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When a stroke occurs, its causes are often multiple. However, tobacco plays a major role that is still too frequently minimized. Discover the interview of Jacques Dumont, Smoking Cessation Specialist at H.U.B. Stroke and tobacco: a link that is still too often underestimated When a stroke occurs, its causes are often multiple. However, tobacco plays a major role that is still too frequently minimized. According to estimates, between 18 and 35% of strokes are directly linked to smoking. This significant figure highlights how deeply cigarettes affect blood vessels… and the brain.Tobacco contains many toxic substances, such as carbon monoxide. These substances damage the vessel walls, making them stiffer and more fragile. At the same time, smoking thickens the blood, promotes clot formation and increases platelet aggregation. As a result, blood flow to the brain becomes more difficult, and the risk of thrombosis increases.Tobacco also promotes atherosclerosis, meaning the buildup of fatty and calcium plaques in the arteries, which reduces their diameter and flexibility. Added to this are vascular spasms, partly related to the increase in blood pressure caused by nicotine.Finally, when smoking, carbon monoxide replaces oxygen in the blood. The brain, an organ extremely sensitive to oxygen deprivation, is therefore less well supplied. All of these mechanisms together significantly increase the risk of stroke or transient ischemic attack (TIA).Most importantly, they continue to act after a first stroke, exposing the patient to a high risk of worsening or recurrence if smoking continues.Quitting smoking after a stroke: rapid… and lasting benefitsThe good news is that the benefits of quitting smoking appear very quickly, even after a stroke.Within the first hours after quitting, oxygen once again circulates properly to the cells. Vascular spasms decrease rapidly: every cigarette avoided is one less assault on the arteries.Other benefits take longer to appear, but they are very real. A reduction in the risk of thrombosis, gradual improvement in arterial health, and a slowing of atherosclerosis can be observed over several weeks or months.But the key message is clear: it is never too late to quit, and every smoke-free day counts in reducing the risk of recurrence.Smoking less or switching products: a false good idea?After a stroke, some patients consider “smoking less” or turning to other products. However, these strategies are rarely effective… and sometimes misleading.Reducing tobacco consumption is only truly beneficial if the reduction is massive, by at least 80%. In practice, going from 20 or 30 cigarettes per day to one or two is extremely difficult to sustain over time. And even at low doses, each cigarette triggers vascular spasms, which remains dangerous after a stroke.As for alternatives:Heated tobacco is not authorized in Belgium.Electronic cigarettes, although less harmful than traditional cigarettes in some respects (notably due to the absence of carbon monoxide), are not harmless. Their effects on blood circulation are still not fully understood and they are not recommended in this context.Methods that have proven effective remain nicotine replacement therapies (patches, lozenges, gums) and certain medications, prescribed and monitored by trained professionals such as tobacco specialists.Stress, weight gain, discouragement: separating fact from fictionAfter a stroke, misconceptions about smoking are common — and understandable.Many patients feel that smoking helps them cope with stress. In reality, tobacco is a false friend: nicotine increases stress hormones. What is perceived as relaxation is often simply the temporary relief of withdrawal-related stress. Learning to breathe deeply, allowing oneself moments of calm, or finding other ways to take a break can restore these sensations… without the risks.Another common concern is weight gain. This is indeed possible, and not only due to snacking. Tobacco increases energy expenditure: a smoker burns around 300 calories per day when smoking 20 cigarettes. When quitting, metabolism changes. However, specialized support often makes it possible to limit or even avoid weight gain.Finally, some believe that quitting “is no longer useful” after a stroke. This is false. The benefits of quitting are clearly demonstrated scientifically, particularly in reducing the risk of recurrence and improving quality of life.The key role of family and healthcare professionals in smoking cessationQuitting smoking is a personal journey, but no one should have to walk it alone.The role of relativesLoved ones can play a decisive role, provided they avoid guilt-inducing attitudes, which are often counterproductive. Expressing concern with kindness, supporting without lecturing, encouraging without forcing: the goal is to strengthen the person’s motivation and autonomy. Change must come from within.The role of healthcare professionalsAll healthcare professionals (neurologists, nurses, physiotherapists, occupational therapists) involved in stroke follow-up can help raise awareness, notably through motivational interviewing. They can all serve as essential relays. General practitioners and tobacco