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Our role Rheumatology is the branch of internal medicine concerned with problems of the joints, tendons, muscles and/or bones caused by certain diseases. These can be diseases of the locomotor system or other pathologies that result in symptoms and pain in the joints, tendons, muscles, bones or any other organ. Image Image Rheumatology is applied immunology: it deals with all disturbances to the immune system and the diseases that result from them. Ultimately, any disease could be linked in one way or another to rheumatology Pr Muhammad Soyfoo Head of Rheumatology Department Our specialities In addition to a general rheumatology clinic, the department covers a number of specialised sectors and consultations: · Early onset arthritis and rheumatoid arthritis consultationsSpondyloarthritis and psoriatic arthritis consultationsSystemic and auto-immune diseases such as lupus, scleroderma, vasculitis, Sjögren's syndrome (see Focus), etc.Consultations for bone diseases of the osteoporosis varietyFibromyalgia consultations, in cooperation with the Multidisciplinary Centre for Pain Assessment and TreatmentVideocapillaroscopy, which is an examination to detect anomalies of the capillary blood vessels. In particular, it makes it possible to detect Raynaud's disease or a scleroderma. The Erasmus Hospital is one of 5 Belgian centres to propose videocapillaroscopy.Joint ultrasoundThe Department also proposes psychosomatic consultations to help patients confront the sometimes major psychological repercussions of their illness. Our Team Image Our medical specialists Focus In consultation with the Ophthalmology and Stomatology Departments, the Erasmus Hospital Rheumatology Department proposes a multidisciplinary approach to Sjögren's syndrome. This auto-immune disease affects mainly perimenopausal women and results in dryness of the eyes, mouth, vagina, etc. The department also has the distinction of being :Scleroderma reference centreEarly arthritis clinicMultidisciplinary centre for systemic and autoimmune diseasesA pioneer in research into systemic diseases Research Rheumatologists at the Erasmus Hospital participate in a number of fundamental or clinical research programmes on the diseases in which they specialise: rheumatoid arthritis, Sjögren's syndrome, etc. The department cooperates in particular with the Metabolic Biochemistry Department and the Immunology Department at Gosselies. Publications Aquaporins: Unexpected actors in autoimmune diseases. Authors : Delporte C, Soyfoo M.Journal : Autoimmun Rev. 2022 Aug;21(8):103131. doi: 10.1016/j.autrev.2022.103131 Neuromyelitis Optica: Pathogenesis Overlap with Other Autoimmune Diseases. Authors : Taheri N, Sarrand J, Soyfoo MS.Journal : Curr Allergy Asthma Rep. 2023 Nov;23(11):647-654 Involvement of CCL2 in Salivary Gland Response to Hyperosmolar Stress Related to Sjögren's Syndrome. Authors : Chivasso C, Parisis D, Cabrol X, Datlibagi A, Delforge V, Gregoire F, Bolaky N, Soyfoo MS, Perret J, Delporte C.Journal : Int J Mol Sci. 2024 Jan 11;25(2):915 Involvement of Epithelial-Mesenchymal Transition (EMT) in Autoimmune Diseases. Authors : Sarrand J, Soyfoo MS.Journal : Int J Mol Sci. 2023 Sep 23;24(19):14481

The concrete on the façade of the Erasme Hospital needs to be repaired for your safety and that of our teams. Scaffolding has been erected in front of the windows on one of our façades; the work will last from 10 May to 13 June. The concrete on the façade of the Erasme Hospital needs to be repaired for your safety and that of our teams. Scaffolding has been erected in front of the windows on one of our façades; the work will last from 10 May to 13 June.For visitors to the hospital and for consultations, there should be no impact. There will, however, be some inconvenience in certain hospital rooms on certain wards. We are doing everything we can to limit the noise from the site, and a film has been put up on the windows of the rooms concerned to ensure that each patient retains their privacy.Your care team will be happy to answer any questions you may have.

