Awardee: Antonio Ciacciarelli, MD, Neurologist and PhD Student – Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
Host Institution: Hospital Clinic, Comprehensive Stroke Centre, Department of Neuroscience, Barcelona, Spain
Period of Visit: 07th February – 22nd February 2022
Despite the short period of stay of 15 days at the comprehensive stroke centre of the Hospital Clinic, Barcelona – Spain, I have learned, observed, and got inspired by so many things which are difficult to recount in a few words. However, I will summarize this extraordinary visit in the three goals I have reached.
I had the occasion to be involved in an extremely organised stroke system. In the acute phase, an efficient pre-notification allows the vascular neurologist to access the past medical history through the electronic health record of the patient and be prepared for the arrival of the stroke to the emergency department. Once confirmed by the neurological examination, in a few minutes the nurse staff get the patient ready for the computer tomography (CT) room where the patient will undergo a multimodal CT scan. The best treatment is rapidly decided, and thrombolysis is given in the CT room while the patient is transferred to the angiography lab. A dual-energy CT scan is performed a few hours after the procedure allowing to discriminate in advance contrast extravasation from haemorrhagic transformation. I was astonished by the quickness and fluency of the gear that allowed it not to lose any second even when three codes stroke arrived at the same time.
In the stroke unit, during the ward round, the patient history and clinical course are revised in detail with meticulous attention to vital signs and continuous glucose monitoring. Carotid, heart and transcranial Doppler ultrasound is performed by a sonographer every day at the patient’s bedside. Spontaneous subarachnoid haemorrhages are admitted to the stroke unit and treated by the vascular neurologist in a multidisciplinary approach with an every-day cerebral vasospasm ultrasound monitoring.
The meetings of the week are an integral part of the stroke unit life. Discussion on clinical cases, doubts on treatments, questions on stroke aetiologies, and new evidence from the literature are constantly shared among the group to keep improving every day the management of stroke patients. I also had the chance to assist virtually in the International Stroke Conference 2022 presentation of the successful CHOICE trial, together with the principal investigators’ group and this was an enormous moment of motivation. I go back home with tons of new ideas and a spirit of continuous improvement. I am grateful for the things I have learned, happy to bring them back to my colleagues and to keep sharing knowledge with European vascular neurologists.
During my stay at Hospital Clinic in Barcelona, I met new people who have increased my enthusiasm for studying and improving stroke care in all its facets and angles. I was able to discuss with them new insights into clinical practice and stroke research field. For this reason, I want to thank dr Ángel Chamorro for not hesitating to accept me in his department from the very first moment. Dr Xabier Urra for his availability in guiding me through the entire visit, and all the neurologists (dr Amaro, dr Renú, dr Rodríguez, dr Santana), the residents and the stroke team for the warm welcome I received. Hope to see you soon and keep collaborating in the future.
Finally, I would like to thank the European Stroke Organisation for giving me this opportunity and for the constant support and assistance needed to arrange the visit during the Covid-19 pandemic. For the young physicians and researchers who are reading this report, I strongly advise you to apply to the ESO Department to Department visiting programme as a stimulus to gain new experience, knowledge, and collaborators around Europe.
About the ESO Department to Department Visit Programme
The Department to Department Visit Programme aims to provide insight into stroke departments outside the applicant`s home country through a grant of EUR 1,500 offered to up to 10 young physicians and researchers to support a short visit of a week or as a contribution to a longer visit to an European department or laboratory.