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The skyline of Barcellona offers always many surprises. One of them is directly connected with our interests.
A special tower stands in a southern residential area neighborhood, this is a popular metropolitan area grown for the workers in the bustling automotive industry of the 60s.
This is the tower of the Hospital Universitari de Bellvitge. We had a quick visit to the 9th floor together with Dr. Pere Cardona Portela IMG_8025.JPG(see photo).
Next to a “pan-optical” stroke unit at the same level of the Neurosurgery ward a special room hosts the “tele ictus” service.
A service active 24/7 for all partner hospitals of Catalunya. This is one of the Telestroke HUB of Barcelona metropolitan area, the other is the Hospital Universitari Vall d’Hebron.
With safe teleconsult techniques an audio-video streaming (see picture) connects the spoke with the hub. This is of help in the decision making process and facilitates the patient dispatchment avoiding futility.
An efficient regional PACS/RIS system support the clinicians for their decisions. The report written by the stroke expert will reach the spoke hospital in real time minimizing the risk of medical errors.
Also mobile devices ara available to guarantee the service from home by the stroke specialists on call. In Bellvitge 1200 patients are admitted each year and thanks to telemedicine 170 patients are centralized for thrombectomy. Every year 350 teleconsults are done with peaks of 3-4 per day.
We leave the “telestroke tower” with a better idea on one of the most exciting challenges for many health care systems: emergency telemedicine.IMG_8028.JPGIMG_8029.JPG
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In the era of mechanical reperfusion, HEMS can be a powerful instrument for improving acute stroke delivery and research that is currently underutilized. The speed of HEMS may allow reperfusion for a large number of patients that would not have immediate access due to geography or traffic congestion. Also, HEMS critical early time period after a stroke where specific interventions to preserve penumbra and prevent reperfusion injury may have a significant influence on outcomes. The impact of physical factors generated by the helicopter on the ischemic brain needs to be studied. HEMS are also an opportunity to increase recruitment of patients in standard clinical trials. Addressing the HEMS stroke gap is necessary to homogenize the delivery of acute stroke care and research capabilities through all care settings, therefore minimizing disparities in outcomes based in geographical location.

European Stroke Journal Sept 2016

Press release

 

Mechanical thrombectomy improves outcomes in acute ischemic stroke.

 

Joint statement of the European Stroke Organisation (ESO), the European Society  of Minimally Invasive Neurological Therapy (ESMINT) and the European Society of Neuroradiology (ESNR)

 

Stroke results from rupture or interruption of blood flow in brain vessels can lead to devastating consequences for patients, their families and society. Steady progress has been achieved in the last 20 years in stroke treatment through better prevention, establishment of stroke care units and the use of clot-busting drugs (intravenous thrombolysis).

 

Last week, new scientific evidence from four major stroke studies was presented at the International Stroke Conference in Nashville, USA. It proved that rapid mechanical thrombectomy (clot retrieval) improves patient function after acute ischemic stroke. To achieve this benefit, patients were treated by interventional neuroradiologists in stroke centers with multidisciplinary stroke teams. This treatment should be performed as rapidly as possible in conjunction with standard intravenous thrombolysis.

 

ESO, ESMINT and ESNR acknowledge this significant progress in acute stroke treatment and strongly support its application in appropriately selected patients in well equipped stroke centers by properly trained neurointerventionists. Further randomized trials of thrombectomy and more detailed analysis of the current trials will help to optimize patient selection and treatment algorithms.

 

Detailed guidelines on mechanical thrombectomy are currently being prepared by the key European societies involved in acute stroke care. Before these detailed guidelines become available, ESO, ESMINT and ESNR have jointly updated and support the consensus statement on thrombectomy by the ESO-Karolinska Stroke Update (see http://2014.strokeupdate.org/consensus-statement-mechanical-thrombectomy-acute-ischemic-stroke).

Background

 

The European Stroke Organisation (ESO) is a society of stroke physicians, researchers, societies and patient organizations with the goal of optimizing  and harmonizing  the management of stroke in Europe by supporting medical education and stroke projects.

More on www.eso-stroke.org

Contact: esoinfo@eso-stroke.org


The European Society of  Minimally Invasive Neurological Therapy (ESMINT) is a multidisciplinary society of individuals and groups working or training in the field of minimally invasive neurological therapy in geographical Europe. It has been established in order to promote the benefits of minimally invasive neurological therapies through education, training and support for high quality scientific research. 

