2023-10-26 13:00:03
One in four women will have a stroke during their lifetime, it is their leading cause of death before heart attack and breast cancer. Women are particularly at risk at 30 and 70 years old.
Summary
Brutal, violent and sometimes associated with serious following-effects, stroke causes the deaths of 50 women per day In France. They are even more affected than men becausethey have more risk factors. A stroke is an accident that hits an artery. We distinguish strokes where the artery becomes blocked (80% of cases) : It is cerebral infarction. Strokes where the artery ruptures (20% remaining) : It is cerebral hemorrhage. Warning signs, causes, following-effects: everything you need to know regarding stroke in women with Professor Sonia Alamowitch from the Neurology and Neurovascular Emergencies department at Saint-Antoine Hospital in Paris.
The frequency of stroke generally increases following the age of 50. Two peaks are observed in women:
► And big peak around 70-75 years old.
► A smaller but increasing among young woman (30-35 years old). “This peak can be explained by the problem of stroke during pregnancy or be linked to the combination of tobacco, pills and migraine. This trio is a very bad combination in young women. Certain oral contraceptives also increase the risk of thrombosis (clot) especially if they are associated with other vascular risk factors, particularly those with a high dose of estrogen” explains Professor Sonia Alamowitch of the Neurology and Neurovascular Emergencies department at Saint-Antoine Hospital (AP-HP Paris) and Secretary General of the French Neuro-Vascular Society (SFNV).
Symptoms of stroke in women do not differ from those of the rest of the population (unlike myocardial infarction which is characterized by more specific signs in this case). They are always brutal that is, they appear From one minute to the next. In the event of a stroke, the woman may present:
A loss of mobilitymotor skills, muscular strength which typically will affect a half-body (right half or left half of the body) or part of the hemibody. A loss of language, the ability to express oneself and understand (aphasia). A loss of sensitivity of the hemibody. A loss of sight (of one or both eyes).
“All of these symptoms are very suggestive of a stroke if they occur suddenly. In particular cases of hemorrhage, it can be a violent and very sudden headache. adds our interlocutor.
The premier (and the only one we can’t do anything regarding) it is age. It is also he who explains that women suffer more from strokes than men. “It is particularly common at 70-75 years old, but women live longer and are therefore more affected” argues Professor Alamowitch. Women also have more risk factors than them, such as:
l’high blood pressure (primary factor of stroke in them), the atrial fibrillation (cardiac arrhythmia) and the pregnancy. “This is a period when women are a little more exposed to different types of stroke,” continues the specialist. Atrial fibrillation: “This disease responsible for heart rhythm disorders represents 20 to 30% of the causes of cerebral infarction and it affects women more” argues Professor Alamowitch. Atherosclerosis, a disease characterized by blockage of large arteries. We suffer from it when we get older, when we have diabetes, high blood pressure, cholesterol, and when we smoke. A disease of small arteries in the brain, favored by high blood pressure.
“You have to move quickly in the event of a stroke otherwise there is a risk that the affected area of the brain will be destroyed.”
Immediately call 15. “We have to go very quickly, insists Professor Alamowitch. Treatments that unclog the arteries are all the more effective when we intervene early. If we let several hours pass, the area of the brain will be destroyed and it will be irreparable. On the other hand, if we intervene in the first hours, the artery can be unblocked, we prevent the brain tissue from suffering and we allow recovery or even a cure. The Treatment in the event of a stroke is always done in a neurovascular intensive care unit. There are some 140 in France.
If we consider the most common case of cerebral infarction: “The treatment is first to do emergency examinations to see what is happening in the brain, explains the specialist. The most effective test is brain MRI. In the absence of an MRI or contraindications, a brain scan can be done. Once the diagnosis is confirmed, treatment begins.” Two treatments are used:
► And infusion treatment with a thrombolytic drug which allows a thrombosis and therefore the clot to be dissolved.
► A thrombectomie (treatment implemented in 2015) when the thrombolytic is not powerful enough to destroy the clot and unblock the artery. It is carried out by a specialist doctor, most often an interventional neuroradiologist. “It will puncture an artery in the groin and go up with a small catheter to reach the arteries inside the brain. Once it is in the artery, it will catch the clot and remove it . This must be done very quickly, in the first hours, before the damage is significant.” specifies Professor Alamowitch.
► In the case of a cerebral hemorrhage (rarer), “It is necessary to lower blood pressure because it is generally very high. If there are malformations of the vessels, interventional treatment is sometimes necessary.”
At the same time, the teams implement treatments to avoid relapses, carry out examinations to identify the causes of the stroke and consider rehabilitation early.
The consequences of stroke differ from person to person. “There are favorable situations where we recover well with treatments, people can resume their lives as before but will need treatment to avoid a relapse. There are cases where people seem to recover well but have problems small following-effects, they go to be able to go home, but with the rehabilitation of a physiotherapist, a speech therapist… And then there is cases where recovery is less good and people then need a more intensive rehabilitation, they have to go to specialized establishments where they go stay a few weeks, even two to three months”, explains our interlocutor.
“We now know that the brain is capable of adapting following a stroke”
A stroke is a serious accident, it imposes a recovery phase. This phase is no different between men and women and always includes rehabilitation. “There is an important element that we now know. The brain, even if it has a part that is destroyed, is capable of adapting a little bit, that is to say, if we do working with neurological rehabilitation, he can reorganize himself to recover a certain part of his mobility, his language, so this intensive rehabilitation is important” testifies the specialist.
“The first thing to do is to screening and treatment for high blood pressureit is the number 1 risk factor for stroke in women, insists the doctor. However, high blood pressure is a silent disease, which we cannot feel, so blood pressure must be taken by the attending physician and pharmacist.” And also :
Stop smoking : “Tobacco is an avoidable risk factor” recalls Professor Alamowitch. Eat a balanced diet, paying attention to your intake of sugars and fats. Have regular physical activity (walking, swimming, running… the important thing is regularity!). Avoid the pill, tobacco, migraine trio.
Thanks to Professor Sonia Alamowitch of the Neurology and Neurovascular Emergencies department at Saint-Antoine Hospital (AP-HP Paris) and Secretary General of the French Neuro-Vascular Society (SFNV).
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