Dr. Fernández Ferro: “A stroke is like a biographical rupture: a before and after for the patient.”

Azucena Galindo was seeing a client at work when she began to notice something wasn't right. Her hands were shaking, she couldn't speak clearly, and she felt a sharp pain . "The client realized something was happening to me, asked me questions, and I couldn't answer . I spoke, but she couldn't understand anything. Then I felt dizzy," she recalls. Her client laid her on the floor and called 911. She had suffered a stroke .

This neurological disease results from a lack of blood flow to a specific part of the brain, and in Spain, around 200 cases are recorded per 100,000 inhabitants each year. Although it usually affects people around 70 years of age with accumulated risk factors, it can also occur in younger people. "Strokes frequently affect young people for a number of reasons, because they are often the manifestation of other diseases," explains Dr. José Carlos Fernández Ferro , head of the Neurology Department at the Rey Juan Carlos University Hospital.

"The main signs of a stroke are speech impairment, drooping of the corners of the mouth, strength problems, and a sudden headache."

That was the case for Azucena, who suffered the episode at age 45. “I didn't have high cholesterol or high blood pressure —nothing. My blood tests were clear. Then they told me it was due to the artery, that it could have been defective from birth, that it had a fold that was causing the blood to clot there.” But beyond the cause, the greatest challenge of the disease is that it can manifest in multiple ways, and it's important to know some of the symptoms in order to act as soon as possible. “We know that a large majority contain at least one of the following four: speech impairment , deviation of the corner of the mouth, strength or sensitivity problems on one side of the body, and a sudden, sudden headache,” summarizes Dr. Fernández Ferro.

When a stroke is suspected, the immediate care protocol known as code stroke is activated. "Within a code stroke, neurologists and radiologists work together in the scanner to determine whether it is an ischemic or hemorrhagic stroke and make treatment decisions as quickly as possible." The first, and most common, is caused by a blood clot blocking circulation; the second, by a ruptured blood vessel . "Both are equally important and are considered medical emergencies," the doctor points out.

In this race against time, the Stroke Unit plays a fundamental role. As Dr. Fernández Ferro explains, "it's a hospital ecosystem made up of a group of professionals working to achieve the greatest benefit for the patient." Neurologists, radiologists, nursing staff, and other professionals converge in this specialized environment to continuously monitor the patient, detect any slight change, and respond quickly. "It's the most effective tool we currently have for both ischemic and hemorrhagic strokes," the specialist affirms. Thanks to this multidisciplinary care , the prognosis and recovery of those who have suffered a cerebrovascular event are significantly improved.

Once diagnosed, if the patient arrives at the hospital in time, treatments can include intravenous fibrinolysis —which dissolves the clot with drugs—or mechanical thrombectomy , a technique that involves physically removing the clot using specialized devices.

After the acute phase, early rehabilitation is key to minimizing the after-effects: “I was left with sluggish limbs on the left side and dysphagia, but everything has recovered except for the dysphagia . I still have some discomfort; I have to be very careful not to choke. But everything else has been resolved; I think I've been very lucky,” says Azucena.

"It is essential to raise awareness about the classic risk factors: high blood pressure, diabetes mellitus, tobacco, alcohol, drugs, and obesity."

However, the impact of a stroke doesn't end with discharge. "I personally define a stroke as a biographical rupture . Normally, whether there are after-effects or not, patients recount a before and after and wonder: 'What am I going to do from now on with these after-effects? What will become of me tomorrow?'" reflects Dr. Fernández Ferro. Azucena confirms: "The worst thing for me is the fear that it will happen again . You feel a headache and say 'ouch'..."

To help patients cope with this new reality, the hospital has created support spaces . “During admission, a lot of information accumulates during a very delicate moment of emotional shock, which is why we launched the Stroke School, a meeting space for patients and families where we address the same issues as during admission, but in a more calm manner where they can better understand it,” says Dr. Fernández Ferro.

However, his final message is clear: “The stroke with the best prognosis is the one you never have. It's essential to raise awareness about the classic risk factors : high blood pressure, diabetes mellitus, smoking, alcohol, drugs, and obesity. We repeat this over and over again, almost monotonously, but it's vital.”