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What is a vasospasm ? A brain vasospasm is a frequent and serious complication that occurs following a subarachnoid haemorrhage (SAH) due to the rupture of an intracranial aneurysm. It is characterised by a prolonged and severe narrowing of the brain arteries, thereby reducing the blood flow to the brain and possibly resulting in secondary strokes.  Symptoms Vasospasm symptoms can vary depending on the area of the brain affected and include:  Severe headachesConsciousness  problemsFocal neurological deficits (paralysis, speech problems)Confusion, agitationEpileptic fitsThese symptoms generally appear between the third and 14th day after the aneurysm rupture, the incidence peaking at around the seventh day.    Treatment Imaging examinationsTo detect and monitor a vasospasm a number of imaging methods are used:    Brain angiograph: regarded as the gold standard for detecting a vasospasm.CT scan  with angiograph (CTA) and perfusion : useful for visualising  the brain arteries and the impact on the arrival of blood in the brain  Magnetic Resonance Imaging (MRI) with angiograph (MRA): non-invasive alternative that is a more complex procedure to carry out in an emergency.Transcranial Doppler (TCD) ultrasound: non-invasive method that makes it possible to measure the rate of the blood flow  to the brain arteries, indicative of a vasospasm.  Medical pathwayPatients having suffered a vasospasm are generally treated at a specialised hospital, in particular in neurosurgery or interventional neuroradiology. The pathway includes the intervention of :  Emergency staff: first to intervene following the rupture of an aneurysm.Neurosurgeons: for initial management of the aneurysm and complications.Interventional neuroradiologists: for diagnosis and treatment with embolization of the aneurysm.Neurologists: for follow up and management of neurological complications.TreatmentTreatment options for a vasospasm include:    Medicinal treatment: administration of calcium channel blockers (nimodipine) to prevent  vasospasms. A high level of evidence for prevention but limited for treatment.  Endovascular treatment: balloon angioplasty, stents or intra-arterial administration of vasodilators  (nimodipine, papaverine, milrinone). These treatments show a variable effectiveness depending on the studies and are often used in the case of severe and refractory vasospasm.  Haemodynamic treatment: increase in blood pressure and in the intravascular blood pressure to improve the blood flow to the brain. Evidence of its effectiveness is debatable.  Multidisciplinary discussionVasospasm treatment requires a multidisciplinary approach involving regular meetings of neurosurgeons, neuroradiologists, neurologists and critical care medicine specialists to discuss complex cases and adapt treatment strategies.  Follow upOngoing monitoring of patients having experienced a post-stroke vasospasm is crucial. This includes:    Regular neurological follow up: to detect and manage neurological  sequels.Rehabilitation: to help patients  recover lost functions.Imaging: to monitor the condition of the blood vessels in the brain and detect any relapses.  Risk factor management: blood pressure checks, stopping smoking, etc. to prevent future strokes.Follow up must be carried out by a multidisciplinary team to optimise the long term results of patients   Discover our Interventional NeuroRadiology Department Our Specialist Dr. Adrien GuenegoRadiologist  Expert in interventional and diagnostic neuroradiology  Specialized in strokes, cerebral aneurysms, AVMs, dAVFs, carotid artery stenosis, pulsatile tinnitus, idiopathic intracranial hypertension, vasospasm, retinoblastoma, and chronic subdural hematomas. Prendre rendez-vous

What is Thrombotic Thrombocytopenic Purpura? TTP or Thrombotic Thrombocytopenic Purpura is a rare disease of the group known as thrombotic  microangiopathies. These are diseases  in which the platelets or thrombocytes (involved in coagulation) clog together in an abnormal manner leading to the formation of blood clots.  This phenomenon causes three problems:A reduction in the number of available platelets = Thrombocytopenia.The red blood cells collide with these clots and break up leading to a reduction in number = Anaemia.The clots can block the blood vessels and reduce the oxygenation of tissues with possible serious consequences for the heart, brain, kidneys, etc.  A number of causes can be responsible for the occurrence of these thrombotic microangiopathies. The TTP is caused by the deficiency of a protein known as   "Adamts 13". This deficiency is most frequently due to the presence of an antibody (= immune TTP) or otherwise it may be a genetic anomaly (congenital TTP).   Treatment TTP must be treated as a vital emergency. Without treatment the mortality rate is 90%. A rapid diagnosis is essential followed by optimal treatment at an expert centre.  Initial treatment of immune TTP consists of two action plans:1.Acute treatmentIncreasing the level of Adamts 13 proteins by means of plasma exchanges: The plasma (the liquid component of the blood that contains cells) is replaced with healthy plasma that serves to increase Adamts 13 levels and remove antibodies.    Since 2019 an innovative medicine specific to TTP has made it possible to prevent the platelets from attaching themselves to each other, thereby resolving the three problems indicated above. This has permitted a clear improvement in the treatment of acute stage patients. Our centre always has this medicine on hand for rapid administration.    2.Fundamental treatmentStopping the production of antibodies that act against Adamts 13. First line treatment consists of the administration of corticoids and a monoclonal antibody that targets the cells that produce the antibodies  Treatment of congenital TTP is based on the administration of plasma. The administration of  synthetic Adamts 13 is not yet reimbursed but is accessible.  All persons suffering from TTP require lifelong monitoring by a haematologist specialising in this type of pathology.    Our specialists Advice TTP can present various and variable symptoms as it can affect a number of organs. The primary clinical manifestation is abnormal bleeding, major hematomas or petechiae (multiple small red/violet marks on the skin).  More severe symptoms can be the signs of a heart attack or stroke.  A blood test showing anaemia and a thrombocytopenia can quickly suggest the diagnosis .Useful links:   Thrombotic Microangiopathies - MaRIH – Rare Immuno-Haematological Diseases Health Network National Reference Centre Microangiopathies TTP Community - Home (Dutch language site)  Make an appointment Focus Our hematology team has gained extensive experience in managing this condition and regularly receives requests for the care of patients from external centers.We regularly collaborate with expert centers from various European countries (France, United Kingdom, Italy).We participate in multidisciplinary consultation meetings with French expert centers. Discover our Hematology Department

