Why do you think your paper is highly cited?

This article is the full text of the update of the European Stroke Initiative (EUSI) Recommendations for Stroke Management, as outlined in the European Stroke Guidelines. It is a document that will influence the way stroke is treated in Europe and beyond, since it has subsequently been translated into a number of languages, including Spanish, Portuguese, Italian, German, Greek, Turkish, Lithuanian, Polish, Russian, and Mandarin Chinese. This clearly describes the paper's significance and why it is cited frequently.

 Would you summarize the significance of your paper in layman's terms?

These guidelines cover both ischaemic stroke and transient ischaemic attacks (TIAs), which are now considered to be a single entity. If recommendations differ for the two conditions, this will be explicitly mentioned; otherwise the recommendations are valid for both conditions. Separate guidelines exist or are being prepared for intracerebral hemorrhage and subarachnoid hemorrhage.

The classes of evidence and levels of recommendations used in these guidelines are defined according to the criteria of the European Federation of Neurological Societies. The article covers referral and emergency management, stroke unit service, diagnostics, primary and secondary prevention, general stroke treatment, and specific treatment, including acute management, management of complications, and rehabilitation.

 Do you foresee any social or political implications for your research?

Stroke is one of the leading causes of morbidity and mortality worldwide. Large differences in incidence, prevalence, and mortality have been noted between Eastern and Western Europe. This has been attributed to differences in risk factors, with higher levels of hypertension and other risk factors resulting in more severe stroke in Eastern Europe.

Notable regional variations have also been found within Western Europe. Stroke is the most important cause of morbidity and long-term disability in Europe, and demographic changes will result in an increase in both incidence and prevalence. It is also the second most common cause of dementia, the most frequent cause of epilepsy in the elderly, and a frequent cause of depression.

Werner Hacke, M.D.
Professor and Chairman of the Department of Neurology
University of Heidelberg
Heidelberg, Germany
Web

KEYWORDS: STROKE PREVENTION; EDUCATIONAL MEASURES; STROKE UNIT; IMAGING; ACUTE TREATMENT; REHABILITATION.