What is slow digestion? Slow digestion, or gastroparesis, is a disorder characterized by delayed gastric emptying. It can cause symptoms such as nausea, bloating, early satiety, or abdominal pain. This condition may be related to underlying diseases such as diabetes or may appear without an apparent cause. Erasme Hospital offers innovative solutions to improve gastric emptying and reduce symptoms. Slow digestion: what medical care is available at H.U.B? The Gastroenterology Department of Erasme Hospital offers an advanced approach to treating slow digestion, combining precise diagnosis with modern therapeutic options. Among innovative treatments, Botox injection into the pylorus helps relax the muscle and speed up the passage of food. Another alternative is the G-POEM procedure (Gastric Per-Oral Endoscopic Myotomy), which involves partially cutting the pyloric muscle to sustainably improve gastric emptying.Our multidisciplinary team, composed of gastroenterologists, radiologists, dietitians, and physiotherapists, provides personalized follow-up for each patient to optimize outcomes and improve quality of life.Patients suffering from slow digestion can improve their digestive comfort by adopting certain habits: choosing smaller, more frequent meals, preferring easily digestible foods, and chewing food thoroughly. Regular hydration and light physical activity, such as walking after meals, can also help. If symptoms persist, a medical consultation is recommended. Discover the Gastroenterology Department of H.U.B Slow digestion: what scientific and medical innovations are available at H.U.B? Erasmus Hospital is a reference center for research on digestive motility disorders. Our teams participate in clinical studies on innovative treatments such as Botox and G-POEM to optimize their effectiveness and develop new approaches. Our goal is to offer patients effective and minimally invasive solutions to improve their digestive comfort. Our Contributions to Scientific Research As members of a leading academic hospital, our healthcare professionals conduct scientific research projects to advance medicine and continuously improve the quality of care provided to patients. View the list of our scientific publications

To ensure you are fully informed about the procedure, please read this information carefully. Your doctor is available to provide any additional details you may require. How to prepare for a small bowel examination with a video capsule? Video capsule examination of the small bowel has been available for several years, but since July 2008 it has only been reimbursed by the INAMI/RIZIV at 75% (APPROXIMATELY €200 to be paid by the patient).The day before the examination, the patient should:Follow a low-fiber diet, meaning no fruits or vegetables (neither cooked nor raw), and no whole wheat or brown bread. You may eat white bread, white pasta, meat, and dairy products.Drink a preparation: purchase a box of PLENVU from a pharmacy (available without a prescription). Around 5:00 PM, have your evening meal. Around 6:00 PM, start the PLENVU: take dose 1, mixed in ½ liter of water (to be drunk within 30 minutes); then drink another ½ liter of clear liquid of your choice.From midnight: remain fasting.On the day of the examination:Remain fasting from midnight.Go to the 1st floor at the Endoscopy Unit, Route 306.If this is your first visit to ERASME Hospital, please first check in at the consultation reception in the hospital lobby.You will swallow the video capsule with a glass of water; the capsule is the size of a medicine capsule (water + 20 ml Endo-Paractol).A belt with a recording device will be fastened around your waist.You will stay in the rest area for 1 hour after swallowing the capsule to ensure it has reached your duodenum.If the capsule is still in the stomach, you will receive a 10 mg Motilium tablet.You may drink water 1 hour after ingesting the capsule, and then eat and drink normally 3 hours after ingestion.Around 4:30 PM, return to the Endoscopy Unit on the 1st floor (Route 306), where the belt with the recording device will be removed.The video capsule will be eliminated in the stool and does not need to be retrieved. N.B.: Do not undergo an MRI (magnetic resonance imaging) on the day of the examination or in the days following.For any information or in case of cancellation, please contact the Endoscopy Clinic by phone at +32 (0)2 555.32.92 or by email at rendez-vous [dot] Endoscopie [dot] erasme [at] hubruxelles [dot] be

