Awardee: Aurora Semerano, MD, Stroke Neurologist and Researcher at San Raffaele Hospital, Milan, Italy
Host Institution: Inselspital Bern, Neurology Department, Bern, Switzerland
Period of visit: 28th June – 9th July 2021
I am happy to bring you back some of my educational experience at Inselspital Bern, Switzerland, and to report here about the many inspirations received. My visit lasted two weeks, and together with Dr Mirjam Heldner, on the first day we designed the program that best suited my interests.
In the Emergency Department, I had the opportunity to follow the care pathway of stroke patients since the very beginning. I am truly grateful to the neurologists and the residents for their warm welcome and their availability to illustrate me the whole process and discuss every single case, even in emergency conditions. An efficient system of pre-notification allows the early activation of neurologists, nurse staff, and neuroradiologists before patient arrival. Moreover, helicopter transportation grants the access to urgent care for patients living in remote areas of Switzerland, such as mountains and valleys. In most cases, the initial imaging of choice is represented by a comprehensive MRI protocol (including parenchymal imaging, MR angiography, and MR perfusion), and an efficient organisation defined in every detail allows to greatly reduce the time of intervention. Within a few days, I had the opportunity to assist to a large spectrum of different cases, including wake up strokes, microbleeds on baseline imaging, distal occlusion strokes, mild strokes with proximal occlusions, and intracerebral haemorrhages on anticoagulation. I could also assist to several procedures of endovascular thrombectomy: in the angiographic suite, the neurointerventionalists illustrated me the entire procedures, and we discussed about dealing with complex anatomy and complications, as well as pharmacological protocols and device details for stenting procedures.
I attended the morning ward round in the Stroke Unit: each single case was discussed in a helpful and cooperative environment together with all the professional figures implied in patient care, including neurologists, residents, specialized nurses, physiotherapists, occupational and logotherapists, and other specialists. The open discussion of each case was also an occasion for me to ask about the practical approaches to unanswered questions and controversies in stroke medicine. I really admire the implementation of the latest scientific findings in the day-to-day care routine and the decision-making process based on a careful evidence-based basis. More, I have learned about the ongoing internal clinical trials, which will give relevant answers to all our stroke community in the next future. I was also curious about observational protocols and clinical research: lots of studies covering the wide spectrum of stroke research fields are ongoing and a dedicated staff is always active to bring research to the best standards.
Last but not least, I would like to express my gratitude for the whole experience. Thanks to the European Stroke Organisation and Prof Urs Fischer for giving me the opportunity to visit the Stroke Centre at Inselspital, to Dr Mirjam Heldner for the careful organisation of the visit, to Prof Marcel Arnold and Dr David Seiffge for the stimulating ideas and discussions, to Dr Pasquale Mordasini, Dr Tomas Dobrocky, Dr Eike Piechowiak for the neurointerventional tips, and importantly to the entire team for the warm welcome and the inclusive environment. Hope to meet you all again in the next ESO conferences!