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The Italian guidelines for stroke SPREAD (sponsored by Bayer health care) reported dabigatran as a safe alternative to warfarin. This is a sort of vital validation for the molecule since almost nothing can be done in stroke medicine without the  SPREAD committee approval at a national level. At a national level also the Mario Negri istitute for pharmacology gave its valuable opinion on Pradaxa.

The Italian online version of the Merck manual depict uncommon cerebrovascular syndromes (subclavian steal, drop attack). Seems not updated since long time.  Dipiridamole, according to the web page,  is considered not effective. The chapter ends with something that sounds like “…a an aggressive treatment for stroke is not recommended…”.

“… Il trattamento aggressivo non sempre è giustificato, specialmente quando i deficit neurologici sono gravi o quando vi siano comorbilità associate (v. Cap. 294)....”

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Is now visible to the public the Spread portal for Italian Guidelines in Stroke management. The idea is to develop a “real time” tool to update guidelines. The site is not available for normal users just for faculty members.