What is idiopathic intercranial hypertension? Idiopathic intercranial hypertension (IIH), also known as a pseudotumor cerebri, is a condition characterised by high pressure in the cerebrospinal fluid (CSF) without any identifiable cause revealed by imaging examinations. It is more common in women of childbearing age or who are overweight. SymptomsThe symptoms of IIH include:Severe and persistent headaches, often worse when lying down.Blurred or double vision.Temporary loss of vision.Ringing in the ears (pulsatile tinnitus).Nausea and vomiting.Swelling of the optic nerve   (papillary oedema) visible during an ophthalmological examination. Treatment Imaging examinationsTo identify IIH and exclude other causes a number of imaging examinations are carried out:  Brain MRI: to visualise the brain structures and  exclude anomalies such as tumours or malformationsMagnetic Resonance Angiography (MRA): to evaluate the cerebral veins and rule out a cerebrovascular thrombosis.  A CT scan of the brain: sometimes used in an emergency to rule out other causes of high intracranial pressure.Medical pathwayPatients with IIL need to consult  number of specialists for comprehensive treatment as a matter of urgency to avoid any deterioration of  the visual function: GP: for an initial assessment of symptoms and to direct the patient to the appropriate specialists.  Neurologist: principal specialist in diagnosing and managing IIH.  Ophthalmologist: to evaluate the effects of the IIH on vision and to monitor the papillary oedema.  Neuroradiologist: to interpret the brain imaging examinations.Neurosurgeon or interventional neuroradiologist: if surgery or endovascular intervention is necessary.TreatmentIIH treatment seeks to reduce the intracranial pressure and prevent any loss of vision:  Weight loss: recommended for overweight patients, this is often effective in alleviating symptoms.Medicines:  Acetazolamide: A diuretic that reduces the production of CSF and is a first line treatment with a high level of evidence.  Repeated lumbar punctures: to drain off excess CSF and used in the case of severe symptoms.  Surgery:  Optic nerve decompression: to prevent irreversible loss of vision in the case of severe papillary oedema.  Cerebrospinal shunt: to drain off the CSF if other treatments fail.  Interventional neuroradiology: venous sinus stenting to improve drainage of venous blood and reduce intracranial pressure when these veins narrow.  Multidisciplinary discussion  IIH management requires a multidisciplinary approach that includes meetings between neurologists, ophthalmologists, interventional neuroradiologists, neurosurgeons and other health professionals to discuss complex cases and coordinate treatment  Follow upThe monitoring of IIH patients is crucial and includes:  Regular vision monitoring: by an ophthalmologist to detect any deterioration.  Neurological monitoring: to assess the effectiveness of treatment and make adjustments when necessary.  Regular weight evaluations: plus dietary advice for overweight patients.Regular imaging examinations: to monitor intracranial pressure and the condition of brain structures.The follow up is carried out by a multidisciplinary team to optimise the clinical results and improve the quality of life of patients.  Discover our Interventional NeuroRadiology Department Our specialists Prendre rendez-vous

What is Premature Ovarian Insufficiency? Premature ovarian insufficiency (POI) is defined as the premature cessation of ovarian function before the age of 40. This leads to a decrease in the production of sex hormones, particularly oestrogen and progesterone, which can cause symptoms similar to those of menopause, such as hot flushes, menstrual irregularities and infertility. POI can have a significant impact on the quality of life of affected women, affecting not only their physical health but also their emotional and psychological well-being. Causes and risk factors Genetic factors : certain chromosomal abnormalities, such as Turner syndrome, or mutations in specific genes, may predispose individuals to POI.Medical treatments : gonadotoxic treatments (i.e. toxic to the reproductive organs), such as chemotherapy or radiotherapy used to treat cancers, may damage the ovaries.Ovarian surgery : repeated surgical procedures on the ovaries, for example to treat endometriosis or ovarian cysts, may reduce the ovarian reserve.Infections : certain viral or bacterial infections may also affect ovarian function.Autoimmune diseases: conditions such as Hashimoto’s thyroiditis or lupus may be associated with ovarian damage.Prevalence of premature ovarian insufficiencyPremature ovarian insufficiency affects 1 to 3.7% of women worldwide. A significant proportion of women may be affected by this condition, often without being aware of it. Precise data on the prevalence of POI are limited, but studies suggest that young patients receiving cancer treatment should be particularly closely monitored for this condition.  