Acute treatment of stroke

Stroke affects 30,000 people in the Netherlands every year. They may be suddenly paralysed down one side, they may be unable to speak or understand (FAST: Face, Arm Speech, Time), or they may die. In fact, one in four of all those who suffer a stroke die from the effects, and about the same number are no longer able to look after themselves, and may need full-time nursing care.

What is a stroke?

A stroke occurs when a blood vessel in the brain becomes closed off. The blood supply to the area of brain that normally controls movement in the opposite side of the body (and possibly other functions) is cut off, and the tissue ceases to function. If this goes on for too long, the affected area of the brain suffers irreparable damage. The consequences can be catastrophic and a severe degree of invalidity or even death may result. However if the blood supply is resumed within three hours, the chances of recovery are much greater.

Intravenous thrombolysis

The modern approach to treating strokes is clearly producing results. The publication of the ECASS and NINDS studies some ten years ago showed irrefutably that an effective form of treatment is available: intravenous thrombolysis. However, it is vital that the patient gets this treatment as quickly as possible – and certainly within three hours. This places huge demands on organisation and logistics. Within these first three hours, a CT scan of the brain and other tests must be made. If the results permit, then the stroke can be treated by thrombolysis. This treatment has already meant that 20% more of those who suffer a stroke can expect to return home to enjoy a good quality of life.

Unfortunately, the actual situation in the Netherlands is less favourable. Even in the most effective hospitals, only about 15% of patients currently receive this type of treatment. In many hospitals, this number is no more than 5%. This means that, ten years after this form of treatment was first introduced, most hospitals are still incapable of delivering it quickly and reliably to those who need it. In short, it should be possible to provide stroke treatment more effectively than is currently the case in the best Dutch hospitals.

More patients will benefit

In close collaboration with partners, Thromboclinics will offer treatment for stroke in which acute care will be embedded in a reliable stroke service. Good organisation, expert physicians and carefully planned ‘focused factory’ logistics will enable 20-30% of the total number of those affected to receive the right treatment. This means that, compared with the present situation in the Netherlands, an additional 15-30% of patients could be treated more effectively, with 1-3 more out of every 10 being able to return to home to a good quality of life. Thromboclinics is developing a clinic that will apply up-to-date medical knowledge to help achieve this goal.

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