You are currently browsing the tag archive for the ‘stroke’ tag.

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.
Advertisements

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 http://ec.europa.eu/health/programme/policy/index_en.htm.Schermata 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

 

iso2016.jpg

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.

The regional Neurology meeting re-opened the issue of local pathways to thrombectomy. The access to most advanced techniques seems slowed by ETS procedures and lack of full week coverage 7/7.

Rapido

An awarness campaign in Italy by ARS and ALICE. Just developed a leaflet to help recognizing warning signs

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 http://ted.com/tedx

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

 

SITS endorses the ESOC – the European Stroke Organisation Conference in Glasgow 17-19 April 2015 – according to an announcement by SITS Chairman professor Nils Wahlgren today.

SITS usually arranges meetings for National Coordinators, SITS participants, workgroups and  regional committees at large conferences and ESOC will be the conference for our meetings in Europe next year, Nils Wahlgren declared.

Nils Wahlgren concluded: We hope to see as many SITS members as possible in Glasgow, since it facilitates networking between those who use SITS.

icaro3

The aim of the ICARO-3 study was to evaluate whether intra-arterial treatment, compared to intravenous thrombolysis, increases the rate of favourable functional outcome at 3 months in acute ischemic stroke and extracranial ICA occlusion. ICARO-3 was a non-randomized therapeutic trial that performed a non-blind assessment of outcomes using retrospective data collected prospectively from 37 centres in 7 countries. Patients treated with endovascular treatment within 6 h from stroke onset (cases) were matched with patients treated with intravenous thrombolysis within 4.5 h from symptom onset (controls). Patients receiving either intravenous or endovascular therapy were included among the cases. The efficacy outcome was disability at 90 days assessed by the modified Rankin Scale (mRS), dichotomized as favourable (score of 0-2) or unfavourable (score of 3-6). Safety outcomes were death and any intracranial bleeding. Included in the analysis were 324 cases and 324 controls: 105 cases (32.4 %) had a favourable outcome as compared with 89 controls (27.4 %) [adjusted odds ratio (OR) 1.25, 95 % confidence interval (CI) 0.88-1.79, p = 0.1]. In the adjusted analysis, treatment with intra-arterial procedures was significantly associated with a reduction of mortality (OR 0.61, 95 % CI 0.40-0.93, p = 0.022). The rates of patients with severe disability or death (mRS 5-6) were similar in cases and controls (30.5 versus 32.4 %, p = 0.67). For the ordinal analysis, adjusted for age, sex, NIHSS, presence of diabetes mellitus and atrial fibrillation, the common odds ratio was 1.15 (95 % IC 0.86-1.54), p = 0.33. There were more cases of intracranial bleeding (37.0 versus 17.3 %, p = 0.0001) in the intra-arterial procedure group than in the intravenous group. After the exclusion of the 135 cases treated with the combination of I.V. thrombolysis and I.A. procedures, 67/189 of those treated with I.A. procedures (35.3 %) had a favourable outcome, compared to 89/324 of those treated with I.V. thrombolysis (27.4 %) (adjusted OR 1.75, 95 % CI 1.00-3.03, p = 0.05). Endovascular treatment of patients with acute ICA occlusion did not result in a better functional outcome than treatment with intravenous thrombolysis, but was associated with a higher rate of intracranial bleeding. Overall mortality was significantly reduced in patients treated with endovascular treatment but the rates of patients with severe disability or death were similar. When excluding all patients treated with the combination of I.V. thrombolysis and I.A. procedures, a potential benefit of I.A. treatment alone compared to I.V. thrombolysis was observed.