SURVIVE & THRIVE AFTER A STROKE
72 | July• 2019
PHOTOS, PREVIOUS SPREAD AND THIS ONE, BY MICHEL LABELLEn July 2015 Florence
Baudouin, then 45, woke
up to find she was in a hos-
pital bed. She had tubes
everywhere, connecting
her to beeping machines.
She remembered collaps-
ing in the street and the
helicopter that arrived
soon after, with rescuers who warned
her not to fall asleep. And that was all.
Florence had no memory of how
to speak. Nor did much else seem to
function. “My brain wasn’t able to give
orders to my body,” she says.
Florence had suffered a stroke.
Research published last year in
theNew England Journal of Medicine
found that one in four people glob-
ally will experience a stroke in their
lifetime. Worldwide, strokes are the
second leading cause of death and the
third leading cause of disability. But
what is a stroke?
In the most common type, ischae-
mic stroke, such as Florence suffered,
blood flow is blocked by a clot in one
of the arteries to the brain. These clots
often form where a cholesterol-laden
plaque ruptures.
Ischaemic strokes account for about
85 per cent of cases. Symptoms come
on suddenly and dramatically when
blood – and the life-giving oxygen it
carries – can’t get past the plug.
Haemorrhagic stroke, responsible
for another approximately 15 per cent,
is caused by a broken vessel bleeding
into the brain.
Stroke experts have a saying: time
is brain. Brain cells, called neurons,
deprived of oxygen begin to die at an
alarming rate: 1.9 million per minute.
The functions those cells control
switch off. A major stroke sufferer
might suddenly be unable to stand,
see or move one of their hands, arms
or legs. Stroke typically weakens or
shuts down one side of the body –
opposite the side of the brain where
the stroke occurs. Half the face might
go slack. Speech can be slurred or
impossible.
At the hospital Florence was treated
with the intravenous clot-buster drug
tPA (tissue plasminogen activator).
The procedure, called thrombolysis,
can stop a stroke in its tracks by chem-
ically dissolving the clot, allowing
blood to circulate unimpeded and
limiting permanent neurological dam-
age. Available in most countries, tPA
has become part of the biggest break-
through in stroke treatment to date.
But thrombolysis isn’t the right
treatment for everyone, explains
stroke expert Professor Keith Muir.
When it is administered within the
first 90 minutes after the onset of
symptoms, Professor Muir says about
one person in five will get significant
benefit and go home with few to no
lingering symptoms. “By the next
90 minutes, it’s one in ten. If you treat
in the next 90 minutes it’s one in 20.
And after that it’s no effect at all.”
The treatment comes with substan-
tial risk of bleeding in the brain and if