During a brief pause in today’s scientific sessions, I took the opportunity to walk through the poster hall. I have a particular interest in acute intracerebral haemorrhage (ICH) and was encouraged by the range of aspects of ICH care being discussed. There were several emergent themes including NOAC vs VKA bleeding associations, blood pressure in the hyper-acute period post ICH and experimental models of ICH. Several posters caught my eye including two posters aiming to improve the delivery of ICH care, the first: Feasilibility of early intensive blood pressure lowering in intracerebral haemorrhage – use of a simple systematic treatment algorithm – Homburg et al. (Denmark). This particular study demonstrated that rapid BP reduction can be obtained in everyday clinical practice using a simple treatment algorithm. The second care delivery study was an important piece of qualitative work: Patient and Physician Communication Priorities in Spontaneous Intracerebral Hemorrhage – Krett et al. (Canada). This study used thematic analysis to investigate communication in ICH care from multiple perspectives using surveys and telephone interviews. The conclusion provided by the authors serves as a reminder as to the importance of understanding the patient’s agenda and delivering shared-decision making. Continuing the theme of robust communication, this can be particularly difficult when advising patient’s on the complications of stroke and subsequent prognostic implications. Convulsive Status Epilepticus After Stroke – Gazioglu et al. (Turkey) provided an important reminder as to the burden of post stroke seizures. The authors demonstrated an incidence of post stroke seizures in their retrospective cohort of 2350 patients of 9.8% (218 patients). 7.8% (17/218) of the included patients had convulsive status epilepticus and this particular diagnosis was associated with a high risk death within one month. This ICH section of posters represented important topical considerations in ICH care, namely: robust acute care (blood pressure control, reversal of anti-coagulation and escalation of care decisions), ICH complications (seizures and early neurological deterioration) and difficult positions of equipoise that ICH can pose in the context of atrial fibrillation and restarting anticoagulation.
ESO BLOG – THE VOICE OF STROKE IN EUROPE
- FESO Interview with Christine Kremer 16. June 2019