Host Institution: Department of Neurovascular Diseases, Karolinska University Hospital, Sweden.

I am very grateful to the ESO Department to Department Visit Programme and to Prof. Ahmed and Dr. Mazya for giving me the chance to visit the Department of Neurovascular Diseases of the Karolinska University Hospital in Stockholm last July.

The Karolinska Neurology Clinic was founded in 1887, the second one in the world after Paris. Since then, the Neurology Clinic continues to be a pioneering and leading Institution in the field of Neurology and Cerebrovascular diseases, with a strong tradition in education, as they host the ESO-Karolinska Update Conference.

The Neurovascular Unit is led by a well-established team of stroke clinicians with a strong support from the neuroradiology team. The region/hospital stroke network is so fluid and the stroke team so well-trained that the door-to-needle time for thrombolysis is extremely (and remarkably) short. In addition, the Karolinska University Hospital is the only Centre to provide endovascular therapy in the Stockholm County, achieving excellent outcomes and avoiding the most of delays and pitfalls thanks to a solid and efficient pre-hospital triage algorithm that guarantees a direct-to-mothership transport for patients who are likely to have a large vessel occlusion.

With my host, Dr. Mazya, I joined the stimulating daily Neurology Department and Neuroradiology meetings, during which the most interesting cases are discussed, and the clinical activity in the Intermediate Care Unit, where all neurological patients (including stroke patients) who are unstable and need elevated monitoring are treated. During my stay, Dr. Mazya was the regional stroke consultant on call, so I had the chance to observe the quick and pragmatic multidisciplinary management of stroke patients transferred to the Karolinska University Hospital.

Michael Mazya has been a great mentor during this week. We had several pleasant and insightful discussions about stroke diagnosis, treatment and secondary prevention. He showed me the main results of his research activity and we had long talks about recent and ongoing trials and their implication in the real-world daily clinical practice. In addition, he did his best to involve me in the clinical decision-making: this was very stimulating and gave me the opportunity to identify my strong and –above all– weak points. Moreover, seeing Dr. Mazya in action during rounds and emergencies, with his rigorous clinical method and his humanity, was extremely inspiring.

All this, put together, helped me a lot not only to get a structured overview of stroke care and research, but also to focus on my personal aspirations and how to achieve them.

Giuseppe Reale, MD
Institute of Neurology
Gemelli University Hospital
Catholic University of the Sacred Heart, Rome