an artery in the brain.

Ischemic strokes or cerebral infarctions account for approximately 80% of cases in France.

3- What are the risk factors for a stroke?

Strokes can be linked to poor lifestyle habits. Smoking and obesity are among the risk factors.

There are also hereditary factors and risks associated with certain conditions such as atrial fibrillation, high blood pressure, or high cholesterol levels.

4- What are the signs to know?

Six signs, which do not necessarily occur simultaneously and in all patients, should alert you:

• Muscle weakness of the face, an arm, or a leg. Frequently, a stroke leads to paralysis of the arm and leg on the same side (the side opposite to that of the brain lesion).
• Loss of sensitivity to touch and heat ranging from simple numbness to anesthesia of a part of the body.
• A sudden difficulty finding words or expressing oneself, the inability to swallow saliva or articulate.
• A sudden disturbance of balance and walking.
• Sudden loss of vision in one eye, double or blurred vision (accommodation disorders), a sensation of glare.
• Severe and intense headaches, accompanied by nausea, without any warning signs.

In the most severe cases, there may also be a loss of consciousness.

To remember the signs of a stroke, think of the acronym FAST:
• F for Face: you notice facial asymmetry when the person smiles or puffs out their cheeks.
• A for Arm: one arm is numb or paralyzed. If you ask the person to raise both arms towards the sky, one arm falls.
• S for Speech: you notice speech difficulties or even an inability to speak.
• T for Time to remind you that every minute counts.

A patient may exhibit one or more FAST signs depending on the area of the brain affected. If several symptoms appear, they are all on the same side (for example, the face droops on the left side and the left arm is numb).

5- How to react to these symptoms?

The warning signs of a stroke constitute an absolute emergency. They appear suddenly and are the same in both men and women.

Even if there is a rapid return to normal, these signs should prompt you to call for help as quickly as possible. Those present should immediately dial 15 because prompt care is the best way to prevent significant neurological and physical sequelae.

You must react as quickly as possible because the earlier the intervention, the higher the chances of survival. Ideally, a stroke should be treated within three hours of the onset of the first symptoms to limit the risk of sequelae.

You should, in order:
• call 15.
• place the person at rest, immobile. If the victim is unconscious, place them in the recovery position (PLS) to prevent airway obstruction.
• note the time of the first symptoms to inform the doctors.
• wait for the emergency services and reassure the victim by telling them that help is on the way.