‘Only half of patients comes into action immediately at the beginning of the stroke”

According to neurologists, the Day of the Stroke (may 14,) was an important day. For signals of a stroke are not always identified. That helps in many cases to irreversible brain damage. Ten questions to ask neurologist Heleen den Hertog.

What is a stroke?

Den Hertog: “At a stroke, a part of the brain for a shorter or longer period of time without oxygen. It can have two causes: a blood clot in the artery in the brain shut down or a torn hersenbloedvat causing blood in the brains.”

“The first case, we call a stroke, the second is a stroke. In both cases, it is caused lack of oxygen, sudden loss of function.”


How do you recognize a stroke?

What phenomena are they? How do you recognize a stroke?

“A stroke is almost always unannounced. The three signals that occur the most, a crooked mouth, slurred speech and a paralyzed arm.”

Signals of a stroke that occur the most:

  • Wry mouth
  • Slurred speech
  • Paralyzed arm

“The symptoms can occur separately or at the same time prevent. Also a paralyzed leg or sudden dizziness, or double vision can indicate a stroke.”

What should you do if you have these symptoms in someone observes?

“Immediately call 112. Not the first time the family doctor or the general practitioner. That takes time. And time is in the case of a stroke of inestimable value. Loss of time is hersenverlies.”

Within how much time there is still a chance for a good outcome?

“You really need to as soon as possible act. The sooner the treatment in the hospital can be started, the better. Every minute die, 1.9 million brain cells. So every minute counts.”

“During a stroke, die, every minute, 1.9 million brain cells.”
Heleen den Hertog, neurologist

What treatments are there?

“At a stroke with intravenous thrombolysis, a stolseloplossend means, the blood clot to be removed. This should be done within 4.5 hours after the first symptoms.”

“Since a number of years, is also the intra-arterial treatment applied. In addition, the clot using a catheter through the groin from the artery is removed. This can take up to six hours after the first symptoms.”

“Treatment with intravenous thrombolysis increases the chance of a good recovery by 10 percent. Additional intra-arterial treatment increases this probability by a further 13 percent.”

Die daily of about 25 people to a stroke, according to figures from the heart foundation. (Photo:

How is a blood clot actually?

“An important reason is atherosclerosis. Another common cause is a blood clot from the heart.”

Why people often arrive late in the hospital?

“Only half of patients take action immediately after the beginning of the stroke. And 20 percent call directly to the ambulance. That has several causes. First of all don’t know what the signals are. A stroke is often only too late noticed.”

“Only half of the patients comes into action immediately after the beginning of the stroke”
Heleen den Hertog, neurologist

“Sometimes people do not know that acting quickly is important. They think: we look tomorrow how it goes and if it’s not better, we’ll call the doctor. And sometimes playing shame play a role. About what the neighbors will say about an ambulance in the driveway.”

What treatment options are there for a stroke?

“The treatment options are more limited than in a cva. When a stroke is attempted, the blood pressure down to increase the bleeding to prevent.”

“Currently there is a Dutch study with a new surgical technique: the ‘minimally invasive’ surgery. It is through a small hole in the skull, the bleeding removed.”

“We hope that, in time, more treatment options and a greater chance of survival for people with a brain haemorrhage.”

How can we the risk of strokes reduce?

“By healthy living. Smoking and excessive alcohol consumption increase the risk. We also need to be less salty food, more exercise, losing weight if overweight, and stress reduction.”

More exercise and reducing stress are important to prevent stroke. ()

What risk factors are there?

“A major risk factor is high blood pressure. Also diabetes has a greater chance of heart disease including strokes. High blood pressure during pregnancy and gestational diabetes increase the risk at a later age. An early menopause also.”

Die daily of about 25 people to a stroke, according to figures from the heart foundation. Is that figure in the future smaller?

“I suspect it. The number of treatment options over the past years. With new research will the treatment improve.”

“So, for example, recently, intra-arterial treatment applied in a small proportion of patients only after six hours at the hospital, arriving, for example, because they wake up with loss of function.”

“These patients are selected with the help of a special CT scan technique. There is also a study in these patients, the applicability of intra-arterial treatment to improve.”

“In addition, work also hospitals constantly greater efficiency for a faster treatment. Both within the hospital and in the process, before the patient is in the hospital.”

“Thanks to campaigns of the heart foundation to know more and more people in addition, what the signals are. People will increasingly take urgent action.”

Dr. Heleen den Hertog is as a neurologist connected to Isala, Zwolle, the netherlands.

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