Practical information Service location: Erasmus Hospital (general hospital), level -1: follow route 671.5 intensive care units: Unit 1-2-3-4-5Visiting hours: 2:30 pm to 7:30 pm: maximum of 2 visitorsIs one of your relatives admitted or due to be admitted to the Intensive Care Unit of Erasmus Hospital?Intensive care reception: 02/555.33.95 (10 am–6 pm) or admissions department: 02/555.16.78.You will find other useful information about our service by clicking here.Are you a general practitioner and would you like to obtain the medical results of your patients?secmed [dot] usi [dot] erasme [at] hubruxelles [dot] be Continuous care for the most vulnerable patients Our department provides multidisciplinary care for patients. These include hospitalized patients or patients referred from the emergency department or the operating room who are in critical condition and require continuous close monitoring, 24 hours a day, 7 days a week. We deliver this care with respect for patients’ autonomy and wishes, without any discrimination based on their condition or beliefs. Image Image Image Image Conditions managed exclusively in the Intensive Care Unit of the H.U.B. Acute neurological care: traumatic brain injuries, cerebral hemorrhages, unexplained coma, stroke, epilepsy, …Acute cardiological care: cardiac arrest and post–cardiac arrest care, arrhythmias, heart failure and circulatory support (LVAD, heart transplantation, ECMO)Thromboembolic diseases (in collaboration with the Pulmonary Embolism Response Team Erasme), pulmonary hypertensionTransplant patients (cardiac, pulmonary, hepatic, renal, pancreatic, …)ARDS (veno-venous ECMO), complex ventilator weaning in collaboration with the pulmonology departmentPulmonary fibrosisComplex thoracic surgery: postoperative follow-upLiver cirrhosis and acute liver failureAcute or chronic renal failureSickle cell diseaseOnco-hematology Image Care services offered by the Intensive Care Unit of the H.U.B. The department brings together specialized staff (physicians, nurses, physiotherapists, …) and the specific equipment required for the monitoring and treatment of critical illnesses.Comprehensive management of patients suffering from organ failurePersonalized care pathways following an acute eventHolistic approach to care in collaboration with a dietitian, a psychologist, an occupational therapist, physiotherapists, nursing assistants, and the hospital’s medical specialistsRegular communication with patients’ familiesInnovations: post–intensive care consultation, possibility of animal-assisted contact with the unit’s dog (Yuki) under strict hygiene conditions, “Green ICU”, … Intensive Care at H.U.B.: key figures Number of patients treated 2.800 each year Number of transplants 190 per year Number of extracorporeal membrane oxygenation (ECMO) procedures 40 per year Prof. Fabio Taccone, Head of the Intensive Care Department Prof. Fabio Silvio Taccone is Professor of Intensive Care Medicine and Head of the Intensive Care Department at the Brussels University Hospital (H.U.B. – Erasmus Hospital). He received his medical training in Italy and specialized in internal medicine and intensive care in Belgium. He then pursued his academic and clinical career at H.U.B., where he is now internationally recognized as an expert in intensive care medicine. His main areas of expertise include neurocritical care (traumatic brain injury, subarachnoid hemorrhage, stroke), the management of sepsis and septic shock, advanced hemodynamic support, and multimodal monitoring techniques in critical care. He is the author or co-author of more than 900 indexed scientific publications and has participated in numerous international multicenter clinical trials. He is an active member of several scientific societies, including the ESICM (European Society of Intensive Care Medicine), and regularly contributes to international guidelines and consensus statements. As department head, he combines clinical, academic, and research activities, with a strong commitment to training young intensivists