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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

Fare un salto in ospedale con l’auto d’epoca… per ricordarsi che un ictus … sei mesi fa rischiava di portarti via l’autonomia, la memoria e la libertà. Questo è il regalo che Loriano ci ha fatto lo scorso 29 Ottobre. E’ successo al San Giovanni Battista.

OLTRE 17 milioni di persone nel mondo – 200mila solo in Italia – vengono colpite da ictus cerebrale ogni anno (di queste ne muoiono 6 milioni). Senza contare poi che sono in molti quelli che seppur sopravvivono, dovranno convivere con gravi disabilità o con il terrore che l’ictus si ripresenti di nuovo. L’ictus cerebrale nel solo 2016 ha ucciso o reso invalida un’enorme quantità di persone, uomini, donne e persino bambini, rubando 116 milioni di anni di vita. E continua ad essere la seconda causa più probabile di morte nel mondo intero”.

All’ictus (in inglese stroke, che significa “colpo”) viene dedicata ogni anno la Giornata mondiale (29 ottobre) e dal 2006 è stata istituita l’Organizzazione mondiale dell’ictus (World stroke organization, Wso), che coinvolge 85 Paesi nel mondo. Perché l’ictus – molto spesso invalidante – se si conosce, si può prevenire. “Investire in prevenzione oggi non è più solo intelligente, è obbligatorio – sottolinea l’associazione Alt – perché nessun governo avrà le risorse sufficienti per assistere tutti coloro che verranno colpiti da ictus o da un altro evento da trombosi nei prossimi anni. Dipende molto da noi: dobbiamo sapere quali sono le cause, modificare i fattori di rischio modificabili, imparare a riconoscere problemi nel battito del cuore in noi stessi o in chi ci sta accanto. Insomma, dobbiamo riconoscere i sintomi sospetti e agire immediatamente”.

Ricordarsi i sintomi dell’ictus può velocizzarne il riconoscimento, quindi la diagnosi e la sua cura. RAPIDO!


Alza il braccio,

Parla e DOmanda aiuto

queste le parole chiave che possono salvarci.

Schermata 2017-06-24 alle 20.56.41.pngThe issue of stroke is particularly noticeable in neurology due to the high prevalence rate and serious consequences. Accordingly, telenurology is also intensively concerned with this disease pattern and attempts to contribute to medical progress in the field of neurology, using knowledge of the use of modern technologies. In Thuringia, the stroke telemedicine network "SATELIT" has existed for almost 5 years and has shown during this time that telemedical developments and application can help to contribute to the improvement of care quality in neurological diseases by means of computer-supported communication and network technologies. In Umbria, Italy a stroke network was successfully deployed since 2016 using fix units in the west of the county and mobile units in the earthquake area to the east. In addition to acute stroke treatment, the German Society for Telemedicine, in cooperation with the Hans Berger Clinic for Neurology at the University Hospital of Jena, will also be discussing with the First German Telenurology Congress the health policy and socio-political significance of the Telemedicine in neurology. The conference is aimed at clinicians, doctors, nurses, therapists and costumers as well as companies interested in current medical developments in the field of neurology, rehabilitation and aftercare. The focus of the 2017 Congress will be telemedicine in stroke care as the most important field of application. Other neurological applications such as dizziness, Parkinson's disease, or epilepsy are also being investigated. In addition, telemedicine products and latest developments are presented in an accompanying industrial exhibition.

Brussels, 30th November 2016 – Jon Barrick SAFE President and Valeria Caso President of the European Stroke Organisation of Stroke Professionals had a meeting today at the European Union Health Commission to discuss the quality of Stroke prevention, care and support within the countries of Europe.

SAFE and ESO made a number of proposals aimed at gathering EU support for encouraging countries across Europe to improve stroke intervention. Stroke now accounts for more than 9% of all deaths in Europe and is the leading cause of long term severe disability.

Topics discussed included the Health Commissioners engagement with proceedings at a Stroke Summit meeting to be held in Brussels on May 11th 2017, the dissemination of the Burden of Stroke report with data on the stroke care pathway performance in each European country, and a report on the current situation  around acute stroke care. Also discussed were support for the SAFE, ESO and others initiative to produce a stroke European action plan to be launched in May 2018, and the potential for creation of an economic burden of stroke report by 2019.

The Stroke European action plan will be the sequel to the Helsingborg declaration of 2006, which set objectives to be achieved by 2015. This is now redundant and many new developments and treatments have occurred since its first appearance, and there is now an opportunity to create initiatives to drive down the death and disability rates from stroke.

Other topics covered were the need for greater awareness of stroke, more effort to be made in preventing stroke, and the need to allocate more resources for stroke research generally. SAFE and ESO were encouraged to provide more examples of good practice to be shared country to country, and questions were asked concerning possibilities of good practice pilot activity.

There was found to be a huge overlap between the work of SAFE and ESO, and that of the EU Health Commission, with all parties seeking to make sure stroke care is sustainable, efficient, and supports resilience within health care systems (the capacity to buffer change, learn and develop, enhance adaptive capacity in a situation of rapid treatment transformations).

As such there was agreement that more work to combat stroke makes a positive contribution to the Health programme aims of the EU 2016-12-04 alle 09.08.51.pngschermata-2016-12-04-alle-09-08-51

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



it was held as usual in Florence (CTO) we followed the top trial session. Ongoing RCT were presented mostly from larger international initiatives. Small national activities are also under construction. A large discussion was opened on the chance to address specific educational programs for interventional neurology. The national need of interventional neurologists is large: 100-200 doctors. Should be a radiologist to practice thrombectmy ? a Neurosurgeon (exceeding number in Italy) ? a well trained Neurologists ? The answer from the faculty board is to wait for a new medical figure that will be possibly available in 5-10 years from now.

In this touching second chapter, Francesca and Roberto take us through the ideas and actions that followed the first TED talk. How it changed and is still impacting not only their lives but also the people who are experiencing the same challange. Be parents of a child who had a prenatal stroke.

Francesca, Roberto and Mario ( their son) were first on the TED Global stage in 2013. From then on their life changed a lot and a lot of projects took life. On our stage they share their experience and achievements. From Inspiring to activate.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at


data from the ministery of health for central italy

So far it was a secret given to word of mouth among health professionals. The new Guide to Health Focus, now in its third edition with the most current data, it also recognizes the right of patients to know which are the most reliable centers to turn to be taken care of in the best way.Of course, hard to choose when you have a heart attack or a stroke: it relies on the ETS and it is hoped that in their region and in their local health healthcare is efficient.


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

European Stroke Conference  #ESOC14 #eurostroke14 in Nice

#ESOC14 en còte d’azur

September 2018
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