Ischemic Stroke (Cerebrovascular Accident – CVA) in Nice
Docteur Ilya Khantalin, Chirurgien vasculaire dans les Alpes-Maritimes
Ischemic Stroke (Cerebrovascular Accident – CVA)
Doctor Ilya Khantalin in Nice
A cerebrovascular accident (CVA), or stroke, is a serious medical event that affects the central nervous system, resulting in an interruption of blood supply to an area of the brain. This interruption can have serious, even irreversible consequences on brain function.
An ischemic stroke comes from the term “ischemia,” referring to a lack or interruption of oxygen supply to a part of the brain due to blood circulation disorders.
In France, over 140,000 new cases of stroke are reported every year.
Arterial diseases are now managed using modern techniques validated by the Haute Autorité de Santé (French National Health Authority), with an approach that prioritizes innovation and adherence to recognized surgical protocols.
Vascular diseases are recognized as Long-Term Illnesses (Affections de Longue Durée – ALD), which allows for 100% coverage by French social security.
What is a Stroke?
Vascular Surgeon in Saint-Laurent-du-Var
A stroke occurs when a region of the brain no longer receives sufficient blood flow, preventing the supply of oxygen and nutrients essential to the proper functioning of nerve cells. There are two main types of stroke:
- Ischemic Stroke represents approximately 80–85% of all strokes: It is caused by a narrowing or blockage of a cerebral artery, most often due to the formation of a blood clot (thrombus) or obstruction by an atherosclerotic plaque.
- Hemorrhagic Stroke represents about 15–20% of all strokes: It occurs when a blood vessel in the brain ruptures, causing bleeding. This type of stroke is less common but often more severe.
Strokes can have a wide range of consequences, from temporary neurological disorders to permanent disabilities. Rapid treatment is crucial to limit damage.
Risk Factors and Indications of an Ischemic Stroke (CVA)
Vascular Surgery Specialist in Saint-Laurent-du-Var
Risk Factors
Several factors increase the risk of developing a stroke. These may be modifiable or non-modifiable.
Modifiable factors:
- High blood pressure (hypertension): The main risk factor for both ischemic and hemorrhagic strokes.
- Smoking: Tobacco accelerates atherosclerosis and promotes blood clot formation.
- Diabetes: Poorly controlled diabetes can damage blood vessels, increasing stroke risk.
- High cholesterol: Excess cholesterol contributes to plaque buildup in brain arteries.
- Sedentary lifestyle and poor diet: An inactive lifestyle and unbalanced nutrition increase overall risk.
Non-modifiable factors:
- Age: Stroke risk increases with age, particularly after age 55.
- Family history: Having close relatives who have had a stroke increases personal risk.
- Sex: Men are slightly more at risk, but women have a higher risk after menopause.
- Ethnicity: Some populations, such as African Americans, have a higher risk due to genetic predispositions.
Symptoms of a Stroke
Stroke symptoms appear suddenly. It is essential to recognize them quickly to allow for urgent medical intervention. Clinical signs of stroke include:
- Sudden weakness or numbness of the face, arm, or leg, especially on one side of the body.
- Speech difficulties or trouble understanding language.
- Visual disturbances, such as blurred vision or vision loss in one eye.
- Loss of balance or coordination, accompanied by dizziness.
- Severe and unusual headaches.
It is crucial to act quickly and call emergency services (15 in France) at the first sign of these symptoms, as early treatment significantly improves the outcome.
Indications for Stroke Treatment
Stroke treatment depends on its type (ischemic or hemorrhagic), its location, and its severity. The main interventions include:
Ischemic Stroke
- Thrombolytic treatments: Administration of a drug (rtPA) to dissolve the clot in the early hours after the stroke.
- Thrombectomy: A surgical procedure to remove the clot using a special device, performed within a limited time after the event.
- Surgery: In cases where a carotid atherosclerotic plaque (stenosis greater than 70%, or plaque with a high risk of embolism) is confirmed by additional tests, surgical intervention may be required to perform a carotid endarterectomy. This consists of removing the plaque via direct access to the carotid artery and its branches. In specific cases, placement of a carotid stent may be considered.
- Control of risk factors: Optimizing the treatment of hypertension, diabetes, and cholesterol is essential.
Hemorrhagic Stroke
- Surgery: In some cases, surgery is needed to remove accumulated blood and repair the ruptured blood vessel.
- Medical treatment: Management of complications such as hypertension is critical to prevent further bleeding.
Rehabilitation and Follow-Up
After the acute phase of a stroke, rigorous follow-up is essential for recovery. Post-stroke rehabilitation includes:
- Physical therapy: To help recover motor skills and coordination.
- Speech therapy: Needed in cases of language or communication disorders.
- Neurological monitoring: Long-term medical follow-up is essential to evaluate neurological progress and adjust treatments.
It is also vital to treat risk factors to prevent recurrent strokes.
Dr. Ilya Khantalin, vascular surgeon in Saint-Laurent-du-Var, recommends regular monitoring of hypertension and diabetes, as well as the management of blood circulation disorders, which are often the cause of ischemic strokes.
A stroke is a medical emergency requiring rapid and appropriate care to reduce the risk of long-term sequelae. Prevention remains the best strategy, particularly through the management of risk factors such as hypertension and diabetes, and by adopting a healthy lifestyle.