and disseminating knowledge. He is also involved in organizing leading international conferences such as ISICEM (International Symposium on Intensive Care & Emergency Medicine). Our team Image Our intensivists Filippo AnnoniGilles BoumazaCharles Dehout  Côme GarinJulie GorhamVincent LabbéRaphaël LarsenMehdi MezidiAnthony MoreauRaphaël MottaleLeda NobileZoé PletschetteChahnez TalebMichael WatchiKatarina Winant-Halenarova  Head nurses:ICU 1: Daniele ColluraICU 2: Gaetan CrohinICU 3: Laetitia GeldhofICU 4: Nathalie BaillyICU 5: Gwenaelle MercierChristian VanderwallenHead Nurse of the DepartmentYves MaetensChief PhysiotherapistFrédéric BonnierPsychologistAraxie MatossianDietitianGabrielle BonneIntensive Care ReceptionFlorence AbrassartLaura JacminDepartment dogYuki Our scientific publications Lien vers https://www.nejm.org/doi/full/10.1056/NEJMoa2214552 Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest Eastwood G, Nichol AD, Hodgson C, Parke RL, McGuinness S, Nielsen N, Bernard S, Skrifvars MB, Stub D, Taccone FS, Archer J, Kutsogiannis D, Dankiewicz J, Lilja G, Cronberg T, Kirkegaard H, Capellier G, Landoni G, Horn J, Olasveengen T, Arabi Y, Chia YW, Markota A, Hænggi M, Wise MP, Grejs AM, Christensen S, Munk-Andersen H, Granfeldt A, Andersen GØ, Qvigstad E, Flaa A, Thomas M, Sweet K, Bewley J, Bäcklund M, Tiainen M, Iten M, Levis A, Peck L, Walsham J, Deane A, Ghosh A, Annoni F, Chen Y, Knight D, Lesona E, Tlayjeh H, Svenšek F, McGuigan PJ, Cole J, Pogson D, Hilty MP, Düring JP, Bailey MJ, Paul E, Ady B, Ainscough K, Hunt A, Monahan S, Trapani T, Fahey C, Bellomo R; TAME Study Investigators. N Engl J Med. 2023 Jul 6;389(1):45-57. doi: 10.1056/NEJMoa2214552. Epub 2023 Jun 15. Lien vers https://www.nejm.org/doi/full/10.1056/NEJMoa2115998 Treating Rhythmic and Periodic EEG Patterns in Comatose Survivors of Cardiac Arrest Ruijter BJ, Keijzer HM, Tjepkema-Cloostermans MC, Blans MJ, Beishuizen A, Tromp SC, Scholten E, Horn J, van Rootselaar AF, Admiraal MM, van den Bergh WM, Elting JJ, Foudraine NA, Kornips FHM, van Kranen-Mastenbroek VHJM, Rouhl RPW, Thomeer EC, Moudrous W, Nijhuis FAP, Booij SJ, Hoedemaekers CWE, Doorduin J, Taccone FS, van der Palen J, van Putten MJAM, Hofmeijer J; TELSTAR Investigators. N Engl J Med. 2022 Feb 24;386(8):724-734. doi: 10.1056/NEJMoa2115998. Lien vers https://www.nejm.org/doi/full/10.1056/NEJMoa2100591 Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest Dankiewicz J, Cronberg T, Lilja G, Jakobsen JC, Levin H, Ullén S, Rylander C, Wise MP, Oddo M, Cariou A, Bělohlávek J, Hovdenes J, Saxena M, Kirkegaard H, Young PJ, Pelosi P, Storm C, Taccone FS, Joannidis M, Callaway C, Eastwood GM, Morgan MPG, Nordberg P, Erlinge D, Nichol AD, Chew MS, Hollenberg J, Thomas M, Bewley J, Sweet K, Grejs AM, Christensen S, Haenggi M, Levis A, Lundin A, Düring J, Schmidbauer S, Keeble TR, Karamasis GV, Schrag C, Faessler E, Smid O, Otáhal M, Maggiorini M, Wendel Garcia PD, Jaubert P, Cole JM, Solar M, Borgquist O, Leithner C, Abed-Maillard S, Navarra L, Annborn M, Undén J, Brunetti I, Awad A, McGuigan P, Bjørkholt Olsen R, Cassina T, Vignon P, Langeland H, Lange T, Friberg H, Nielsen N; TTM2 Trial Investigators. N Engl J Med. 2021 Jun 17;384(24):2283-2294 Lien vers https://jamanetwork.com/journals/jama/fullarticle/2824930 Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury: The TRAIN Randomized Clinical Trial Taccone FS, Rynkowski CB, Møller K, Lormans P, Quintana-Díaz M, Caricato A, Cardoso Ferreira MA, Badenes R, Kurtz P, Søndergaard CB, Colpaert K, Petterson L, Quintard H, Cinotti R, Gouvêa Bogossian E, Righy C, Silva S, Roman-Pognuz E, Vandewaeter C, Lemke D, Huet O, Mahmoodpoor A, Blandino Ortiz A, van der Jagt M, Chabanne R, Videtta W, Bouzat P, Vincent JL; TRAIN Study Group. JAMA. 2024 Nov 19;332(19):1623-1633 Research in Intensive Care Ongoing clinical studiesEsScape 996Multicenter phase III study evaluating the efficacy and safety of trimodulin versus placebo in adult hospitalized patients with community-acquired pneumonia requiring mechanical ventilation.Secondary objectives include detailed assessment of pharmacokinetic (PK) properties in a sub-study and evaluation of pharmacodynamic properties.Sponsored by Biotest AG.BONANZAInternational multicenter ICU study aiming to reduce