Two previous pan-European consensus meetings, the 1995 and 2006 Helsingborg
meetings, were convened to review the scientific evidence and the state of
current services to identify priorities for research and development and to set
targets for the development of stroke care for the decade to follow. Adhering to
the same format, the European Stroke Organisation (ESO) prepared a European
Stroke Action Plan (ESAP) for the years 2018 to 2030, in cooperation with the
Stroke Alliance for Europe (SAFE). The ESAP included seven domains: primary
prevention, organisation of stroke services, management of acute stroke,
secondary prevention, rehabilitation, evaluation of stroke outcome and quality
assessment and life after stroke. Research priorities for translational stroke
research were also identified. Documents were prepared by a working group and
were open to public comments. The final document was prepared after a workshop
in Munich on 21–23 March 2018. Four overarching targets for 2030 were
identified: (1) to reduce the absolute number of strokes in Europe by 10%, (2)
to treat 90% or more of all patients with stroke in Europe in a dedicated stroke
unit as the first level of care, (3) to have national plans for stroke
encompassing the entire chain of care, (4) to fully implement national
strategies for multisector public health interventions. Overall, 30 targets and
72 research priorities were identified for the seven domains. The ESAP provides
a basic road map and sets targets for the implementation of evidence-based
preventive actions and stroke services to 2030.
SUMMARYObjective: In 2014 the European Union-funded E-PILEPSY project was launched to improve awareness of, and accessibility to, epilepsy surgery across Europe. We aimed to investigate the current use of neuroimaging, electromagnetic source localization, and imaging postprocessing procedures in participating centers. Methods: A survey on the clinical use of imaging, electromagnetic source localization, and postprocessing methods in epilepsy surgery candidates was distributed among the 25 centers of the consortium. A descriptive analysis was performed, and results were compared to existing guidelines and recommendations. Results: Response rate was 96%. Standard epilepsy magnetic resonance imaging (MRI) protocols are acquired at 3 Tesla by 15 centers and at 1.5 Tesla by 9 centers. Three centers perform 3T MRI only if indicated. Twenty-six different MRI sequences were reported. Six centers follow all guideline-recommended MRI sequences with the proposed slice orientation and slice thickness or voxel size. Additional sequences are used by 22 centers. MRI postprocessing methods are used in 16 centers. Interictal positron emission tomography (PET) is available in 22 centers; all using 18F-fluorodeoxyglucose (FDG). Seventeen centers perform PET postprocessing. Single-photon emission computed tomography (SPECT) is used by 19 centers, of which 15 perform postprocessing. Four centers perform neither PET nor SPECT in children. Seven centers apply magnetoencephalography (MEG) source localization, and nine apply electroencephalography (EEG) source localization. Fourteen combinations of inverse methods and volume conduction models are used. Significance: We report a large variation in the presurgical diagnostic workup among epilepsy surgery centers across Europe. This diversity underscores the need for highquality systematic reviews, evidence-based recommendations, and harmonization of available diagnostic presurgical methods.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.