ESO: Likely increase in the risk of death or disability from stroke during the COVID-19 pandemic

ESO: Likely increase in the risk of death or disability from stroke during the COVID-19 pandemic

The European Stroke Organisation (ESO) cautions against the consequences of the Coronavirus-Crisis on stroke care.

Basel, 08 April 2020 – Each year, 1.5 million Europeans have a stroke. Two to three of every 10 patients die as a consequence of stroke, and about one third remain dependent on the help of others. The likelihood of a favourable outcome is critically dependent on patients presenting promptly after symptom onset and on hospitals providing immediate access to optimised stroke care. This includes treatments for vessel recanalisation, securing brain vascular malformations, specialised stroke unit care, secondary prevention, and rehabilitation.

In a survey among 426 stroke care providers from 55 countries, only one in five reported that stroke patients are currently receiving the usual acute and post-acute care at their hospital. The lack of optimal care is likely to lead to a greater risk of death and a smaller chance of a good recovery.

There is no reason to assume that the incidence of stroke declined since the onset of the COVID-19 crisis, but in many countries, fewer people with symptoms suggestive of stroke present to the hospital. This may be due to a range of factors, including fear to become infected with COVID-19 in the hospital or the assumption that doctors are too busy treating patients with COVID-19 to treat patients with stroke.

ESO supports the efforts to manage to COVID-19 pandemic and to treat patients with COVID-19, but emphasises that patients with stroke symptoms should still present to hospital as soon as possible and that efforts should be made to maintain the usual level of stroke care, including intravenous and endovascular reperfusion strategies, irrespective of the patient’s COVID-19 status, to avoid unnecessary ‘collateral damage’ through inadequate treatment of this often disabling or life-threatening condition.

Issued by the ESO Executive Committee.

Image by Gerd Altmann from Pixabay

Small vessel disease poorly understood but advanced magnetic resonance imaging scans can help

Small vessel disease poorly understood but advanced magnetic resonance imaging scans can help

Damage to the small blood vessels in the brain (known as „Small Vessel Disease“) can lead to stroke and vascular dementia.
Despite causing these important conditions small vessel disease remains relatively poorly understood compared to other blood vessel diseases. With the better understanding of small vessel diseases, the study SVDs@target will develop novel therapeutic treatments and finally contribute to the prevention of stroke and dementia.

The project also includes 3 studies with stroke patients. They are:

ZOOM@SVDs, a high-resolution imaging study to look at vascular function and brain  damage

INVESTIGATE-SVDs, an imaging study to assess the blood/brain barrier and vascular function,

TREAT-SVDs, testing the effects of different blood pressure lowering agents on vascular function in patients with distinct SVDs

Michael Stringer_UEDIN

We spoke with Michael Stringer, Research Fellow in Magnetic Resonance Imaging and Image Analysis from the Centre for Clinical Brain Sciences, Edinburgh Imaging and the UK Dementia Research Institute at the University of Edinburgh.

Why does this trial (Zoom/INVESTIGATE or TREAT) on small vessel diseases matter?

Investigate-SVDs recruits small vessel disease (SVD) patients to have advanced magnetic resonance imaging scans. SVD remains poorly understood, this study has great potential to further knowledge & ultimately improve outcomes for patients.

What is it that you do in this project?

As a research fellow in medical physics at the University of Edinburgh I helped setup the magnetic resonance imaging protocol (guide to running the scans), liase with other sites and am heavily involved with analysis of the imaging data.

Why do you do it?

My research focuses on applying advanced imaging and mathematical methods to study disease. I enjoy applying these tools to study real world problems, and as a highly multidisciplinary area it provides a lot of variety – it is seldom dull.

SVDs@target has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 666881.

Photo credit: A print screen from the official SVDs@Target website.

EFNA publish Position Paper on Access

EFNA publish Position Paper on Access

The European Federation of Neurological Associations (EFNA)  are pleased to publish a position paper on ‘Advocating for access to neurology treatment, services and support’. The document is based on feedback from an EFNA workshop held in Warsaw in October 2019, attended by approximately 50 representatives of patient and health professional organisations, industry partners and other experts. The contents of this paper reflect the insightful and lively debates and the arising conclusions and recommendations.

These outputs have been captured to inform EFNA’s strategic plan for 2020-2025, particularly on its focus area of ‘ensuring equitable access’ to neurological care for all patients in need. These recommendations define our way forward and are a proactive framework for action. Ensuring that the EFNA work programme is consistent and capable of impacting policy discussions throughout the 2019-2024 EU mandate is essential in order to make progress in the areas identified.

Read the Position Paper here:

Stuck in isolation and feel powerless? Why not building up your stroke advocacy skills for free

Stuck in isolation and feel powerless? Why not building up your stroke advocacy skills for free

Author: Jelena Misita, SAFE Awareness and Advocacy Manager

As we witness an unprecedented global public health crisis, many of us are forced to #stayhome for the greater good and stop Covid-19 from further spreading.

