For 2018, via the ESO newsletter, we are focusing the spotlight on prominent ESO members under 45. In January we introduced you to Georgios K. Tsivgoulis. For February, we learned more about Else Charlotte Sandset. In March we presented Urs Fischer. In April you met Charlotte Cordonnier.

Hopefully you were able to meet some of these prominent young members in person during the ESOC in May. From the ESOC, the Young Stroke Physicians and Researchers Committee published daily interviews with Ayse Tanritanir, Stefania Nannoni, and Maren Ranhoff Hov. 

In the June edition of this series Marialuisa Zedde answered some questions. In July, we introduced Jesse Dawson, in August we met Diana Aguiar de Sousa and in September we got to know Robert Mikulik. For October, we interviewed Mira Katan.

This month, we present, George Ntaios, University of Thessaly School of Medicine, Larissa, GR. George is an active member of the ESO Executive Committee. and former co-chair of the Guidelines Committee.

What ESO has added and what do you expect ESO to add in the future to grow a new generation of stroke clinicians/researchers?

Like all of us, I am proud to serve a fresh, vibrant and expanding organization like the ESO. I think that what attracts us all to the ESO is, among others, its democratic and transparent structure which is open for its members to become actively engaged irrespective of their age, gender, geographical region and medical specialty. It is this commitment of its members which makes ESO strong and allows our organization to offer a generous portfolio of educational platforms like our Congress, our Journal, the Summer and the Winter Schools, the Stroke Science Workshop, the Guideline Development Workshops, the Department-to-Department visit program, scholarships for the European Master Program in Stroke Medicine and many others.

All these activities aspire to grow a generation of stroke specialists. During the recent few decades, the stroke community witnessed an enormous increase in the understanding of virtually any aspect of Stroke Medicine like primary prevention, stroke etiology and pathophysiology, diagnostic approach, hyperacute management and prevention of acute complications, secondary prevention, and rehabilitation. Nowadays, Stroke Medicine has evolved so broadly and deeply that now clearly extends horizontally beyond and across the boundaries of the traditional specialties that are typically engaged in the care and management of stroke patients. Now, more than ever, it becomes obvious that Stroke Medicine needs to be acknowledged, certified and accredited as a distinct, independent subspecialty for physicians of various medical backgrounds who should be rigorously trained, officially certified and dedicated. Each one of our patients deserves the right to be treated by a certified Stroke Specialist, and this is something that the ESO can work on.

What is the added value of multidisciplinarity to the activity of a Stroke Team/Stroke Unit?

Stroke is not a single disease; it is a syndrome and, actually, a complex one: it is caused by a vascular pathology, which results in neurological symptoms and medical complications, and requires etiological treatment (recanalization), general supportive management, chronic rehabilitation and strategies to prevent a recurrent event. From this perspective, the stroke patient is perhaps one of the most representative examples of patients requiring a truly holistic and multidisciplinary approach. In this context, physicians of various medical backgrounds, nurses and non-medical personnel need to join forces in an open-minded and respectful manner, and collectively walk our patients through their stressful journey and back to independence.

What are your main fields of interest in stroke research and what are the main unsolved questions in clinical stroke research for the near future in your opinion?

In one of his mythical labours, Hercules had to fight Lernaean Hydra, a dreadful monster with many heads and a unique feature: every time Hercules cut off one of its heads with his sword, the Hydra would regrow two new heads. More or less, this reflects the evolution of research: every time a question is answered, new questions arise. Despite huge steps of progress in stroke diagnosis, management and prevention during the recent years, we are all confronted with so many uncertainties in our clinical practice which highlight the research pathway ahead of us: precision medicine and individualized, patient-centered strategies of acute management and secondary prevention, treatment of intracerebral haemorrhage, more evidence-based approach in rehabilitation, more efficient ways to implement established knowledge in our existing patient care pathways, just to mention a few. The stroke research field that I am mainly involved in is secondary prevention. Despite many trials and important steps forward, an unacceptable proportion of our stroke patients will face another event at some time.

How do you manage clinical and research activity in your daily routine?

What a challenge it is to try to be a good clinician for your patients, an engaging teacher for your students, an inspiring mentor for your fellows, an esteemed researcher, a stimulating speaker at the congress, a good husband for your wife, a good father for your children and a good friend for your friends!

I am fortunate to share this journey together with some excellent long-lasting collaborators, friends and mentors, with whom we share the same mentality and vision. As the engagements continuously accumulate, it is important to prioritize and to learn to say “No” sometimes, in order to reserve some secure time for the most precious task: gratefully caring for our beloved ones.