Medical management of POI DiagnosisThe diagnosis of premature ovarian insufficiency involves several steps:Clinical assessment: a thorough medical examination and a history of symptoms, including menstrual cycles and medical history, are necessary.Hormonal tests: blood tests to measure hormone levels, particularly oestrogen and follicle-stimulating hormone (FSH), may indicate impaired ovarian function.Ultrasound: an ultrasound examination may be performed to assess the presence of follicles, the anatomy of the ovaries and uterus, and to detect abnormalities such as cysts or lesions.Treatment optionsOocyte retrieval and freezing: before starting gonadotoxic treatment, patients may consider having their oocytes retrieved and frozen to preserve their fertility.Hormone replacement therapy (HRT): this therapy may help relieve symptoms associated with early menopause, such as hot flushes and mood disturbances. Non-hormonal therapies are also available in the event of contraindications.Psychological support: psychological support is often necessary to help women cope with the emotional aspects of POI.Required medical follow-upRegular medical follow-up is essential for patients with POI. This may include endocrinology consultations to monitor hormone levels and assess whether hormone therapy needs to be adjusted. Fertility consultations may also be recommended to discuss conception options and assisted reproductive techniques. Services involved in the management of POI at Brussels University Hospital:Gynaecology: gynaecologists are often the first healthcare professionals involved in the diagnosis and management of POI.Endocrinology: endocrinologists may be involved in overall management.Oncology: oncologists play a crucial role in monitoring patients who have undergone cancer treatment and are at risk of developing POI.Psychology: psychologists or psychiatrists can provide emotional and psychological support to women facing the challenges of POI.Fertility Clinic: fertility specialists are involved in managing fertility preservation options and assisted reproductive techniques.Endometriosis Clinic: gynaecologists specialising in endometriosis can refer young patients at risk to discuss fertility preservation strategies with specialists.  Make an appointment with the Gynaecology Department

What are bile duct diseases? (Strictures, stones and leaks) Various conditions can cause an obstruction of the bile ducts (benign narrowing, scarring, cancer, gallstones, …), leading to symptoms such as jaundice, itching, infections and pain. After imaging assessment, some situations require an endoscopic procedure to treat the biliary obstruction.In this way, these procedures can be performed in a minimally invasive manner under radiological guidance by passing an endoscope through the mouth (endoscopic retrograde cholangiopancreatography – ERCP) in order to extract stones, place one or more biliary prostheses (stents), and take tissue samples. In some cases, it is necessary to use a miniature camera to access the bile ducts to directly evaluate or treat these diseases on site (cholangioscopy). After trauma or surgery, a bile duct leak may occur. Similarly, ERCP can be used to resolve these complications without the need for further surgery.If you experience any of the following symptoms (yellow eyes or skin, dark urine, itching, abdominal pain, fever), please consult your doctor. After blood tests and imaging (abdominal ultrasound or abdominal CT scan), a suspicion of bile duct disease may be identified. In some cases, an abdominal MRI (magnetic resonance imaging) will be necessary for the diagnosis. In all these situations, a consultation with a specialist should be requested, or even a visit to the emergency department, which may be followed by hospitalization. Make an appointment for a consultation Bile duct diseases: what medical care at H.U.B? Within the Endoscopy Clinic, all the techniques required to treat bile duct diseases are available in the hands of the gastroenterology team (endoscopic and percutaneous retrograde cholangiography, biliary drainage guided by endoscopic ultrasound), allowing patients to be treated within a short time. Furthermore, the multidisciplinary approach, enabling discussion of the ideal treatment for each patient with various specialists (radiologist, pathologist, oncologist, surgeon, …), is a major asset of our clinic. Discover the H.U.B Endoscopy Clinic Bile duct diseases: what scientific and medical innovations at H.U.B? Erasmus Hospital has been a pioneer in the endoscopic treatment of bile duct diseases since the 1970s, when many innovations were developed under the leadership of Prof. Cremer and later Prof. Devière. This well-established expertise continues today, together with numerous related innovations, as evidenced by the department’s many scientific publications. 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

What is oesophageal dysplasia? Dysplasia is a precancerous lesion. Various factors, including alcohol and tobacco consumption, as well as gastro-oesophageal reflux, can alter the type of cells lining the oesophagus (e.g. Barrett’s oesophagus). In some cases, this increases the risk of cancer. It is now possible to detect precancerous lesions and, in some cases, remove them (endoscopic resection by mucosectomy or submucosal dissection (ESD)) or ablate them by burning them (radiofrequency). Oesophageal dysplasia: what medical care is available at H.U.B.? Thanks to the expertise of the team and the latest-generation endoscopes available at Erasme Hospital’s Endoscopy Clinic, these precancerous lesions can be identified with great precision and treated optimally, thereby limiting the need for oesophageal surgery and the risk of disease progression. The multidisciplinary approach specific to the academic hospital makes it possible to discuss each patient jointly with the surgical, oncology and radiology teams, in order to offer each patient the best possible treatment.If you have undergone an endoscopy that demonstrated the presence of Barrett’s oesophagus or dysplastic lesions (precancerous lesions), and would like the opinion of Erasme’s specialist team, please do not hesitate to make an appointment for a consultation (by email at ConsGastroMed [dot] erasme [at] hubruxelles [dot] be (ConsGastroMed[dot]erasme[at]hubruxelles[dot]be) or by telephone on +32 (0)2 555.35.04. Depending on your medical file, a new endoscopic assessment may be proposed using our latest-generation endoscopes, in order to determine the best treatment to offer.  Discover the H.U.B Endoscopy Clinic Care pathway High-grade dysplasia in Barrett’s oesophagus: What is it?  