He has in mind this man who ended up coming to consult at the start of the week, already having great speaking difficulties, and a paralyzed arm. He hadn't dared to call the emergency room earlier. Faced with these too many situations, Professor Pierre Amarenco, head of the neurology service of the Bichat hospital in Paris, calls on the population so that they do not hesitate to seek treatment.
Is the situation so worrying as that?
Pr PIERRE AMARENCO. It's simple, in the Paris region, there are 50 to 70% fewer arrivals at the hospital for cerebrovascular accidents (strokes) or transient ischemic attacks (Editor's note: AIT, a kind of mini-stroke) ) . At first, we thought it was because there had been a lot of departures to the province, but not: everywhere else, this drop is 30 to 40%. We are therefore well faced with a collateral and unexpected effect of Covid-19 which poses a huge problem in terms of public health. The authorities have not hammered enough that everyone should consult, they have been doing it for a few days.
But how is it possible not to consult for something as serious as a stroke?
Patients no longer dare to come to the hospital, either for fear of disturbing them, or for fear of being infected with the virus themselves. They minimize their symptoms, tell themselves that it will pass. However, we have three hours to properly manage a stroke. Six for a TIA, if not, there is a risk of having a massive stroke in the hours or days that follow. The consequences of a delay in diagnosis are serious: paralysis of an arm, a leg, aphasia, vision problems, etc.
Are they right to think it is risky to come to the hospital?
No, and I say it with as much force as possible: "Come, we are there for you!" Patients must be reassured: doctors are available to them, there are specific routes to the hospital so that they do not come across infected people, there are “special Covid” scanners and others Covid. Ditto for MRIs. All precautions are taken. And this, whatever the field. Cardiologists experience the same agonizing situation with myocardial infarction. Earlier, my colleague gastroenterologist received a patient with 3 g of hemoglobin in the blood (Editor's note: we talk about anemia when this rate is less than 12 g for a woman). It's catastrophic. Today, a lot of people postpone their care. There is danger.
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For the stroke, what signs should alert?
A side of the face or body that begins to suddenly paralyze. Or the feeling of anesthesia - as in the dentist - also on half the body. Loss of sight either in one eye or part of the visual field. Speech difficulties. Sudden and sudden headache. Finally, someone who starts walking like a drunk person, no longer standing on his legs. In these cases, no hesitation, you must call 15!