cerebral hypoxia following severe traumatic brain injury. The study evaluates whether optimization of cerebral oxygenation management using a brain monitoring catheter, compared with standard care based solely on intracranial pressure monitoring, improves neurological outcomes at 6 months.In collaboration with Monash University (New Zealand).BTI-203Randomized, double-blind, placebo-controlled phase II study assessing the efficacy and safety of recombinant human plasma gelsolin as an adjunct to standard therapy in moderate to severe acute respiratory distress syndrome (ARDS) due to pneumonia or other infections.Sponsor: BioAegis Therapeutics, Inc.CAFSRandomized controlled trial comparing three management strategies (risk control, heart rate control, and rhythm control) for de novo supraventricular arrhythmias during septic shock in adult patients. The primary endpoint is a hierarchical outcome combining mortality and duration of septic shock. Secondary endpoints include rhythm control efficacy, morbidity and mortality, and tolerance.Study conducted by AP-HP (France).EPO-TRAUMARandomized, double-blind, multicenter trial comparing erythropoietin alfa versus placebo in severely traumatized mechanically ventilated patients. The primary endpoint is mortality and severe disability at 6 months.Conducted in collaboration with Monash University (New Zealand).LATTEClinical study evaluating the impact of hypertonic sodium lactate administration in patients surviving cardiac arrest who remain unconscious.Funded by the European Society of Intensive Care Medicine (ESICM) and the Erasme Fund for Medical Research.OXYTRIPInternational, multicenter, randomized controlled study comparing two transfusion strategies in ICU patients: a “standard” strategy (target hemoglobin ≤ 9 g/dl according to international guidelines) versus a “targeted” strategy (target hemoglobin ≤ 7 g/dl to optimize oxygen debt).Initiated by the University of Ferrara (Italy).PRINCESS 2Prehospital Resuscitation Intranasal Cooling Effectiveness Survival Study. International multicenter study investigating whether early therapeutic hypothermia in out-of-hospital cardiac arrest improves survival and neurological recovery. Brain cooling is initiated on-site using intranasal cooling (RhinoChill) versus standard resuscitation with normothermia maintained for 72 hours in ICU.In collaboration with Karolinska Hospital (Stockholm, Sweden).PRO-ACTMulticenter, randomized, double-blind study evaluating probiotics versus placebo to reduce ventilator-associated pneumonia in brain-injured or stroke patients in ICU.STEPCAREInternational multicenter study on post-resuscitation care in unconscious patients after out-of-hospital cardiac arrest. The goal is to determine the optimal combination of sedation, temperature, and blood pressure management to improve survival and limit neurological sequelae.Study sponsor: Helsingborg Hospital.STRADA-CEFNational multicenter study evaluating stratified ceftriaxone dosing based on augmented renal clearance in hospitalized patients with severe community-acquired pneumonia. The aim is to assess the impact of adjusted dosing on length of stay.Initiated by UZ Leuven.TELSTAR 2Randomized, multicenter clinical trial with medico-economic evaluation of anti-epileptic drug treatment in comatose patients after cardiac arrest presenting with status epilepticus on continuous EEG. The study assesses whether anti-epileptic therapy improves recovery.Conducted by the University of Twente (Netherlands).TRECRandomized multicenter study evaluating red blood cell transfusion thresholds (liberal ≤ 9 g/dl Hb vs restrictive ≤ 7 g/dl Hb) in patients receiving ECMO. The primary endpoint is 90-day mortality.Conducted by Amsterdam UMC.VENTILORandomized, controlled, multicenter trial comparing non-invasive ventilation with high-flow nasal oxygen in post-extubation respiratory failure. The primary endpoint is 28-day mortality.Sponsor: Poitiers University Hospital (France). Intensive Care Education at H.U.B. Our academic department welcomes healthcare professionals in training from all medical and paramedical disciplines on a daily basis. Teaching takes place at the patient’s bedside as well as through numerous seminars and practical training sessions using simulation.