Barrett’s oesophagus is a change in the type of cells lining the lower part of the oesophagus, resulting from several factors, including gastro-oesophageal reflux. Endoscopic monitoring, through detailed image analysis and biopsies, makes it possible to detect any dysplasia (precancerous lesions).Current virtual and acetic acid chromoendoscopy techniques improve detection capabilities. Dysplastic lesions with a clearly visible lesion must be distinguished from those without a visible lesion.How can dysplasia in Barrett’s oesophagus be treated?If dysplasia is detected, the first step is to perform a new endoscopy by an expert using a latest-generation endoscope, under optimised acid-suppression treatment (proton pump inhibitors), within 3 months of the initial endoscopy. This examination will determine whether or not there is a visible lesion and clarify its size and predictive nature. In addition, the initial biopsy specimens will be reviewed by an expert anatomical pathologist to confirm or rule out the presence of dysplasia.If a visible lesion is considered superficial, the treatment of choice is endoscopic resection, either by endoscopic mucosal resection (EMR) (for lesions smaller than 15 mm) or by endoscopic submucosal dissection (ESD) (for lesions larger than 15 mm). These two techniques are performed in the therapeutic endoscopy rooms at Erasme Hospital. If the specimen shows no contraindication to continuing endoscopic treatment, ablation of the residual Barrett’s oesophagus will be proposed at a later stage, depending on the patient’s age, general health and life expectancy.In the absence of a visible lesion, if high-grade dysplasia is confirmed in new Barrett’s oesophagus biopsies, and following endoscopic resection for HGD or a pT1 carcinoma, ablation of the Barrett’s oesophagus will be proposed according to the above-mentioned criteria, using radiofrequency ablation (RFA).Regarding EMR, ESD or RFA:You will be positioned on an examination table. The procedure may last 30–90 minutes and is performed under anaesthesia for your comfort.An endoscope will be inserted through your mouth, allowing a detailed examination of the Barrett’s mucosa.For a resection, after lifting the tissue by submucosal injection, the affected tissue will be removed using an instrument with an electrocautery current.For RFA, a probe or balloon will be applied to rapidly and standardisedly burn the surface affected by Barrett’s oesophagus. With treatment using proton pump inhibitors, the tissue will heal without residual Barrett’s oesophagus. Treatment cycles will be performed every 3 months until the Barrett’s oesophagus has disappeared, with a maximum of 5 sessions per patient.After remission (disappearance of dysplasia and Barrett’s intestinal metaplasia, both in terms of endoscopic appearance and biopsy results), a structured endoscopic follow-up programme will be arranged (endoscopy every 6 months during the first year, followed by annual endoscopy). Long-term treatment with proton pump inhibitors will be prescribed.What happens after endoscopic treatment?After the procedure, you will remain in hospital for at least one night to ensure that you do not develop abdominal pain, which generally subsides during the first 12 hours. You will receive acid-suppression treatment and a puréed diet for a few days.Complications related to these treatments are rare. The most common is pain. Scar-related stenosis may occur in 5–10% of cases. What scientific and medical innovations are being developed at the H.U.B.? Our hospital is accredited by INAMI to use radiofrequency to treat Barrett’s oesophagus by endoscopy (in cases of precancerous lesions or following the removal of an early-stage cancer). In addition, Erasme Hospital is accredited by INAMI as a referral centre for oesophageal surgery (a specialised centre operating under a convention), making this multidisciplinary approach crucial for providing patients with better treatment. Finally, the team has published several scientific papers on the subject in recent years, demonstrating the pioneering nature of the endoscopy clinic in this field. 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

What is Alzheimer’s disease? Alzheimer’s disease is a progressive neurodegenerative disorder that primarily affects memory, but also language, thinking, reasoning, and the ability to perform everyday tasks. It is the most common cause of dementia in older adults. The disease progresses slowly over several years and leads to a gradual loss of independence.Alzheimer’s, memory issues, and normal aging: telling the differenceOccasionally forgetting a name or an appointment can be part of normal aging. However, when a person forgets recent events, gets lost in familiar places, or repeatedly asks the same questions, this may be a sign of a pathological disorder. Normal aging does not lead to loss of independence, unlike Alzheimer’s disease.Why is a medical diagnosis essential?An early diagnosis makes it possible to:Understand the difficulties encounteredBetter organize daily lifeAccess treatments (pharmacological or non-pharmacological) to slow disease progressionReceive support for the patient and their relativesEventually participate in research protocols and clinical trials Symptoms, causes, and risk factors Cognitive, behavioral, and functional symptomsCognitive: memory loss, difficulty with orientation, speaking, understanding, or planningBehavioral: irritability, anxiety, depression, agitation, possible hallucinationsFunctional: loss of independence in daily activities (managing finances, meals, mobility, hygiene, …)Known biological mechanisms (proteins, neurodegeneration – simplified)Identified risk factorsRole of sleep, lifestyle, and environmental factorsThe disease is linked to the accumulation of two abnormal proteins in the brain: beta-amyloid, which forms plaques, and tau, which accumulates inside neurons. These deposits disrupt communication between cells and lead to their degeneration.Age (main factor)Family history and genetics (APOE ε4)Cardiovascular factors (hypertension, diabetes, cholesterol, obesity)Tobacco or alcohol useSedentary lifestyleSocial isolationHead injuriesSleep disorders or depressionHearing or vision lossAir pollutionPoor sleep quality, an unbalanced diet, physical inactivity, and exposure to pollution may contribute to the onset or worsening of symptoms. Conversely, physical activity, cognitive stimulation, and social interaction are protective. Key figures and prevalence in Belgium Approximately 200,000 people are currently living with dementia in Belgium, and since 2019 it has become the leading cause of death in the country.Alzheimer’s disease accounts for about 70% of dementia cases.This number could double by 2050 due to population aging and increasing prevalence of risk factors. The societal impact is considerable: loss of independence, caregiver burden, and rising healthcare costs.