125,000 patients annually and nearly 50 000 deaths. For the survivors, serious physical, cognitive or psychological sequelae. Such is the sad record of cerebral vascular accidents in France. However, this disease suffers in Europe and in France of a cruel lack of recognition particularly. Dr. Jacques Boulliat, president of the association stroke, tells us more.
Doctissimo: What are the tasks and milestones of the Association stroke?
Dr. Jacques Boulliat: Our association France stroke was established in 1998. We have set for mission information to the general public as well as professionals. Although strokes are the third leading cause of death and the leading cause of disability, this disease remains too often unknown to the general public. Our actions are designed to help patients and their families as well as to promote research. We thus organise a wiretapping, public meetings, networking between patients and the families of victims.
We are instead antennas departmental in Saône- et -Loire, Isère and Meurthe- et -Moselle. A social service and website should soon see the day.
Doctissimo: Are what you currently with health authorities?
Dr. Jacques Boulliat: A good low echo in reality… Awareness-raising activities remain the paramount step in any other action. The creation of specialized units as in English-speaking countries (the “Stroke center”) would be that of little use if the victims do not recognize the symptoms of a stroke.
A survey carried out in 2001 with our patients found that the average time between the first symptoms and arrival at the hospital was 4 hours, with variations ranging from 30 minutes to 24 hours… That is when the first moment that we can limit the damage caused by ischemic vascular accident by different operations such as the injection of thrombolytic agents, for example.
Doctissimo: How can we explain this lack of recognition?
Dr. Jacques Boulliat: The average age of the victims is still important. In the collective imagination, the stroke applies only to older people. In addition, the absence of pain brings not always patients to consult.
Nearly a third of the accidents strokes are preceded by warning signs too often overlooked (the transient ischemic vascular accident). It is possible to prevent the onset and recurrence of such tragedies. Finally, cerebral vascular accidents are currently the leading cause of heavy disability and the second cause of dementia in the Western world.
Stroke research expenditures are minimal compared to other diseases. In 1987, I had tried to create a national day against stroke. The lack of national and regional authorities relay me unfortunately forced to limit myself to departmental awareness. It was nevertheless a success. However, the ageing of the population should provide this disease public health priority.
Doctissimo: Regarding these tragic consequences, what are structures that can accommodate patients and offer them appropriate rehabilitation?
Dr. Jacques Boulliat: The capacity remains very uneven from a Department to another. Some areas have several rehabilitation centres while others are lacking. We come to the first directory of rehabilitation centres for victims of stroke. So far, no records existed to guide patients and their entourage to appropriate structures. Yet, we know that back at home or in long-stay institutions does not benefit from an optimal support for some patients.
Early rehabilitation can reduce complications and neurological sequelae, retrieve the ease of essential functions and use the “recovered” brain potential so that the aftermath at least hamper the everyday life of the patient. Currently, our resources are extremely limited and we are looking for relays to be able to publish and distribute this guide.