How 42,000 Dutch people are impacted annually by strokes: understanding its causes and recognizing its symptoms.

Cancer may influence strokes in young people, say doctors at Radboud university medical center in Nijmegen. But what is a stroke, and how likely are you to get one? Monique Lindhout, director of patient association Hersenletsel.nl, explains.

1. What exactly is a stroke?
Lindhout: ,,A stroke is officially called a Cerebro Vascular Accident or CVA, literally translated ‘an accident in the blood vessels to the brain’. A CVA can occur in two types: with a cerebral infarction, a blood vessel in the brain or in the carotid artery leading to the brain becomes blocked by a blood clot, silting up or a combination thereof. A cerebral hemorrhage is when a blood vessel in the brain ruptures or leaks. About 80 percent of strokes are cerebral infarctions, and about 20 percent are cerebral hemorrhages.

How serious the stroke is varies per case, but what is remarkable about strokes is that they can be very small or very large. Sometimes it is just a very small clot that needs to be removed. Someone can then go home after a few days and then have no or few complaints. In the case of a serious infarction, a blood clot is often caused by a heart rhythm disorder (atrial fibrillation) and has ended up in a hard-to-reach place. After such a large infarction, patients often have serious complaints and have to rehabilitate for a long time.

2. How can you recognize a stroke and what do you do?
“If you think someone might be having a stroke, look at the following four things: Does the person have a headache? A crooked mouth? You can see this clearly by asking the person to show their teeth. Does the person have difficulty speaking? You check this by asking the person to repeat a sentence. Ask him or her to lift both arms and then (sitting) both legs at the same time. Does one leg or arm come higher than the other? This may indicate paralysis on one side. If you see these things, call 911 immediately.”

3. And what signs should you watch out for in yourself?
,, Pay particular attention to things that may seem small: can you suddenly not use your arm? Do you see double or is part of your vision lost? Do you suddenly have trouble speaking clearly or finding words? Then call the doctor, even if the symptoms disappear after a while. It can mean that you have a TIA (transient ischemic attack, ed.): a temporary hiccup in the blood supply to the brain. That could be a precursor to a stroke.”

4. How common is a stroke? And what are the chances of getting one?
“Each year, about 42,000 Dutch people have a stroke, 110 per day. Although anyone can have a stroke at any age, we see that the risk increases in people over the age of 55. In addition, there are four risk factors that can increase the risk of a stroke: high blood pressure, blood sugar and cholesterol, and high or irregular heartbeat. A person’s lifestyle plays a very large role in the chance of having a stroke. Being overweight, smoking, drinking alcohol and eating fatty foods increase the risk.”

5. Can you avoid having a stroke?
“In a sense, yes. Changing your lifestyle can significantly reduce your risk of having a stroke. International research shows that up to 90 percent of strokes could be prevented if people lived healthier lives. As an association, we advocate another population study: for people over the age of 55, the four risk factors must be examined annually. This does not have to be drastic: the GP can do the tests once a year. In the (near) future, people are expected to be able to measure the values ​​at home, with the same technologies that are already available in smartwatches.

Partly because the population is getting older, the predictions are now that the number of strokes will increase sharply. It is true that with new developments in the treatment, people with a stroke can often be helped more quickly and recover better. Compared to fifteen years ago, more people now survive a serious stroke. That means that we now also have more people who have to rehabilitate for a long time.”