specialists are trained to support patients in quitting.Providing information without judgment, using a motivational approach, and offering support adapted to the patient’s life context: these simple actions have a real impact on the success of smoking cessation.It should be noted that some alternative methods, such as laser treatment, are not part of scientific recommendations and have no proven effectiveness. They therefore cannot be endorsed in a hospital setting.ConclusionAfter a stroke, quitting smoking is not just a recommendation: it is a real opportunity to protect the future. With appropriate support, guidance and information, this goal is achievable — at any age and at any stage of the care pathway.Need to contact the Neurovascular Clinic (Stroke Unit) of Erasme Hospital H.U.B?📞 +32 (0)2 555 33 52✉️ cons [dot] neuro [dot] erasme [at] hubruxelles [dot] beTo make an appointment with the Smoking Cessation Center of Erasme Hospital H.U.B📞 +32 (0)2 555 37 73✉️ jacques [dot] dumont [at] hubruxelles [dot] be Jacques Dumont, Smoking Cessation Specialist at H.U.B

Jessica Hendrickx, psychologist at the H.U.B., and Géraldine Decrolière, social worker at the H.U.B., support the caregivers of stroke patients on a daily basis. They explain what caregivers go through… and how to help them avoid burnout. Read more Image Stroke: when the caregiver becomes the invisible hero How can you prevent burnout?We don’t talk enough about them. About those whose lives change overnight because a loved one had a stroke. About those who make appointments, reorganize family life, and stay upright while everything around them collapses. These are the caregivers — the everyday heroes we hardly see, but who carry so much.Psychologist Jessica Hendrickx and social worker Géraldine Decrolière support them every day. They explain what caregivers go through… and how to prevent exhaustion.A life turned upside down overnight“A stroke changes a person. And that changes the whole family,” Géraldine explains.Modified mobility, comprehension difficulties, language problems, unstable emotions… The caregiver often has to learn to live again with someone who no longer reacts as they used to.The burden is immense:Organizing careAlmost constant supervisionAdapting the homeManaging the patient’s fatigueRepeated emotional shocksAnd while everyone focuses on the patient, the caregiver often forgets themselves.Why do caregivers burn out?It’s not only the physical fatigue from transfers, washing, or meals. It’s also:Fear of another strokeSadness at seeing the loved one changeFrustration of unpredictable daysSocial isolationLack of respitePressure to “do things right”“The caregiver’s well-being often follows that of the patient. If the patient is doing badly, the caregiver can collapse too,” notes Jessica Hendrickx. Many don’t realize they’re burning out… until their body gives way.How to recognize signs of exhaustion?In the bodyPersistent fatiguePoor sleepPain, migraines, recurring illnessesIn the heart and mindIrritability, anxietyMore frequent cryingLoss of motivationGuiltLoss of self-confidenceIn daily lifeIsolationLoss of interest in activities they used to enjoyDifficulty thinking or concentratingIncreased use of alcohol or tobaccoFeeling like they’re no longer themselvesGéraldine adds: “When a caregiver refuses all help, that’s sometimes already a sign they are too tired.”Real solutions do existNo family is meant to carry this alone. Here’s what can help:Talk about what you feelWith your loved one, with the care team, with a psychologist. Buried emotions drain you. Know your limits“No” is a protective word. You can’t do everything — and that’s okay. Ask for help — and accept itFamily, friends, neighbours… Many want to help but don’t know how. Surround yourself with professionalsHome care, nurses, family aides, care coordinators. Adapt the home environmentGrab bars, assistive devices, adapted chairs: small changes that make a big difference. Keep time for yourselfOne hour a week, an activity, a moment alone: it’s not a luxury — it’s vital. Join a support groupKnowing others are going through the same thing changes everything. You feel less alone. See a psychologistFirst-line consultations are available at reduced rates. A few sessions can help restore balance.What support can you access?Caregiver associations: information, workshops, support groupsHome help and care services: family aides, nurses, ergotherapistsDay centres: patient care one or more days a week to offer respiteMobile specialized teams: at-home guidance, advice, adaptationsPsychologists: partially reimbursed through platforms or insuranceSocial services and health insurance funds: financial support depending on the situationEven if services are sometimes full, asking remains essential: every bit of support counts.You are not alone. And you have the right to be helped.Becoming a caregiver isn’t a choice. It is an act of love. But loving someone doesn’t mean forgetting yourself.“To help someone well, you need to be well yourself,” Jessica reminds us.To all caregivers:You matterYou are legitimateYou deserve supportYou are doing more than you thinkTo everyone else: a message, a meal, a visit, stepping in for an hour — it can change a caregiver’s life.

