Stroke, also historically called “apoplexy,” is the second leading cause of death worldwide and in Hungary. It is the most common cause of permanent disability and the most frequent neurological disorder. Every year, around 40,000 people are hospitalized due to stroke in Hungary, and nearly every second patient dies.

In Hungary, two people are affected every hour, often preceded by many small, symptom-free episodes, which occur ten times more frequently. Treatment usually begins only after irreversible complications have developed.

It doesn’t have to be this way: the pathological process starts 15–20 years earlier, at a stage when in the vast majority of cases it is still completely curable and reversible.

The underlying risk of stroke is based on inflammatory widening of the arterial intima and its causative factors, which can be measured (quantified). At MIND Clinic, we assess this risk using a combination of imaging and laboratory tests:

• Carotid Doppler ultrasound
• TCD: Transcranial Doppler ultrasound
• MR angiography
• Laboratory tests: CRP, cholesterol
• Gut permeability and inflammation markers: zonulin, calprotectin
• Targeted microbiome testing: S16-NGS

Dr. Szabolcs Szatmári is a stroke specialist whose research focuses on stroke treatment and prevention, including the role of the microbiome.

“The root cause of stroke and vascular diseases is the same: atherosclerosis,” emphasizes Professor László Csiba. Stroke is a widespread health issue in Hungary. Worldwide, there are 12 million new stroke cases annually, with 6.6 million deaths each year, and the number of cases is steadily increasing.

In his lecture, Professor Csiba points out that one in four strokes is caused by blockage in the carotid arteries, and the high prevalence of the disease can be reduced by focusing on prevention that is, detecting and treating atherosclerosis before symptoms appear. Thickened arterial walls can be treated and even reversed.

Risk factors include: high blood pressure, excessive alcohol consumption, smoking, coagulation disorders, cholesterol imbalances, heart rhythm and heart diseases, diabetes, obesity, and inflammatory processes.

Diagnosis involves measuring the thickness of the arterial intima using ultrasound. Carotid ultrasound and arteriography help assess the risk of stroke and guide treatment for existing vascular problems.

Professor László Csiba is a professor at the Neurology Clinic of the University of Debrecen, a member of the Hungarian Academy of Sciences, and president of the Hungarian Neurological Society.

The majority of stroke cases caused by arterial blockage could be prevented if we find the root cause of arteriosclerosis and reverse the process. For example, in the case of high blood pressure, this is possible, as it is the most common cause of cardiovascular diseases. Five years ago, I wouldn’t have thought that the key to this could also be found in the gut," says Dr. Szabolcs Szatmári, neurologist and stroke expert. "This is achieved when antihypertensive medications can be discontinued with personalized treatment alongside decreasing blood pressure. We have been researching this for years, and in 2018, our domestic publication in the Medical Weekly received the award for the best Hungarian-language publication of the year. We have now implemented this in clinical practice," adds Dr. Richárd Schwab.

Primary prevention is possible when the patient has not yet had a stroke, but only measurable risks are present. The big challenge comes from silent strokes, which affect brain areas that do not show symptoms. In many cases, symptom-free strokes have already occurred, and in these cases, the actual risk is much higher than perceived. However, this is like "Russian roulette": on average, the weapon fires on the tenth time, but with serious consequences long-term paralysis and death threaten. Over time, silent infarctions also increase the risk of early dementia.

One of the most important early signs is high blood pressure: medication-based blood pressure reduction decreases the risk of short-term complications. However, the treatment of the underlying cause starts here, and we don’t rest until we can make the patients medication-free. High blood pressure, just like type 2 diabetes and insulin resistance, can and should be cured. This also reduces the risk of stroke.

If we reach medication-free high blood pressure and, during the 5-point glucose tolerance test, the blood sugar returns to normal without medication, and the hs-CRP value drops below 0.5 then we can rest easy. The good news is that this diagnostic procedure is available in every domestic general practice.

In the following video conversation, we will discuss other risk factors, inflammation, the importance of reducing hs-CRP levels, and why an imbalance in the gut microbiome represents a stroke risk. In other words, how should we change our diet and lifestyle to avoid having a stroke?

Our expert doctors in the video will also highlight that almost all risk factors can be eliminated, meaning the risk of stroke can be virtually zeroed. The good news is that at the center of this is lifestyle and diet, with genetic factors playing a role of less than 5%.

Take the first step towards recovery by scheduling an appointment over the phone at +36 1 600 50 90 or by emailing us at idopont@mind.hu!

You can book an appointment ONLINE most quickly by clicking the button below, or initiate an email or phone call!

WHAT WE DO NOT DEAL WITH: Professional guidelines prohibit emergency patient care for stroke treatment where revascularization treatments are not available. In such cases, the patient benefits the most if the blocked artery can be reopened. Therefore, we do not accept patients with acute symptoms for diagnostic examinations. In such cases, an ambulance should be called immediately, and the National Ambulance Service will transport the patient to the nearest stroke center, where specific examinations and artery reopening procedures will take place.