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Accident vasculaire cérébral : De la prise en charge précoce à la rééducation

par Heuschling, A.;Gazagnes, Marie-Dominique ;Hatem, Samar
Référence Revue médicale de Bruxelles, 34, 4, page (205-210)
Publication Publié, 2013-09

Article révisé par les pairs

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Résumé :

Stroke is a major health problem. The incidence of stroke in Belgium is estimated at 18,875 cases per year. Primary care needs to be fast in order to reduce mortality and disability. The European recommendations for the management of stroke are the following : 1) stroke patients should be treated in specialized stroke units. Therefore, suspected stroke victims should be transported without delay to the nearest medical centre with an available stroke unit, or to a hospital providing organized acute stroke care if a stroke unit is not available ; 2) stroke should be considered as a medical emergency requiring fast management. Once stroke symptoms are suspected, patients or their proxies should call emergency transportation or a similar system ; 3) Stroke Unit should provide co-ordinated multidisciplinary care by medical, nursing and therapy staff who specialize in stroke care. Treating patient in a specialized stroke unit allows reducing the mortality by 20 % and improving the functional outcome of patients, regardless of age and/or stroke severity. Once the diagnosis of stroke is confirmed, causes and mechanisms should be clarified in order to prevent the recurrence of stroke. In case of ischemic stroke, less than 3 hours after the first symptoms, thrombolysis (which is the only curative treatment at present) may be proposed to the patient. The aims of neurological rehabilitation after stroke are : A) to enable the patient to recover a satisfactory quality of life considering the patient's status and environmental factors ; b) to coordinate all means to prevent (or minimize) the inevitable functional, physical, psychological, social consequences and economic impairment caused by disability (activity limitation). These objectives are pursued by stimulating maximally the residual abilities of the patient.