What is Sturge-Weber syndrome? Sturge-Weber syndrome is a rare disease affecting the small blood vessels of the face and brain. It is characterised by the presence of an angioma (port wine stain) on the face that often leads to the diagnosis. The presence of an angioma in the brain can result in neurological complications such as epilepsy, hemiplegia, retarded development, intellectual disability and stroke.  Eye complications (glaucoma) can also develop. Treatment An early diagnosis of the disease makes it possible to limit the complications, inform parents of important signs to look out for and identify (notably epilepsy, stroke), rapidly begin drug or local treatment (epilepsy, face angioma, glaucoma) and, if necessary, initiate early rehabilitation therapy. Multidisciplinary monitoring (neurological, dermatological and ophthalmological) is essential throughout childhood and into adulthood.  Specific care pathways Our team cooperates closely with specialist teams when the child’s condition requires it (epilepsy surgery, laser treatment of the angioma). We also network with GPs and paediatricians, child therapists (physiotherapists, speech therapists, occupational therapists, psychologists, etc.), support services, respite care services, associations and psycho-medico-social centres. A transition consultation can be arranged at the Erasmus Hospital when the child enters adulthood.      Our specialists Children's patients (Children's Hospital)The multidisciplinary consultation is organised by the Neuroaediatrics Department.Neuropaediatrics: Dr Anne MonierDermatologist: Dr Pamela El NemnomOphthalmologist: Dr Deborah BuisseretGeneticist: Dr Catheline VilainAdult patients (Erasmus Hospital)The consultation is organised by the Neurology Department (Cons [dot] Neuro [dot] erasme [at] hubruxelles [dot] be (Cons[dot]Neuro[dot]erasme[at]hubruxelles[dot]be))Neurologist: Dr Chantal Depondt 

On November 8, 2024, the Brussels University Hospital(H.U.B.) will host an international symposium dedicated to pediatric epilepsy neurosurgery. This event will bring together national and international experts to discuss the latest advancements and explore future perspectives in this highly specialized field Program and ThemesThe symposium will focus on several major themes aimed at improving the management of epileptic patients, particularly children resistant to medication. Topics to be covered include:Utilization of SEEG (Stereo-electroencephalography) and LITT (Laser Interstitial Thermal Therapy): These advanced techniques are crucial for pediatric patients whose epilepsy does not respond to traditional pharmaceutical treatments. SEEG provides a detailed analysis of brain activity to precisely locate epileptogenic zones, while LITT offers a minimally invasive method to treat these areas without resorting to traditional open surgery.Analysis of Neural Connectivity: This innovative method aims to predict the absence of postoperative seizures, allowing for more precise surgical planning and optimized outcomes for patients.New Surgical Approaches: The symposium will introduce a novel concept of proposing resective surgery for non-refractory focal epileptic children. The goal is to minimize the impact of antiepileptic drugs on children's cognitive development and quality of life by reducing the need for long-term pharmacological treatments.Experts and DiscussionsThe event will host renowned experts, both national and international, who will share their expertise, discuss the latest advancements, and explore future perspectives in pediatric epilepsy surgery.Registration and ProgramRegistrationProgramDate: November 8, 2024Time: 8:30 AM - 5:30 PMLocation: Musée de la Médecine, Erasme Hospital ULB, 808 route de Lennik, 1070 BrusselsContact Information: Email: Symposium_Epilepsy [dot] Neurosurgery [at] hubruxelles [dot] beFees:Medical Professionals: €60Paramedical Professionals and Students: €20