(sources: Sciensano, WHO). Early-onset Alzheimer’s: a still underrecognized reality A form occurring before age 65Alzheimer’s disease can occur earlier, sometimes as early as the forties or fifties. This is referred to as early-onset Alzheimer’s. It affects approximately 6 to 9% of patients (source: KCE Report 2021).Specific challenges (diagnosis, professional life, family)Frequent diagnostic delay (symptoms attributed to stress or depression)Major impact on professional and family lifeIssues with administrative recognition (pension, insurance, social rights)Importance of a structured and specialized care pathwayA structured, multidisciplinary, and early care approach is essential: neurologist, neuropsychologist, social worker, caregiver support, inclusion in research programs. Our specialists Our specialists Prof. Mélanie StraussAcademic Head of the Integrated Memory Clinic (CIMe)Head of the Adult Sleep Functional Unit (SomA)PositionNeurologist, Hospital ProfessorSpecialist in cognitive neuroscienceSpecialist in sleep and vigilanceFNRS researcher Dr. Jean-Christophe BierHead of the Integrated Memory Clinic (CIMe)Member of the HUB hospital-faculty ethics committeePresident of the Clinical Ethics Reflection Unit – ErasmePositionNeurologist, Deputy Head of ClinicSpecialist in cognitive neuroscience and behavioral disorders Clinical research and innovation: the REMEMBER project Understanding and anticipating Alzheimer’s diseaseObjectives of the REMEMBER projectThe REMEMBER project, led by the Integrated Memory Clinic (CIMe) at Erasme Hospital, aims to better understand the origins of Alzheimer’s disease, identify early signs even before marked memory loss appears, and develop new non-pharmacological therapeutic approaches. Concretely, this involves building a large patient cohort followed over time, with a comprehensive assessment combining brain imaging, memory testing, biological analyses, and sleep recordings.Sleep, memory, and Alzheimer’s: an inseparable trioWe now know that sleep is not just a period of rest. It plays a fundamental role in memory consolidation and brain cleansing, particularly through a system called the “glymphatic” system, which is especially active during deep sleep. When sleep is disrupted, the brain becomes less efficient at clearing certain proteins such as beta-amyloid and tau, which accumulate abnormally in Alzheimer’s disease. The REMEMBER project specifically aims to better measure the link between poor sleep quality, memory loss, and the development of characteristic brain lesions.Why is this important?To better identify at-risk individuals from the earliest signs (mild memory issues, insomnia, anxiety…) and address modifiable risk factors quicklyTo monitor disease progression in a personalized wayTo test innovative approaches such as auditory stimulation during deep sleep (CLAS) or immersive virtual realityWhat does this change for patients?More precise cognitive and biological assessments conducted over a few daysFaster care with a personalized treatment planOpportunity to participate in clinical studies or access emerging therapiesBetter information and long-term support, including for familiesA project supported by the Erasme FundThe Erasme Fund for medical research is a key player in this project. Thanks to its support, the REMEMBER cohort has been launched in a structured, innovative, and human-centered environment. It also funds complex analyses, specialized equipment (such as portable electroencephalography), and research positions involved in the study. The Integrated Memory Clinic An innovative structure serving patients, their families, and researchIn response to the rapid increase in age-related cognitive disorders and the anticipated arrival of disease-modifying treatments for Alzheimer’s disease, Erasme Hospital – H.U.B launched in 2025, with the support of the Erasme Fund, the Integrated Memory Clinic (CIMe). This pioneering structure combines diagnosis, care, and cutting-edge research in one place, offering patients and their families comprehensive, coordinated, and accessible care.Designed as a reference center, CIMe provides a global, human, and innovative approach. Each patient benefits from a structured care pathway from the earliest cognitive complaints, including an in-depth assessment, a personalized care plan, and regular follow-up, also involving caregivers and family members. Discover the Clinic

Definition Cephalalgia is the medical term describing pain in the head. It is a pain felt in the head, jaw, or upper neck. They can be occasional or recurrent, mild or very intense, and affect different areas (forehead, temples, back of the head…).Headaches are not a disease in themselves: they are a symptom that may occur in many situations such as fatigue or stress, or may reflect a more specific neurological condition. Symptoms Symptoms vary depending on the type:Tension-type headache• Sensation of pressure, tightness, or a band around the head• Continuous pain, mild to moderate• Rarely associated symptoms• Often linked to stress, fatigue, or poor postureMigraineMigraine is a specific type of headache, often more severe. It is not just a bad headache: it is a neurological disorder with specific features (ICHD3 criteria):• Pulsating pain, often on one side• Duration of 4 to 72 hours without effective treatment• Sensitivity to light, sound, or smells• Nausea or vomiting• Sometimes preceded by visual, sensory, or motor disturbances called “aura”Migraine is therefore a specific type