In these extraordinary times, there are groups of people who became even more vulnerable than they were. The stroke survivors and their loved ones for sure make one of these groups.

To be honest, the situation wasn’t good to begin with. There are around nine million stroke survivors currently living in Europe, with a support that is often undefined, fragmented or non-existent in majority of European countries, as shown in previous SAFE research projects, the Burden of Stroke Report (2017) and the Economic Impact of Stroke Report (2019).

Recent advancements in medicine enabled more lives to be saved in the acute phase of stroke, meaning that more and more stroke survivors will get a chance to live another 10, 20, 30 years or even longer. However, survivors and their families may face decades of existence in which they are largely reliant on self-management. The problems caused by stroke-related disabilities are often complicated by other diseases and additional issues related to their internal and external environment, self-care and self-esteem, their role as a spouse, parent, employee, and so on.

If you add the Covid-19 crisis and its implications to an already long list of difficulties that stroke survivors face every day- it may be just too much for them to handle. If whole hospitals are being turned to Covid-hospitals, what is happening with people who have a stroke? We learned that stroke doesn’t choose the time or place. It doesn’t discriminate and it can happen to anyone at any time, even in the Covid-19 most affected areas. Where does that leave the person who suffers a stroke? How likely would it be for this person to receive the necessary treatment in these conditions?

To get answers to these and many other questions, the European stroke community needs more skilled stroke advocates, who would be able and willing to take a stand and advocate for better stroke prevention, treatment and especially for better life after stroke conditions, because, as SAFE’s Board member and stroke survivor Grethe Lunde said, a saved life must also be lived.

If you feel it within you, if you want to make a change, but don’t know where to start- we have a solution for you. It is called SSOFT- the Stroke Support Organisation Faculty Tool.

SSOFT  is a free platform. It provides knowledge and training on how to make effective advocacy activities and campaigns to deliver positive change at a local and national level on stroke prevention, treatment and care. This innovative eLearning platform includes six modules that provide information on:

Module 1: Stroke Support Organisations (SSOs)

Module 2: Making Change Happen

Module 3: Use of Evidence

Module 4: Role of Patient Voice

Module 5: Health System Advocacy

Module 6: Public Advocacy

In the end, why not using this period of isolation and social distancing to improve our skills and be better prepared for the changed world when the crisis is over?

We know that stroke survivors and their families will be thankful for it.

It’s up to you, click here, register and become one of us.



The Global Stroke Alliance Meeting held in Rio de Janeiro

The Global Stroke Alliance Meeting held in Rio de Janeiro

Source: World Stroke Organization

The Global Stroke Alliance Meeting, held in Rio de Janeiro, Brazil from March 11 to 14 was an innovative meeting that aimed to stimulate a global alliance to improve stroke care worldwide and to discuss the best strategies to implement evidence-based interventions access the continuum of care

The Global Stroke Alliance Meeting brought together leaders from 20 countries around the world with extensive experience in the organization of stroke systems of care, alongside researchers, health professionals, health managers, scientific societies, private hospitals, industry and patients associations. There were 570 in person participants and several by teleconference, with live transmission from the main sessions. The meeting reached its goal of disseminating knowledge, exchanging experiences and creating action plans tailored to each region. All actors working together, joining initiatives and adding efforts in the same direction.

In addition to representatives of international stroke societies, several representatives of Ministry of Health of Brazil and Ministry of Latin American countries, Health Secretaries from States and Cities of Brazil, the meeting included a strong participation of Dr. Anselm Hennis, Director of Non-Communicable Diseases of Pan American Health Organization from Washington – that represents World Health Organization in Americas.

The dynamics of the event included a series of forums on the most diverse themes, in an attempt to cover all fronts related to the disease -research, political, logistical and educational.

You can read the full article here.

Image by Pete Linforth from Pixabay

Survey on Stigma & Neurological Disorder

Survey on Stigma & Neurological Disorder

In 2018, the European Federation of Neurological Associations (EFNA) conducted a survey of young people affected by neurological disorder, to assess the impact of these conditions on their lives. Stigma was identified as one of the biggest issues affecting respondents.

As a result, EFNA has decided to develop a new survey, delving deeper into this issue, exploring the areas where stigma is felt and the situations which give rise to it. By identifying these areas EFNA can focus attention where it is most required and move to develop strategies that will combat stigma.

This survey is open to anyone who is living with a neurological disorder, living in Europe. The survey is available in 8 languages and will remain open until June 15th 2020.

Access the survey at:

PROOF trial: Breathing of pure oxygen increases the oxygen dissolved in the blood

PROOF trial: Breathing of pure oxygen increases the oxygen dissolved in the blood

Can high-dose oxygen therapy reduce the effects of stroke? This is the subject of an EU funded study called PROOF.

An ischaemic stroke is the most common type of stroke. The arteries that supply the brain with blood become clogged by clots. This kills the cells at the centre of the stroke and puts those nearby at great risk.

