Abstract
This December issue marks a significant milestone for the journal: the completion of our first decade and our final issue published under Sage. Beginning 1 January 2026, ESJ will embark on a new chapter with Oxford University Press as its publisher and will transition to a fully open access journal, broadening its global reach and accessibility.
Over the past 10 years, ESJ has addressed key and emerging topics in clinical stroke research, integrating diverse perspectives across the continuum of stroke care, from hyperacute treatment to rehabilitation and from primary to secondary prevention. We take this opportunity to extend our sincere gratitude to Sage for their valuable partnership, and to our editorial board, authors, reviewers and readers, whose dedication, expertise and enthusiasm have been central to the journal’s growth and success. In particular, we acknowledge the superb foundation built by our former Editor in Chief, Bo Norrving, who was ably assisted by Didier Leys and Karin Klijn.
As we celebrate this important milestone, the present issue also reflects the journal’s continuing mission: to promote excellence, inclusiveness and innovation in stroke research and care. It underscores the need to care for the person with stroke in a truly comprehensive way – addressing not only the acute phase of the disease, but also the long-term goal of improving quality of life for increasing numbers of stroke survivors. Stroke care must aim to reduce functional deficits and promote recovery while recognising the complexity of each patient. Equally, it must be inclusive, attentive to gender differences and responsive to the persistent geographical and social inequalities that continue to shape access to care and outcomes.
In this perspective, the publication of four new ESO guidelines represents a major achievement. The ESO Guideline on Stroke due to Spontaneous Intracerebral Haemorrhage, 1 developed in collaboration with the European Association of Neurosurgical Societies, highlights the importance of multidisciplinary partnership in managing one of the most complex cerebrovascular conditions. This guideline represents a massive contribution to optimal clinical management of ICH, truly exceptional in its scope. We congratulate Thorsten Steiner and his colleagues for a superb critique of the evidence. The ESO Guidelines on Aphasia Rehabilitation, 2 Visual Impairment in Stroke 3 and Motor Rehabilitation 4 complete this quartet of clinical guidance to optimise recovery, independence and quality of life. Taken together, these guidelines embody a vision of stroke care that is evidence-based, integrated and patient-centred.
However, implementing and integrating such guidelines into everyday clinical practice remains a challenge. Resource constraints – such as workforce shortages, inequalities in care infrastructure and financial limitations – continue to hinder consistent adoption. In this context, identifying and prioritising gaps in stroke care emerges as a valuable strategy to guide context-specific, evidence-based interventions and to support international efforts aimed at reducing the global burden of stroke. 5
This issue also draws attention to the importance of equity, diversity and inclusion in stroke care. Two studies published here explore sex differences in outcomes after endovascular therapy 6 and frailty in older stroke patients. 7 These contributions highlight the biological and social determinants that shape recovery and reinforce the need for personalised strategies in clinical decision-making.
The inclusion of these studies alongside the new guidelines highlights the journal’s commitment to addressing the multifaceted challenges of stroke care, and advancing both quality and equity, to ensuring that scientific progress translates into real-world improvements for all patients, regardless of geographic, social or demographic differences.