What is a parental project involving sperm donation? In which cases am I concerned?If you are an infertile couple:The use of donor sperm may be considered in cases of total or almost total absence of spermatozoa, or to avoid the transmission of a genetic disease from a male carrier to his offspring.If you are a female couple:The use of donor sperm is a common option to start a family. This donation makes it possible to create a two-parent family unit and to carry and give birth to one or more children. For a second child, the same partner may carry the pregnancy, or the couple may choose to alternate.If you are a single woman:The decision to pursue single motherhood through sperm donation may result from life circumstances that made it difficult to build or maintain a stable relationship, or from concerns related to age and fertility.If you are hesitant to commit to solo motherhood, or if you are in a relatively new relationship, it is possible to undergo a fertility assessment.If you are under 38 years old, you also have the option to preserve your fertility by freezing your oocytes for future use (see the section on fertility preservation for “non-medical” reasons).Anonymous sperm donor or known (directed) sperm donor?In Belgium, anonymous donation is used in the majority of cases. The sperm comes from voluntary donors who are fertile, in good physical and mental health, and whose motivation aligns with the purpose and ethics of donation. These donors undergo genetic and serological testing beforehand to ensure optimal safety conditions for recipients.Donor anonymity is respected under Belgian law, even when sperm samples come from sperm banks outside Belgium.For infertile couples, the ethnic origin, physical characteristics, and blood group of the future father are considered when matching with a sperm donor.For female couples or single women, matching is based on ethnic origin. When the time comes, the Clinic selects the most appropriate donor.As we can, if necessary, work with other sperm banks offering equivalent safety guarantees, there is generally no waiting period. However, if a donor of “extra-European” origin or with a rare blood group is required, some waiting time may be necessary to find the best match.In terms of safety, regardless of whether the donation is anonymous or directed, only sperm that has been frozen and for which the donor has undergone serological testing at the time of freezing and/or six months later may be used, in order to prevent any risk of infection transmission.Regardless of the reason for donation, Belgian legislation limits the use of sperm from a single donor to six families. Once this “quota” is reached, the remaining sperm straws may still be used for a new pregnancy within these six families, provided that sperm samples are still available at the time of the request.Directed sperm donation, in which the donor is known, is permitted in Belgium. If you plan to receive sperm from a donor you have chosen, it is essential that the donor meets the psychological and medical criteria established by the clinic. Once the donation is made, Belgian law releases the donor from any parental obligation and stipulates that they will have no rights over the child. If you live in another country, the laws on parentage applicable in your country will apply. Medical services Psychological consultation(s)For any request involving the use of donor gametes, Belgian centers are legally required to offer a psychological consultation prior to donation.In our center, one to three psychological consultations are systematically scheduled before medical treatment begins. You will meet psychologists specialized in fertility, who work closely with your gynecologist to ensure multidisciplinary care. Particular attention is paid to issues specific to this mode of parenthood, especially those related to informing relatives and the child about the mode of conception.If, for ethical reasons, our center is unable to respond favorably to your request, we will provide you with all the necessary information to refer you elsewhere.Medical assessmentOnce patients decide to proceed after reflection, a standard preconception fertility blood work-up is prescribed for the future mother. The uterine cavity and tubal patency are assessed. Certain tests are also prescribed for the partner.Practical modalitiesDepending on the medical assessment of the person who will carry the pregnancy, intrauterine insemination with donor sperm is generally proposed as the first-line treatment.If other factors of female infertility are identified or in the case of repeated insemination failures, in vitro fertilization (IVF) may be proposed. Advice We recommend anticipating pregnancy follow-up by contacting in advance the gynecologist or midwife who will monitor your pregnancy, in order to share your assisted reproduction journey with them. Focus As a general rule, our