The longer the brain suffers from oxygen and blood deficiency, the more serious the consequences, and the more brain tissue will die. Emergency treatment must therefore get rid of the blocked arteries as quickly as possible.

Starting January 2017 at the Tübingen University Clinic – and at eleven other clinical centres in eight European countries – the PROOF trial started testing whether the consequences of stroke can be reduced by rapidly applying high-dose oxygen therapy to new patients.

We used the opportunity to talk about this with Dr Sven Poli, Deputy Medical Director from Department Neurology & Stroke, University of Tuebingen.

SAFE: If you were to explain the project’s aim to a person without any medical background, what would you say?
SP: Recanalization of the occluded vessel is the established stroke treatment today.

Despite successful vessel recanalization, however, many patients suffer severe stroke because brain cells died before recanalization was achieved. The main driver of brain cell death in stroke is the lack of oxygen in the ischemic regions.

Breathing of pure oxygen (instead of room air) increases the oxygen which is dissolved in the blood.

The increased oxygen in the blood should compensate the lack of oxygen and, thus, keep brain cells alive until the occluded vessel has been successfully recanalized.

SAFE: What types of partner do you need to carry out a project like this?
SP: Many study centres with highly motivated study teams and stroke doctors.

SAFE: Can you briefly describe your role in the project?
SP: Coordinating investigator is responsible for the trial protocol, for the trial conduct, and communication between study centres and competent authorities.

SAFE: What (if any) are the difficulties with carrying out the work?
SP: Patient recruitment requires high motivation and personnel allowing 24/7 readiness to enrol patients within a very short therapeutic time window.

SAFE: What personally attracted you to be in this project?
SP: I started my career in the field of stroke medicine in 2006. Bad outcomes despite standard therapies, i.e. recanalization by either intravenous thrombolysis or endovascular thrombectomy, pushed me to research on neuroprotection. My two favourite approaches were oxygen and also hypothermia. Whereas latter still is hard to apply in humans, former seemed to me easy to implement in clinical acute stroke workflow.

SAFE: When this project ends, what do you expect to change, i.e. how it will reflect on stroke treatment?

SP: In case oxygen works, this treatment might even be started at home right after symptom onset. This may revolutionize stroke treatment, buying time for the brain and the patient until reperfusion.

The PROOF trial has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 733379.

Image by Michael Schwarzenberger from Pixabay

Stroke Care at Home booklet- Get your copy for Free

Stroke Care at Home booklet- Get your copy for Free

Written by Rafael Klavert | Source: Angels Initiative 

As our movement is becoming more and more restricted, this Stroke Care at Home booklet may now be more useful than ever.

Developed by the Centre for Rehabilitation Studies in Stellenbosch University, this comprehensive 60-page guide was created with home carers and caregivers of stroke patients in mind.

Below is a link to the PDF file in case you know someone who can benefit from it. It is now being translated into 12 other languages and will be published once ready.

Stroke Care at Home booklet


Teleconsultations in times of crisis: Rehabilitation for recently discharged stroke patients in Italy

Teleconsultations in times of crisis: Rehabilitation for recently discharged stroke patients in Italy

SIMFER – Italian Society of Physical and Rehabilitation Medicine has activated a teleconsultation service aimed at recently discharged stroke patients and their families who should continue rehabilitation treatments.

A.L.I.Ce OdV (Italian Stroke Association) spreads this new important free remote support and consultancy service offered by SIMFER Italian Society of Physical and Rehabilitation Medicine.

In consideration of the difficulties that many patients find in accessing physiatric visits and rehabilitation treatments, due to the limitations imposed by the current situation, SIMFER has activated (in Italy) in collaboration with A.L.I.Ce Ferrara odv a telemedicine-rehabilitation service, a sort of “virtual clinic”, made available in totally free form, which makes use of a selected group of physiatrists, able to offer indications and information support relating to the needs of people with disabling conditions of different origin.

The patient or caregiver who needs it, can write an email to SIMFER ITALY  and will be contacted as soon as possible to carry out a teleconsultation with one of the SIMFER volunteer doctors.

For any additional information please visit

Image by mohamed Hassan from Pixabay

#BrainLifeGoals Project Grants 2020 by EFNA

#BrainLifeGoals Project Grants 2020 by EFNA

In 2020, within the framework of the #BrainLifeGoals campaign, the European Federation of Neurological Associations (EFNA) will again provide grants to support work in one of their focus areas. This year the focus will be on:

Ensuring Equitable Access to Treatment, Services and Support for Neurology Patients and their Carers.

Donna Walsh, EFNA Executive Director, explained “Access to treatment is one of the central #BrainLifeGoals of many neurology patients, and we want to help make that a reality across Europe! Therefore, EFNA will provide up to 10 grants of €3,000 each to selected organisations.”

The closing date for applications is May 1st.

Find out about eligibility and requirements here: