By Kateriine Orav, Department of Neurology, North Estonia Medical Center, Tallinn, Estonia
There is no shortage of interesting research E-Posters this year so let’s continue the virtual walk in the Poster Gallery…
The worldwide meta-analysis GLOBAL DIFFERENCES IN RISK FACTORS, AETIOLOGY AND OUTCOME OF ISCHAEMIC STROKE IN YOUNG ADULTS A WORLDWIDE META-ANALYSIS ON INDIVIDUAL PATIENT DATA: THE GOAL-INITIATIVE (Jacob MA et al) highlights significant ethnic and regional differences in risk factors and mortality among 18-50 year old stroke patients. The authors emphasize that this should serve as a call to action to improve healthcare facilities in low- and middle-income countries.
An important cause for stroke in young adults is cerebral venous thrombosis. The authors of so far the largest study on DECOMPRESSIVE NEUROSURGERY FOR PATIENTS WITH CEREBRAL VENOUS THROMBOSIS. A PROSPECTIVE MULTICENTER REGISTRY (DECOMPRESS2) (Ferreira J et al) reported higher mortality and functional dependence than have previous retrospective studies. However, by 6 months 2/3 of patients were alive and 1/3 were independent, so this study supports the current ESO-guidelines for CVT, which provide a strong recommendation for decompressive neurosurgery in patients with CVT with impending herniation.
The question of bridging with intravenous thrombolysis before endovascular therapy remains unresolved, especially in patients who are admitted directly to EVT capable hospitals. THE IMPACT OF INHOUSE BRIDGING THROMBOLYSIS ON FUNCTIONAL OUTCOME IN PATIENTS WITH LARGE VESSEL OCCLUSION STROKE – FINDINGS FROM THE GERMAN STROKE REGISTRY (Maier I et al) study reports that inhouse bridging therapy was associated with improved functional outcome in LVO patients so this strategy can’t be completely written off. What could aid in the choice is if we had better models to predict the risk of symptomatic intracerebral hemorrhage, for example as described in the study PERSONALIZED RISK PREDICTION OF SYMPTOMATIC INTRACEREBRAL HEMORRHAGE AFTER STROKE THROMBOLYSIS USING MACHINE LEARNING MODEL (Wang F et al).
The Czech study TRANSPORT STRATEGY FOR ISCHEMIC STROKE PATIENTS WITH LARGE VESSEL OCCLUSION: OUR EXPERIENCE (Černik D et al) brings to our attention that interhospital transport time could be much quicker for drip-and-ship patients if the same medical rescue team who brought the patient to the first stroke center transferred the patient to the comprehensive stroke center once the imaging is done and IVT started. And talking about being faster, IDENTIFICATION OF LARGE VESSEL OCCLUSION ON NON-CONTRAST CT USING A DEEP LEARNING SOFTWARE (Olive-Gadea M et al) could be very useful for choosing where to transport stroke patients in mobile stroke units.
Much more great research is just a click away so I strongly suggest taking a stroll in the gallery before the end of the conference. And enjoy the remaining talks of the ESO-WSO conference!