team has set an age limit for single-parent projects between 30 and 45 years.In cases of ovarian insufficiency, egg donation combined with sperm donation (double donation) is also possible.Men who wish to become anonymous donors can be seen for an information-only consultation. Our specialized secretaries are also available to answer any questions.Possibility of using BEGECS for donor matching. Our specialists Associated servicesDepartment of Gynecology-Obstetrics / Fertility ClinicAll members of the MAR (Medically Assisted Reproduction) team manage requests for anonymous or directed sperm donation.For donor candidates:Dr. Isabelle DUPONDDr. Catherine HOUBADr Fabienne DEVREKER Psychology team:Chantale LaruelleIsabelle PlaceDenis Walravens 

Under construction The Erasmus hospital offers this service for the care of our patients. The page is currently being updated. However, you can make an appointment for this service by clicking on "make an appointment". Our team Image Our specialists

Just imagine: You get up one morning and your arm refuses to move, your mouth is lopsided or you have difficulty speaking. Every minute counts. You are perhaps having a stroke. Read more Interview with Dr. Noémie Ligot, Director of the Stroke Unit at H.U.B. Just imagine: You get up one morning and your arm refuses to move, your mouth is lopsided or you have difficulty speaking. Every minute counts. You are perhaps having a stroke. Which is not rare: World data (GBD/WHO, 2018) indicate that one in four persons aged over 25 will suffer a stroke at some time in their life. What is a stroke? A stroke occurs when part of the brain no longer receives oxygen and the nutrients it needs. There are two principal kinds of stroke:2  Ischaemic stroke (85 % of cases): a clot blocks an artery preventing the blood from reaching certain areas of the brain.    Hemorrhagic stroke (15 %): an artery ruptures and causes bleeding in the brain.   The symptoms are the same, whether it is an ischaemic or hemorrhagic stroke: difficulty in speaking, weakness in an arm or leg, lost or blurred vision. Only a scan or MRI can differentiate between the two.    The TIA: A warning signal A TIA, or transient ischaemic attack, is similar to a stroke but is soon over, often in less than an hour. Although the symptoms soon pass, it is a warning sign: There is a high risk of a major stroke within the coming days. You must act immediately.    How to recognise a stroke or TAI? The golden rule: F.A.S.T Face: sagging on one side of the face Arm: weakness in an arm or leg Speech: speech or language disorders Time: every minute counts, call 112 immediately Any sudden neurological deficit — blurred vision, dizziness, numbness in a limb — must be taken seriously and you should go immediately to the hospital emergency department. “Even if the symptoms seem to be ceasing, they often signal an imminent risk of a more serious stroke. So you must go to hospital emergencies immediately. Every minute counts to protect the brain,” stresses Dr. Noémie Ligot, Head of the Neurovascular Clinic at Brussels University Hospital.   In the rest of this article we will speak mainly of ischaemic strokes. These are the most common strokes and for which there is now specific treatment in the acute phase. The causes vary depending on age and state of health: Among elderly people (65 and over) the accumulation of cardiovascular factors over many years renders the arteries fragile. Atherosclerosis (deposition of fatty material in the main arteries) or microangiopathy (damage to very small arteries) are frequent. Atrial fibrillation (irregular heart rhythm) is also a major factor as it can lead to blood clots that travel to the brain.    Among so-called “young patients” (under 45-55), the causes are often different than among elderly people and are not generally linked to usual cardiovascular risk factors and may include: dissection of a neck artery (following a trauma, a sudden movement or certain sports practices), some congenital heart defects such as a permeable foramen ovale   (editor’s note: a small opening between the two upper chambers of the heart – the atria – that remains in certain adults when it should close at birth), the consumption of drugs such as cocaine or amphetamines, coagulation problems or, more rarely, a heart attack occurring during a prolonged migraine aura.    Strokes in young people: A warning sign For young stroke victims a specific diagnostic approach is needed: specialised brain MRI, heart ultrasound, cerebral artery Doppler and extended blood test. The aim is to understand the precise cause so as to adapt the treatment and prevent a recurrence. In some cases, no cause is found despite an exhaustive search. This does not mean that there is no solution, and the right monitoring and preventive measures can nevertheless greatly reduce the risk of another stroke.Dr. Noémie Ligot stresses that: “Even in a young adult with no conventional risk factor, a stroke can occur. It is essential to never underestimate the importance of the symptoms.” Stroke care and prevention: a rapid and comprehensive pathway You will now have understood: When suffering a stroke, time is a key factor. The quicker the patient gets to hospital the greater the chances of limiting the after-effects.  