Poster Walk by João Pedro Marto,

Department of Neurology, Hospital de Egas Moniz, Lisbon, Portugal

Member of the Young Stroke Physicians and Researchers Committee

What a great meeting and a wonderful way to celebrate the 10th anniversary of ESO!

As in the past years, the ESOC was the perfect opportunity to meet colleagues from all around the world and listen to the top experts in the field of stroke.

We were all privileged to witness the presentation of numerous high-quality research studies in the main large clinical trials and scientific communication sessions.

However, many other studies presented as posters deserved our attention.

During the poster walk, I attempted to summarize some of the many interesting posters displayed on Thursday and Friday.

Among the posters on ACUTE MANAGEMENT, I would like to highlight the poster on DABITAGRAN ETEXILATE VERSUS WARFARIN IN CEREBRAL VENOUS THROMBOSIS IN CHINESE PATIENTS (CHOICE-CVT): AN OPEN-LABEL, RANDOMIZED CONTROLLED TRIAL by Duan J et al. which aimed to assess the safety and efficacy of dabigatran versus warfarin in patients with CVT. This trial was recently published in the International Journal of Stroke (DOI: 10.1177/17474930241234749), and its results align with previous studies such as RESPECT-CVT (RCT) and ACTION-CVT (retrospective observational study). Together, they support DOAC therapy as a safe and equally effective alternative to warfarin in patients with CVT.

On the CLINICAL TRIALS topic, the individual patient data meta-analysis presented by Kaufmaan JE et al. on ANTITHROMBOTIC TREATMENT FOR CERVICAL ARTERY DISSECTION also caught my attention. Just published in JAMA Neurology (DOI: 10.1001/jamaneurol.2024.1141.), this study included patients from the CADISS and TREAT CAD RCTs. The authors did not find a significant difference between anticoagulants and antiplatelets in preventing early recurrent events. Results from the recent large observational study STOP-CAD Study (doi: 10.1161/STROKEAHA.123.04573) introduce treatment duration and the presence of occlusive dissection as potentially important factors for individualized decisions.

On the topics of SMALL VESSEL DISEASE and COGNITION AND VASCULAR COGNITIVE IMPAIRMENT, I found two posters about cerebral amyloid angiopathy (CAA) particularly interesting. CEREBRAL AMYLOID ANGIOPATHY WITH AND WITHOUT CORTICAL SIDEROSIS: CAN WE TALK ABOUT MICROBLEEDERS AND MACROBLEEDERS by Losa M et al. characterized and compared patients with CAA depending on the presence of cortical superficial siderosis (cSS). As previously described, the authors showed that patients with cSS have a higher risk of intracerebral hemorrhage (ICH) during follow-up. Additionally, patients without cSS more frequently presented with cognitive symptoms and had a great degree of medial temporal lobe atrophy. Finally, in a subgroup of patients, those with cSS had lower CSF levels of Aβ40. In their conclusions, the authors advocate for a phenotypic spectrum of CAA with patients having a “cognitive-neurodegenerative CAA” while others have a “hemorrhagic CAA”. From another perspective, the work from Pinho J. et al. IMAGING MARKERS IN PATIENTS WITH CAA FROM A MEMORY CLINIC COHORT – EVIDENCE FOR A PATHOPHYSIOLOGICAL TIMELINE showed that patients with CAA and hemorrhagic markers were older, had longer symptom duration, lower global cognitive performance, and lower CSF Aβ42 levels in comparison with patients with CAA without hemorrhagic markers. The authors conclude that the presence of hemorrhagic markers in CAA patients with cognitive presentation is associated with a more advanced disease. Whether there are clear different CAA phenotypes and/or different stages of CAA progression is likely an interesting topic for future studies and discussion.

Finally, on the topic of SAH and ICH the work by Ouyang M et al. conveyed an important message for all stroke physicians. In their work entitled PREDICTIVE ACCURACY OF PHYSICIANS’ ESTIMATES OF DEATH AND RECOVERY AFTER ACUTE INTRACEREBRAL HEMORRHAGE, the authors assessed the capability of physicians to predict mortality, functional outcome, and quality of life at 6 months, during the first 7 days after ICH in patients included in the RCT INTERACT 3. While the capability of physicians to estimate the likelihood of survival for ICH patients was good, their ability to predict functional outcomes and quality of life was poor. These results reinforce the need to develop better prognostic tools for patients with ICH. Additionally, physicians should be aware of their limited capability in predicting prognosis while communicating with patients and their family members, and while taking treatment decisions.

And that’s it!

Looking forward to the ESOC 2025 in Helsinki! Hope to see you there!