by Davide Strambo

In these exciting years of continuous innovations in stroke care, there is something never changing: stroke is a clinical-based diagnosis and we don’t have to be too confident on MRI: DWI-NEGATIVE STROKE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF FREQUENCY AND OUTCOMES (R. Gurney et al.) remind us that some ischemic strokes (about 9%) have no lesion on DWI.

However, stroke medicine still has many areas of uncertainty, as we can see in the poster session on NEUROINTERVENTION – EXCLUDING CLINICAL TRIAL RESULTS. Here great attention was given to mechanical thrombectomy for posterior circulation strokes:

the ENDOVASCULAR RECANALIZATION IN POSTERIOR CIRCULATION STROKE WITH ASPIRATION DEVICES IS FASTER, EFFECTIVE AND NOT DETRIMENTAL TO OUTCOME COMPARED TO STENT RETRIEVER DEVICES: THE NORDICTUS REGISTRY (de la Riva et al.) showed excellent procedural results (speed and rate of recanalization) with aspiration devices. From the results of MECHANICAL THROMBECTOMY FOR BASILAR ARTERY THROMBOSIS, LOCATION AS A DECISIVE FACTOR (S. García-Madrona et al.) the localization of basilar artery occlusion (proximal vs. distal) appeared a key factor affecting the efficacy of endovascular treatment.

Another hot topic in this session was the treatment of tandem occlusion, for which many questions are still open, first of all: to stent or not to stent the ICA? And which antiplatelet regimen administer? The interesting study CAROTID STENTING IN THE ACUTE PHASE OF STROKE: ANTIPLATELET THERAPY REGIMEN BASED ON EARLY DUAL-ENERGY CT SCAN (García Rúa et al) propose dual CT to guide the choice of the antiplatelet regimen. ACUTE CERVICAL CAROTID STENTING IN PATIENTS WITH TANDEM OCCLUSIONS: A RETROSPECTIVE SINGLE-CENTRE STUDY present the positive experience of a single center in patients treated with acute ICA stenting.

If you want to discover new data on another gray zone of endovascular treatment don’t miss THROMBECTOMY VERSUS MEDICAL TREATMENT IN PATIENTS WITH ACUTE ISCHEMIC STROKE WITH ISOLATED M2 OCCLUSION (García Rúa et al.), ENDOVASCULAR THROMBECTOMY IN 47 PATIENTS WITH ISOLATED M2 OCCLUSIONS: CLINICAL AND REPERFUSION OUTCOMES (A. Kohli et al.) and ENDOVASCULAR TREATMENT FOR ACUTE ISCHEMIC STROKE DUE TO M2 OCCLUSIONS IN CLINICAL PRACTICE. These three posters propose different perspectives on the endovascular treatment of isolated M2 occlusion.

If after all the adrenaline of acute ischemic stroke treatment you are interested also in stroke recovery, don’t miss the promising results of virtual reality in stroke rehabilitation presented in THE EFFECTIVENESS OF VIRTUAL REALITY INTERVENTIONS IN THE TREATMENT OF BALANCE IMPAIRMENT IN PATIENTS WITH CHRONIC STROKE: A SYSTEMATIC REVIEW (Y. Emuk et al.) and encouraging role of TDCS in the rehabilitation of spatial neglect – EFFECTS OF TDCS IN MODULATING THE AFTER-EFFECT OF PRISMATIC LENSES TRAINING IN SUBACUTE STROKE PATIENTS WITH NEGLECT. When it comes to the diagnostic work-up of ischemic stroke patients, UTILITY OF TRANSTHORACIC ECHOCARDIOGRAPHY IN DIAGNOSTIC EVALUATION OF ISCHEMIC STROKE (J. Harris et al.) raise the question: Is transthoracic echocardiography overused in the diagnostic assessment of ischemic stroke patients? Going back to the basics of internal medicine FRANK’S SIGN AND STROKE SUBTYPES: RELEVANCE IN REFINING THE CLINICAL PROFILE OF CRYPTOGENIC STROKE (ESUS) (J. Serena et al.) re-propose a new application of Frank’s sign in better characterising the profile ESUS patients.

Completely changing topic EVALUATION OF SLEEP APNOEA SHOULD BE PART OF ROUTINE RISK ASSESSMENT IN STROKE PATIENTS remind us the importance of including sleep apnea assessment in the routine risk assessment in stroke patients.

But most important of all, in these days of intense scientific activity during the day and social life in the night don’t forget the importance of sleeping as suggested in DAYLIGHT SAVING TIME (DST). RISK FACTOR FOR ACUTE ISCHEMIC STROKE? (Folyovich et al.)