At the Brussels University Hospital, the care respects the strictest international standards with a pathway designed to be ultra fast, precise and effective.    1. The acute phase: Act fast to save the brain On arrival at the emergency room the patient benefits from:   A brain scan that serves above all to rule out a haemorrhage but also to assess the first ischaemic brain lesions, and an angio scan to precisely locate the clot and assess the condition of the arteries.   A perfusion scan to detect those areas of the brain that can still be salvaged and those irremediably affected.   This information guides the treatment: Thrombolysis that consists of injecting medication into the veins to dissolve the blood clot. It must be administered as rapidly as possible to be fully effective. It is generally carried out within the first 4 or 5 hours but, thanks to perfusion imaging, some patients can still benefit from this up to 9 hours after the onset of symptoms.  A thrombectomy that is an endovascular procedure to remove the blood clot directly from the artery. This is reserved for blockages in the brain’s biggest arteries. It must be carried out as quickly as possible: the sooner it is carried out the more effective it is. It is usually carried out within the first 6 hours but, thanks to perfusion imaging, some patients can still benefit from it up to 24 hours after the onset of symptoms. This procedure is carried out 24 hours a day, 7 days a week by a specialist team ready to intervene immediately, including at night or during the weekend.   2. Follow-up and the search for the cause Once the stroke has been stabilised, the diagnosis is exhaustive, with : Detailed imaging to detect dissections, vascular anomalies or a silent heart attack. A cardiac assessment to detect any atrial fibrillation or permeable foramen ovale. Blood tests to detect any coagulation problems or inflammatory factors. “The aim is to understand precisely the cause of the stroke so as to adapt the treatment and prevent any further strokes as much as possible. Even if the cause is not found in 100% of cases, the team can determine the best prevention strategy for the individual patient,”   explains Dr. Ligot. 3. Rehabilitation and global support Recovery does not stop at the hospital: Patients benefit from adapted rehabilitation (physiotherapy, speech therapy, occupational therapy, neuropsychology)  from the very start. Psychological  support is proposed to help overcome stress, anxiety and depression associated with the stroke. Education for the patient and patient’s family on the  risk factors and prevention is essential : high blood pressure, smoking, cholesterol, physical activity, balanced diet.   4. A unique reference centre The H.U.B. has a reference Stroke Unit, with: 10 monitored beds dedicated to stroke patient surveillance. Trained interventional vascular neurologists and neuroradiologists who are ready to supervise patients after each procedure. A multidisciplinary team (radiologists, accident and emergency doctors and specialised nurses, physiotherapists, speech therapists, etc.) who receive continuous training in the latest techniques. More than 120 thrombectomy procedures a year and regular follow-up of patients following a stroke. Since 2018, the H.U.B. has been recognised by the European Stroke Organisation (ESO) as Belgium’s first certified Stroke Centre, a guarantee of quality and compliance with international standards.  This organisation also permits comprehensive, rapid and precise care that is adapted to the needs of the individual patient, whether a young adult or an elderly person.   5. Prevention: Acting before the stroke Prevention remains the central pillar: Check cardiovascular factors: blood pressure, cholesterol, weight. Stop smoking and limit alcohol consumption. Take regular physical exercise, limit stress and adopt a balanced diet.  Key takeaways of this articleA stroke can occur at any age, often without warning.  Recognising the symptoms and acting immediately can save lives and limit after-effects. Every minute counts: Knowing the symptoms, acting fast and prevention remain the best protection. Thanks to an exceptional reference centre, the H.U.B. provides   rapid, comprehensive and personalised care, from the emergency procedures to rehabilitation, for the young and old.  Source: Feigin VL, Nguyen G, Cercy K, Johnson CO, Alam T, et al. Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016. New England Journal of Medicine. 2018;379(25):2429-2437.  doi: 10.1056/NEJMoa1804492