What is systemic mastocytosis Systemic mastocytosis is a rare disease. Mastocytosis is a group of diseases that cause an excessive build up of mast cells in the body. A mast cell is a type of white blood cell that helps our immune system to function correctly.  When you suffer from systemic mastocytosis an excess of mast cells builds up in the skin, bone marrow, digestive tract or other body organs. When activated these mast cells release substances that can trigger signs and symptoms similar to those of an allergic reaction. Serious inflammation can sometimes cause organic lesions. Common triggers include alcohol, spicy food, insect bites and some medicines. Mast cell activation syndrome and systemic mastocytosis present the same signs and symptoms. In the case of mast cell activation syndrome there is no build up of mast cells in the bone marrow. Systemic mastocytosis is also characterised by the presence of a mutation of the c-KIT gene. This mutation is not generally hereditary.  Care The signs and symptoms of systemic mastocytosis depend on the part of the body affected by an excess of mast cells. An excess of mast cells can build up in the skin, liver, spleen, bone marrow or intestines. More rarely, other organs such as the brain, heart or lungs can also be affected The signs and symptoms of systemic mastocytosis can include Flushing, itching.Abdominal pain, diarrhoea, nausea or vomiting.Palpitations, feeling faint.Allergic reactions ranging from urticaria to Quincke’s oedema and anaphylaxis Coughing, shortness of breath, rhinorrhea, lachrymation.Frequent urination, urinary burning.Bone and muscle pain.Depression, mood changes or problems concentrating.Anaemia or bleeding disorders.Enlarged liver, spleen or lymph nodes.The various triggers for mastocytosis symptoms include: Insect bites.Food rich in histamine or histamine liberators.Physical factors (change in temperature, fever) Surgery, traumas.Certain medicines.To diagnose systemic mastocytosis a biopsy of the organ or organs affected is necessary to establish the link between the symptoms and the illness. The biopsy is to detect the presence of an accumulation of mast cells as well as the c-KIT mutation. The tryptase level is a blood marker that is very often useful for the diagnosis. Once the diagnosis has been established a number of additional examinations must be carried out (abdominal ultrasound, bone density test, osteo-medular biopsy) to determine the severity.   There are two aspects to mastocytosis treatment. The symptomatic treatment aims to control the symptoms whereas the antiproliferative treatment aims to control the excessive production and accumulation of mast cells in the organs. Antiproliferative treatment is not always required and will depend on the specialist’s assessment. Symptomatic treatment is based on identifying and eliminating factors that trigger the symptoms as well as the use of antihistamines, antacids and other anti-allergy medication. An adrenaline pen is proposed to patients who have had a severe anaphylactic reaction.The antiproliferative treatment is based on chemotherapy and certain targeted therapies. In rare cases an allogeneic stem cell transplant can be envisaged  Advice If you are being monitored for a stystemic mastocytosis and you have respiratory distress or feel faint (Quincke’s oedema or anaphylaxis) you should go immediately to the emergency department or dial 112. If you have an auto-injector EPIPEN (adrenaline) you should use it to make an intramuscular injection while awaiting the arrival of the ambulance.  Focus Patients with symptoms that are suspected to indicate a mastocytosis will be directed to a consultation with a specialist. You may be directed initially to haematology or internal medicine and then redirected to another specialist depending on the results.  Our specialists Related services