Abstract
The present issue of the European Stroke Journal is again rich in information for stroke clinicians and researchers. The European Stroke Organisation (ESO) continues to provide you with guidelines to guide your practice. In this issue, you find the guideline for the management of extracranial and intracranial artery dissection, the joint guideline of ESO and the European Academy of Neurology on post-stroke cognitive impairment, and the joint guideline of ESO and the European Society for Swallowing Disorders for the diagnosis and treatment of post-stroke dysphagia. These guidelines are all prepared according to the ESO standard operating procedure. Because Guideline preparation and publishing is a developing field in itself, the ESO standard operating procedure has been adjusted and brought up to date. We recommend reading this article both for those who are involved in writing guidelines as well as for those who make use of any of the ESO guidelines in their practice. Specific attention has been paid to improving practicability of the guidelines.
From ESO, you will also find the expert opinion on cerebral venous sinus thrombosis occurring after SARS-CoV-2 vaccination, which can guide you in the diagnosis and treatment of this rare but important complication.
The original articles in this issue span the full range from acute stroke treatment to palliative care. A study of patients from Ireland, Greece, and Sweden explored the relation between clot length before mechanical thrombectomy and number of passes for clot removal and recanalization. A study from the Oxford Vascular Study investigated the effect of early BP lowering treatment after TIA or non-disabling stroke on cerebral haemodynamics measured by transcranial Doppler (TCD) ultrasound. Also, there is a report from the Estonian young stroke registry, showing a high burden of risk factors and high prevalence of cardioembolic and large-artery stroke. A study from the Netherlands investigated difference in MRI markers of small vessel disease between lacunar stroke and non-lobar intracerebral hemorrhage. Finally, investigators from the Netherlands studied the quality of dying after acute stroke, by a specific questionnaire that was filled by family members and nurses.
One systematic review and meta-analysis addresses the clinically important topic of prevalence of fatigue after stroke. Another systematically reviews the evidence on the impact of intracerebral hemorrhage volume and expansion on three months outcome.
Finally, there are four different protocols, also spanning the range from acute treatment to rehabilitation phase after stroke. INDIVIDUATE is a randomized controlled trial comparing standardized blood pressure management and individualized blood pressure management during endovascular treatment. OxHarp is a randomized, double blind, crossover trial of sildenafil, cilostazol, and placebo in patients with mild to moderate small vessel disease and a previous lacunar or cryptogenic stroke or TIA with MCA pulsatility measured by TCD ultrasound as the primary outcome. SUSHI will study the clinical effectiveness of the
SaeboGlove on upper limb function after stroke, and CARE fOR U will study a computer-game-based rehabilitation platform to treat upper limb deficits after stroke, both in a randomized controlled trial design.
In summary, ESJ continues to be the platform where you can find the newest ESO guidelines, and other important developments in the field of stroke. Enjoy!