of headache requiring tailored management.Other types of headachesLess common types include trigeminal neuralgia, cluster headaches, paroxysmal hemicrania, medication-overuse headaches, and secondary headaches due to underlying conditions. Prevalence (Belgium) Headaches are very common:Most adults experience at least one headache per yearAbout 20% of adults report migraines yearly in BelgiumWomen are more affected than menMigraines and tension headaches are the most common Medical care Management depends on the type of headache, its frequency, its intensity, and its impact on daily life. It is based on:An accurate diagnosisIdentification of triggering factorsAn appropriate treatment planPrevention of recurrenceDiagnosisDiagnosis is mainly based on:Medical consultation: description of the pain, frequency, duration, and associated symptomsClinical (neurological) examinationInternational diagnostic criteria (e.g. number of attacks, duration, associated signs, etc.)In most cases of primary headaches (such as migraine or tension-type headache), no additional tests (CT scan, MRI) are required as a first-line approach.Treatment – Acute PhaseObjective: to relieve the attack when it occursFor tension-type headaches:Rest and hydrationSimple analgesics (paracetamol, ibuprofen, according to medical advice)For migraine:Specific treatment to be taken at the first signsMedications such as triptans, sometimes prescribed by a doctor depending on the situationAnti-nausea medication if nausea is presentTreatment taken too late or too frequently may sometimes worsen headaches (rebound effect).Chronic Treatment / Follow-upIf you experience frequent or disabling headaches:Keep a headache diary (date, duration, etc.)Regular medical evaluation with your general practitioner and follow-up with a neurologist if necessaryPrevention with:Lifestyle modifications (sleep, hydration, stress)Preventive medications (by prescription)Complementary techniques (physiotherapy, stress management, relaxation, physical activity, etc.)For chronic or severe migraine, specific preventive treatments may be proposed. For these, it is necessary to complete and keep headache calendars throughout the course of the condition. FAQ 1. What is a cephalalgia (headache)? A cephalalgia, also called a headache, is pain felt in the head or neck. There are different types of headaches, the most common being tension-type headache and migraine. 2. What is the difference between a headache and a migraine? Migraine is a specific type of headache. It is characterized by:Pulsating pain ("beating"), often on one side of the headModerate to severe intensityAssociated symptoms (nausea, aura, etc.)Migraines are a type of headache, but not all headaches are migraines. 3. What are the most common causes of headaches? The most frequent causes include:Stress and fatigueLack of sleepDehydrationMuscle tension in the neck, shoulders, and scalpMigraineIn most cases, headaches are not linked to a serious illness. 4. When should I see a doctor for headaches? It is recommended to consult a doctor if:Headaches are frequent or worseningPain is unusual or very severeHeadaches interfere with daily lifeUsual medication is no longer effectiveYour primary care doctor recommends specialist advice 5. What are warning signs of a serious headache? Seek urgent medical attention if the headache:Appears suddenly and is very severeIs accompanied by fever, stiff neck, or confusionIs associated with unusual neurological symptoms (vision, speech, weakness)These situations are rare but require prompt evaluation. 6. Can stress cause chronic headaches? Yes. Stress is a major trigger for tension-type headaches and can worsen migraines. Prolonged exposure to stress can lead to recurrent or chronic headaches. 7. Can painkillers cause headaches? Yes. Taking painkillers too frequently can cause medication-overuse headaches, with almost daily pain. Medical advice is recommended if treatment is taken multiple times per week or more than 10 days per month. 8. Do I need a CT scan or MRI for headaches? In most cases, imaging is not necessary. A CT scan or MRI is only recommended in specific situations, based on medical evaluation, for example when warning signs are present. 9. Is migraine a chronic disease? Migraine is a chronic neurological condition that occurs in attacks. It can be managed with appropriate treatment and regular medical follow-up. Migraine may improve or worsen over a person’s lifetime. 10. How can I prevent headaches and migraines? Prevention involves:Regular sleepAdequate hydrationStress managementIdentifying triggersPreventive treatment if necessaryMedical follow-up allows management to be adjusted as needed. 11. Who should I consult for repeated headaches? For frequent headaches, it is recommended to:First consult your general practitionerSee a neurologist if necessary, based on your doctor’s adviceErasmus Hospital (H.U.B.) offers specialized care for headaches and migraines. SecMed [dot] Neuro [dot] erasme [at] hubruxelles [dot] be (Make an appointment). Useful Resources and Links For more information or support: Belgian Headache League – information, peer support, and patient resources (FR) Headache Calendar (document to download and complete) FR

Definition Dementia and neurocognitive disorders are observed in many conditions. They involve problems with memory, language, reasoning, or the organization of thought, which may impair the ability to perform daily tasks. These neurocognitive and behavioral disorders can worsen over time. Their frequency increases with age. The first reported symptoms often include a loss of sense of time, recurrent forgetfulness, word-finding difficulties, or trouble following a conversation. Among the degenerative diseases responsible for these symptoms, the most common are Alzheimer’s disease, Lewy body disease, and frontotemporal dementia. They may also be observed following brain injuries caused, for example, by one or more strokes. Care Management The Neurology Department of Erasme Hospital provides individualized medical care, starting from the diagnostic process, which is developed together with the patient and their relatives. Within our Integrated Memory Clinic (CIMe) and cognitive disorders unit, the patient is assessed globally (physical, cognitive, behavioral, and other aspects) using clinical tests and paraclinical examinations that allow for a precise diagnosis. Treatments, both pharmacological and non-pharmacological, are then systematically adapted and discussed with the patient.As research lies at the heart of the hospital’s values, clinical study protocols—focusing both on new therapeutic approaches and more fundamental research—are regularly offered to patients and their relatives if they wish.If they choose, the patient’s relatives may also benefit from support and guidance, including the possibility to participate in therapy sessions with the patient or to receive home care assistance. Research Our expertise is applied in a multidisciplinary manner, both in the diagnostic approach—using modern technologies (such as magnetoencephalography), new biomarkers (plasma-based, electrophysiological, or imaging), and refined neuropsychological assessment—and in the care of patients and their relatives. Their integration into the medical strategies developed for them is systematically encouraged. In addition to the opportunity to contribute to the development of a very large, collaborative, and clinically detailed cohort at the forefront of knowledge, it is also possible to participate in numerous studies, whether pharmaceutical or involving, for example, the use of virtual reality for diagnostic and therapeutic purposes.

What is a defunctioning stoma? A stoma is the connection of an internal organ to the skin.Sometimes, when the digestive or urinary system is damaged, blocked, or diseased, it may need to be diverted. The surgeon will divert the digestive or urinary system using a portion of intestine brought out onto the abdomen. A pouch (a bag) that will collect stool or urine is placed over the stoma.The stoma is created by a surgeon and can be:Temporary: it is put in place to allow an organ to heal, and is later closed.Permanent: it is permanent when natural continuity cannot be restored.The main types are:Colostomy (colon)Ileostomy (small intestine)Urostomy (urinary tract)A stoma is not a disease: it is a medical solution that helps preserve health, life and/or improve the patient’s quality of life.  What are the indications for a stoma? A stoma may be indicated in several medical situations.Digestive indicationsCancer of the colon, rectum or anusCrohn’s disease or ulcerative colitisIntestinal obstructionPerforation or severe intestinal complicationUrinary indicationsBladder cancerSevere urinary function disordersCongenital malformationsNeurological conditions affecting the bladderThe decision to create a stoma is made on a case-by-case basis, after medical discussion and patient information. How to care for a patient with a stoma at home? Returning home is an important step. With proper support, care becomes part of daily routine.Stoma careClean the skin around the stoma with waterDry thoroughly before applying a new deviceChange the pouch according to recommendations (generally every 1 to 3 days)Check that the appliance adheres properly to prevent leaksMonitoring the skin and the stomaThe skin around the stoma must remain healthyAny redness, pain or oozing must be reportedObserve the size and height of the stomaDiet and hydrationAdapted diet and hydration (depending on the type of stoma you have)In the case of a digestive stoma, certain foods may alter bowel movements: for example increase gas or odors (cabbage, onions, carbonated drinks)Remember to follow the advice given by the dietitian and your stoma care nurse during your surgeryPsychological supportLiving with a stoma can be emotionally difficult. Support from relatives and healthcare professionals is essential, and sometimes that of a psychologist. What to do in case of complications? Certain situations require special attention:Contact your stoma care nurse if:Itching under the pouchRepeated leaksPersistent skin irritation or wound around the stomaIf you have any doubt or question: one phone call is better than isolating yourself out of fear or concern.Seek medical attention quickly if:The stoma becomes black, purple or very painfulSignificant bleeding appearsAbdominal pain, fever, nauseaIf in doubt, do not stay alone: contact your home care team, the stoma care nurse or, if necessary, go to the emergency department. Your contact persons at H.U.B? At the Brussels University Hospital (H.U.B), several professionals support patients with a stoma:Stoma care nurse: main contact for care, education and adaptation of equipmentFollow-up at Erasmus Hospital: 02 555 56 30Follow-up at Jules Bordet Institute: 02 541 03 02Specialist doctor (surgeon, gastroenterologist, urologist)Medical secretariatAt night or on weekends, if possible wait until the next day or Monday, contact your home nurse or your general practitioner, or go to the emergency department if needed. Resources and useful links about stomas FAQ – The 10 most frequently asked questions about stomas 1. Can you live normally with a stoma? Yes. After an adaptation period, most patients resume an active, social and professional life. 2. Is the stoma painful? The stoma itself is not painful. Pain may occur in case of irritation or complications. 3. Can you shower with a stoma? Yes, with the pouch. 4. Can you do sports with a stoma? Yes, most sports are possible, with certain precautions (support belt, avoid contact sports, no abdominal pressure). 5. Are there odors? Modern pouches are designed to be airtight and absorb odors. 6. How long does a stoma last? It depends on the condition: some are temporary, others permanent. 7. Can you travel with a stoma? Yes. It is recommended to bring sufficient supplies; contact your stoma care nurse to help you prepare and anticipate. 8. What to do in case of pouch leakage? Change the appliance, check the fit of the equipment and contact the stoma care nurse if the problem persists. 9. Should the diet be modified when you have a stoma? Sometimes. Certain foods may influence urine, bowel movements, gas or odors. A dietitian will inform you about specific recommendations. 10. Who to talk to in case of psychological difficulties? Your stoma care nurse, healthcare professionals, hospital psychologists.

Pain management The Brussels University Hospital offers a comprehensive range of services, from acute to chronic pain, with specialised teams available at several sites. 1. Pain consultations Acute and transitional pain — Imedia CentreThese consultations are intended for all patients requiring an algology consultation: medication management, pre-infiltration assessment, post-infiltration follow-up, and other acute situations.Days: Monday to FridayLocation: Imedia CentreAccess: MyHUB and RosaChronic pain — CMETD (Imedia Centre)For patients requiring multidisciplinary care. A report from a specialist doctor is mandatory to access these consultations.Location: Imedia CentreAccess: not accessible via MyHUB or RosaSpecialist doctor’s report mandatoryAcute and chronic pain — Lothier PolyclinicThe Lothier Polyclinic welcomes patients for acute and chronic pain consultations. A third time slot on Thursdays will be available soon.Days: Monday and Tuesday (+ Thursday coming soon)Location: Lothier PolyclinicAccess: MyHUB and Rosa 2. Interventional Algology — Pain Clinic Imedia CentreTwo image-guided infiltration sessions are available every day, open throughout the day, and accessible to general practitioners via MyHUB.Days: Monday to Friday — all day1 ultrasound-guided session + 1 fluoroscopy-guided sessionAccess for GPs: via MyHUBLothier PolyclinicOne ultrasound-guided infiltration session on Tuesday morning. A second session on Thursday morning will be added shortly. Accessible to general practitioners via MyHUB.Days: Tuesday morning (+ Thursday morning to come)Technique: ultrasound-guidedAccess for GPs: via MyHUB Discover the H.U.B Pain Clinic 3. Survivorship Programme Survivorship Pain ConsultationsSupport for patients experiencing pain following oncological treatment.Days: Tuesday, Wednesday and ThursdayLocation: Imedia CentreAccès: MyHUB and RosaSurvivorship Acupuncture ConsultationsAcupuncture consultations as part of post-cancer follow-up. Gradual rollout across two sites.Site Cairos — from June 2026 4. Paediatric pain Children and adolescents suffering from chronic pain receive specialised care at the CMETD of the Children’s Hospital (HUDERF).Population: paediatric patientsType: chronic painSite: CMETD — HUDERF Appointment Most of our consultations can be accessed directly via the MyHUB and Rosa platforms. For multidisciplinary chronic pain consultations (CMETD) and requests for the Pain Clinic, a report from your specialist is required beforehand.

The Cerebral Palsy Centre provides patients with cerebral palsy with individualised and regular support, as well as assessment by a specialised multidisciplinary team. Since 2006, Erasme Hospital has been one of the sites of the Interuniversity Reference Centre for Cerebral Palsy (ULB-VUB-Ulg): CIRICU. This centre has established an agreement with INAMI enabling patients with cerebral palsy to undergo assessments by a specialised multidisciplinary team. It therefore provides patients and their families with individualised and regular support. In practice, patients with cerebral palsy are assessed in the unit once or twice a year. The first assessment consists of a multidisciplinary evaluation carried out by all the professionals involved (psychologist, physiotherapist, occupational therapist, speech therapist, social worker, orthopaedic surgeon and neurologist), which takes place over one day in the unit. At the end of this day, therapeutic objectives and treatment plans are proposed and discussed with the patient or their family. The patient’s usual treating physician and physiotherapist are invited to this discussion, and a report is always sent to them if the patient gives their consent. Collaboration with the various services already involved in the patient’s care is essential. Subsequent assessments involve the physician and at least two paramedical professionals and are also always followed by a report summarising the points discussed during the consultation. Patients registered with the reference centre may also benefit at the hospital from specialised examination and treatment techniques, such as the gait laboratory or botulinum toxin injections. The team consists of: Paediatric neurologists and rehabilitation physicians, who coordinate the assessments and reports Orthopaedic surgeons Physiotherapists Occupational therapist Speech therapist Social worker Psychologists Coordinating nurse Making an appointment Tel.: 02 555 6851 Email: secmed [dot] CRFNI [dot] erasme [at] hubruxelles [dot] be (secmed[dot]CRFNI[dot]erasme[at]hubruxelles[dot]be) Medical secretariat Tel.: 02 555 6978 Email: secmed [dot] CRFNI [dot] erasme [at] hubruxelles [dot] be (secmed[dot]CRFNI[dot]erasme[at]hubruxelles[dot]be)