From stroke to speech: Andrea’s survival story and the crucial role of timely care

"A stroke is a life-altering event, marking a clear divide between the life you knew before and the one after. Everything changes - you change, but you can come through it and prevail," says Andrea Vianello, now 63, who suffered a stroke 5 years ago.

"My stroke left me unable to speak. As a journalist, words have always been my banner, my identity, and the tool of my trade, so losing that ability was a significant blow. At first, I couldn't even say my children's names. Then, thanks to a long and challenging rehabilitation process, along with the support of my family, I relearned how to speak and returned to work in less than 2 years."

"Not everyone is as lucky as I have been. On the morning of my stroke, everything happened at just the right time. My wife acted swiftly, calling emergency services immediately. The responders quickly recognized the signs of a stroke and rushed me to the nearest hospital, where the stroke unit had already been alerted. The doctors were ready with the right treatment tailored to my needs, and I later received the necessary rehabilitation services."

The stroke chain of survival: "time is brain"

Andrea's experience reflects the stroke chain of survival, which refers to a series of critical steps that need to be taken to ensure timely and effective treatment of a stroke. Each link in the chain represents a crucial, time-sensitive action that can significantly impact the outcome for a stroke patient.

Medical experts use the phrase "time is brain" to underscore the urgency of treating patients quickly to restore blood flow to the brain.

"During a stroke, time is of the essence; every second counts to preserve brain function. The more time passes, the more brain cells die. The brain is like a lawn, without blood it becomes arid. Fortunately, other areas of the brain can adapt and learn to take on new tasks," Andrea explains, drawing on his own experience and his role as President of the Italian Association for the Fight against Strokes (ALICe).

"But the chance of survival and recovery shouldn't come down to luck. Raising awareness about the signs of stroke in both the public sphere and at public health policy level is crucial. Additionally, ensuring that stroke units are accessible nationwide is vital to guarantee that all patients receive the care they need."

Stroke units: multidisciplinary teams

Stroke units are specialized hospital wards designed for acute stroke patients. These units are equipped with dedicated beds and continuous monitoring, staffed by multidisciplinary teams that deliver rapid treatment, early rehabilitation, and secondary prevention strategies to enhance recovery outcomes and reduce the risk of recurrence.

Establishing and optimizing stroke units is just one crucial step; by implementing evidence-based strategies across health-care systems, countries in the WHO European Region can significantly lower stroke-related mortality rates and enhance long-term outcomes for stroke survivors.

Strategic actions to reduce stroke mortality

Preventing strokes and minimizing their recurrence is one way to make significant strides toward achieving Sustainable Development Goal 3, which aims to reduce premature mortality from major noncommunicable diseases by a third by 2030. It requires concerted efforts, but with a huge return, as stroke is a major cause of death for people in the Region.

Central to these concerted efforts is addressing one of the primary risk factors for strokes: hypertension, more commonly known as high blood pressure.

It is essential that hypertension is diagnosed and managed through standardized treatment protocols and team-based care in primary care settings. Additionally, improving access to essential medications and medical devices for individuals diagnosed with hypertension is a critical objective in the effort to prevent strokes.

Other modifiable risk factors include tobacco use, unhealthy diet (high amounts of salt and trans-fats and low amounts of fruits and vegetables), air pollution, obesity, physical inactivity, diabetes, alcohol consumption and socioeconomic deprivation.

Strokes are often sudden and life-threatening events - but they can be prevented and treated. With the right prevention strategies, such as detecting and treating hypertension and addressing other risk factors, strokes can be avoided. For those who do experience a stroke, timely treatment and access to rehabilitation services can make all the difference.

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