More on www.esmint.eu

Contact email: office@esmint.eu

 

The European Society of Neuroradiology / ESNR Diagnostic and Interventional is a professional society organising European neuroradiologists. The Society organises Annual Scientific meetings – ESNR Congress, common European Training courses in neuroradiology – European Course of Neuroradiology (ECNR) and is a forum for professional development of European Neuroradiology.

More on www.esnr.org

Contact email : info@esnr.org

 

IMG_1409

The European Stroke Organisation (ESO) announced on May 9th, 2014, that the first ESO Stroke Conference will be held in Glasgow on April 17-19, 2015. Here topics it will be nice to be there with all my colleagues. In the pipeline we have a couple of nice contributions

After a decade of preparation….

At the EFNS/ENS Joint Congress of European Neurology in Istanbul, June 2014, one strong unified European neurological society, the

EUROPEAN ACADEMY OF NEUROLOGY

will be founded.

ean_logo_4c_final

THE ASSEMBLY OF DELEGATES will be the democratic heart of the EAN: 45 national delegates representing the 45 member nations of the EAN and an equal number of delegates representing the currently 900 individual members.

THE EAN BOARD – 7 elected and two appointed officers: President, Vice President, Secretary General, Treasurer, Chairpersons of the Scientific and Liaison Committees and one Member at Large; Congress Programme and Education Committees chairpersons.

THE EAN HEAD OFFICE will be in Vienna, Austria with two branch offices in Brussels, Belgium and Basel, Switzerland.

THE EUROPEAN JOURNAL OF NEUROLOGY will be the official publication of the EAN.

THE FIRST EAN CONGRESS will be held in Berlin, Germany in June 2015.

The WordPress.com stats helper monkeys prepared a 2012 annual report for this blog.

Here’s an excerpt:

The new Boeing 787 Dreamliner can carry about 250 passengers. This blog was viewed about 1,500 times in 2012. If it were a Dreamliner, it would take about 6 trips to carry that many people.

Click here to see the complete report.

 

 

 

 

 

 

 

 

Cardioembolic Stroke as one of the  leading cause of global  disability deserves much more attention from health care authorities, the world stroke organization promotes the suscription of the “world stroke charter”

a signature may save lives

……We call on national governments, policy makers, payers and healthcare providers to take action to improve the lives of those with AF and drastically reduce the risks and costs of AF-related stroke.

 

 

 

 

 

 

 

Next week will take place in Sweden the annual meeting of the EFNS. This will be a chance to remember the pioneering work in the field of valsular neurology of Gösta Hultquist that in 1942 with his dissertation ”Über Thrombose und Embolie der Arteria carotis und hierbei vorkommende Gehirnveränderungen. Pathologisch-Anatomische Studie” TIA and symptomatic carotid stenosis were described and studied by the doctors of the Department of Pathology at St. Göran’s Hospital in Stockholm.

 

 

 

 

 

An excellent overview on current stroke syndromes, including problematic clinical pictures various editors (Bogousslavsky, Agnelli, Caso and Paciaroni) .
In the Frontiers of Neurology and Neurosciences by Karger out this month.

Since Stroke is the most common neurologic disease and the leading cause of adult disability in Western countries. The initial diagnosis of stroke is clinical and needs to be done as rapidly as possible to guarantee optimal medical and interventional therapy. The emergency stroke management depends heavily upon stroke scores to quantify the damage and to speed up the diagnosis process. Unfortunately, several important stroke syndromes are not taken into consideration in these currently used stroke scores and therefore tend to be overlooked and not treated. Compiled by leading international experts, this book provides an excellent overview on current stroke syndromes, including particularly problematic clinical pictures. Thus, together with stroke scores, the publication will lead to more thorough assessments in emergency settings.

“…..This book is indispensable for neurologists, neurosurgeons, neuroradiologists and physicians involved in the care of stroke patients…..”

The FDA is adding the following revisions and recommendations to the drug’s label: Healthcare professionals should prescribe the drug only to patients who can be converted into normal sinus rhythm, and the drug should be discontinued in patients in AF. Healthcare professionals should monitor the heart rhythm of patients taking dronedarone by ECG at least once every three months.
dronedarone

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