Challenges in Stroke Care

Dear Colleagues,

Ischemic stroke is the leading cause of disability and one of the leading causes of death worldwide. Much effort has been made in the last three decades to establish multidisciplinary stroke services to improve patients’ outcome.

Tissue plasminogen activator (tPA) thrombolysis remains the gold standard treatment for acute ischemic stroke within a limited window (~4–5 hours in most countries in Europe). However, the role of endovascular treatment has been rapidly increasing, widening the time limit with the application of perfusion imaging techniques. Appropriate patient selection and rapid evaluation and selection of a treatment modality are essential as “time is brain”.

The number of patients receiving intravenous or endovascular treatment, however, remains low, and a limited number of potential candidates arrive at the hospital within the time window. Furthermore, stroke mimics (seizures, complicated migraines, conversion disorders, etc.) account for approximately one in five clinically diagnosed acute strokes, and the proportion of stroke mimics that are thrombolyzed can be as high as 15–20%.

For this Special Issue, we welcome original research, meta-analysis, and review articles on any topic associated with challenges in hyperacute stroke care, from preclinical research to multidisciplinary clinical management.

Topics relevant to this Special Issue include, but are not limited to:

1. preclinical patient selection;
2. differential diagnosis of stroke mimics in thrombolysis situations;
3. challenges in systemic thrombolysis;
4. challenges in endovascular treatment;
5. stroke of unknown time of onset;
6. imaging-based patient selection;
7. the role of biomarkers (including in stroke mimics);
8. early seizures.

Dr. Gergely Fehér
Prof. Dr. Péter Klivényi
Dr. Joel Rodriguez-Saldana
Guest Editors

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