Stroke Master Bern students in teaching courseAuthor: Silja Räty, MD, PhD

Department of Neurology, Helsinki University Hospital, Finland

The Master of Advanced Studies in Stroke Medicine (MAS) Programme has been providing hundreds of aspiring stroke physicians and researchers with up-to-date knowledge on all aspects of stroke. The ongoing course that started in 2022 was the first that was organised by the University of Bern in Switzerland after many successful years in Krems, Austria. Although the new programme is just over halfway through, this post will highlight some of the most interesting topics.

As the programme attracts participants from all over the world, the studies are mainly executed on an online platform, complemented by three onsite weeks in Bern and visits to European stroke units. The programme covers epidemiology, pathophysiology, aetiology, diagnosis, acute treatment, secondary prevention, and rehabilitation of stroke, as well as research, organisation of stroke care, and education. The lecture topics range from more theoretical ones, such as molecular mechanisms of stroke, to highly practical questions, including how to manage antithrombotic medication during interventions or how to perform meta-analyses. They highlight both historical breakthroughs and the most cutting-edge innovations that are yet to be established in routine care.

The MAS curriculum provides an opportunity to expand one’s focus from the individual patient to the regional and global impacts of stroke. Some of the most eye-opening talks have addressed the global burden of cerebrovascular diseases: the implications to public health and connections to social and environmental issues beyond medicine. These are topics that a stroke physician rarely encounters in daily practice, but that should not be ignored in the stroke community when advocating for better stroke prevention and care.

Management of acute stroke is one of the fields in neurology that has developed most rapidly in recent years. Consequently, the topic is profoundly covered by experts involved in milestone trials and guideline development. This includes up-to-date evidence for recanalisation treatments of ischaemic stroke in specific clinical situations: intravenous thrombolysis, endovascular thrombectomy and its new techniques, stenting, add-on medications, treatment goals, blood pressure management, and choice of sedation mode during procedures. However, the sessions also address open questions within the field and point out ongoing trials that may fill some of the current knowledge gaps in the future.

One of the programme modules addresses the aetiology of stroke. Besides the common causes, attention is also paid to more infrequent aetiologies, such as inflammatory vasculopathies, Moya-Moya disease, hereditary small vessel disease, and rare stroke syndromes. An interesting entity for a stroke physician working mostly with adult patients is the aetiological distribution of stroke in children and the young – a topic less familiar from clinical practice but essential to know on rare occasions.

Although the evidence-based practices of stroke care prevail in the programme, topics related to decision making are also an integral part of the studies. Common errors of judgement, difficult prognosis, and misdiagnosis are issues that receive little attention in textbooks, journal articles, or conferences. However, they are highly relevant to professionals working in a field that requires such fast and deliberate decisions as stroke neurology. By acknowledging these topics and giving a forum to discuss them with peers and experts, the master’s programme completes the curriculum filled with scientific evidence and practical knowledge that can be recommended to any future stroke professional.

Learn more about the European Stroke Master Programme.