Marijana Bosnar Puretić

HRČAK - Portal of Croatian Scientific and Professional Journals

Acta clin Croat, Vol. 41, No. 3, 2002 271Acta clin Croat 2002; 41:271-276 NewsNEWSEuropean Society of Neurosonology and Ce-rebral Hemodynamics MeetingBerne, Switzerland, May 26-28, 2002The European Society of Neurosonology and CerebralHemodynamics Meeting was held in Berne, Switzerland,this May. The meeting was organized as an annual event,and also in celebration of a particular discovery. Only 20years ago, Rune Aaslid was working at Insel Hospital inBerne at the Department of Neurosurgery. At that time,there was a problem of vasospasm detection. Aaslid tookit upon himself to find a solution. He explored the ultra-sound principle for possible usage. With the use of a lightbulb inside a human skull he found bone rarifications (tem-poral, occipital and orbital), today known as bone windows.Further investigation was necessary in terms of depth,output gain and power. Therefore, he drew his legendaryrepresentation of the circle of Willis as oil on canvas. Ithelped him then and it is still helping us today in Dopplerlaboratories all over the world. Standard values were de-termined, Lindegard index was subsequently developed.The principle has been maintained since then, however,some features have been added, i.e. M mode and measure-ment of emboli, vasoreactivity, and monitoring.Rune Aaslid was an honorary guest at the meeting andwas awarded a plaque by the Society as a sign of appreci-ation. He has been proclaimed a honorary member and assuch he held a lecture explaining his first steps in the field.The congress was organized in sessions during threedays. Invited lecturers were not only neurologists but alsoneurosurgeons, cardiologists and radiologists. Some ses-sions were very interesting, opening new horizons in thefield. Some of these were the sessions on the physiologyof cerebral hemodynamics, on IMT, and on atherosclero-sis. The new insights in the field are of great value for fur-ther advancement in ultrasound development and betterpatient care.Department of Neurology and its Laboratory of Cere-brovascular Diseases participated in the meeting withthree scientific posters: Impaired visually evoked responsein posterior cerebral artery in patients with advanced ca-rotid stenosis or occlusion; Three-dimensional ultrasoundof the plaque ulceration; and Three-dimensional ultra-sound of the vertebrobasilar system. We tried to presentthe current area of work and interest, and new discoveriesin the field. Three-dimensional ultrasound is still at thebeginning, with the aim of reaching the imaging possibil-ities of computed tomography some day. The work in thefield is rather pioneering at this point, exploring possibleadvantages and future directions.The meeting was very successful indeed, showing greatinterest of many medical professionals engaged in the workand its problems. Some conclusions were drawn based onthe current techniques and knowledge. At the meeting,the next years gathering in Alicante, Spain, was an-nounced. Miljenka-Jelena Kesiæ11th European Stroke ConferenceGeneveSwitzerland, May 29-June 1, 2002The beautiful city Geneve hosted the 11th EuropeanStroke Conference, May 29-June 1, 2002. The conferencecovered topics like stroke outcome and predictors of theoutcome, sleep apnea, the role of patent foramen ovale(PFO) in stroke, stroke epidemiology, prevention, thera-py and rehabilitation after stroke.More than 2 000 participants from all over the worldvisited this meeting. The conference was organized ineducational symposia, satellite symposia, teaching cours-es, oral and poster sessions.The main topics of interest during the whole meetingwere long-term stroke outcome, predictors of stroke out-come and the role of blood pressure treatment in strokeprevention and outcome. Although hypertension is themajor risk factor for both ischemic and hemorrhagic stroke,still there is no conclusive statement of exact treatmentof elevated blood pressure in acute stroke. This year someweaker interest for acute stroke therapy and thrombolysis272 Acta clin Croat, Vol. 41, No. 3, 2002Acta clin Croat 2002; 41:271-276 Newswas present, most probably since the results of large trialsare already presented on meetings past several years. In-stead, the financial side of stroke units and thrombolysiswere stressed, so the session about stroke management andfinance was intensely visited. The major focus was put onstroke risk factors and stroke subtypes. Lacunar stroke iscomplication of hypertension and diabetes. Large trial ofdifferent antihypertension treatment (ACE inhibitors,calcium antagonists), including secondary end-point strokeprevention, showed reduction of lacunar stroke incidence.Even in milder hypertension ACE inhibitors exhibit ben-efit in stroke prevention by specific mechanism of action.Also, the design of new studies in high-risk patients waspresented, inviting high quality centers to participate.Atrial fibrillation (AF) is major preventable risk factor forembolic stroke. In older females with AF the risk of strokeis five-fold higher, enhancing risk of death two folds. Aspi-rin exhibits some risk reduction effect, but still warfarinand cumarine showed higher relative risk reduction (36%in all trials). Target INR is ranged from 2.0.-3.0. Duringthe oral session on intracerebral hemorrhage (ICH) theresults were biased due to relatively small numbers of clas-sified different types of hemorrhage (hypertension, arte-rio-venous malformation, amyloid angiopathy, hematholog-ic disorders, subarachnoidal hemorrhage). Proposal wasmade for large, multicentric trials with precise design ofstudy that would give exact answers on ICH treatment(both medical and surgical), recurrence rate and outcomeprediction.The biggest debate was about PFO: how to diagnose;validation of sonographyc criteria, how and when to treat(transcatheter closure, medical treatment), what are thecomplications and the relevance of treatment.Stroke outcome is now widely analyzed because strokeis leading cause of disability and dementia since the mor-tality of stroke patients in modern society is reduced, lead-ing to increased portion of disabled population. Statisti-cal models for stroke outcome prediction are designed aim-ing to express increased stroke burden.Croatia was represented by neurologist from Zagreb,Sestre milosrdnice University Hospital, University Depart-ment of neurology. They presented results of one-yearstudy on blood pressure dynamics in acute stroke and itsinfluence on outcome. This paper was widely discussedduring the poster session since this topic was of high in-terest this year.Abstracts were published in Cerebrovascular diseases,Supplement 3, Vol.13, 2002.Participating in the conference, meeting the expertsfrom the field of stroke was great pleasure and stimulat-ing for future professional work and research. Althoughtime schedule was tight participants could find time forsightseeing of Geneve, smallest of the big capitals.Marijana Bosnar PuretiæInternational Postgraduate Course: HealthyLifestyle and Prevention of StrokeDubrovnik, Croatia, May 20-25, 2002Organizers: Interuniversity Center Dubrovnik, Acad-emy of Medical Sciences of Croatia, and Croatian Societyfor Prevention of StrokeThis year, the traditional Postgraduate Course HealthyLifestyle and Prevention of Stroke was held on May 20-25, in Dubrovnik. The Course has been regularly held atthe Interuniversity Center Dubrovnik since 1990, with theexception of the years of war in Croatia, when it took placein Zagreb and Brijuni, and 1999 when it was organized inMedulin due to the war in Kosovo. Thanks to the greatefforts and persistence of its organizers, the continuity ofthe Course has been preserved. Co-organizers of theCourse are Academy of Medical Sciences of Croatia andCroatian Society for Prevention of Stroke. Directors of thisinternational postgraduate course are: Professor Vida De-marin, University of Zagreb; Professor Roman Haberl,Ludwig-Maximilians University from Munich; ProfessorKurt Niederkorn, University of Graz; and Assist. ProfessorTanja Rundek, Columbia University from New York.The first course was held in 1990, as a gathering of agroup of enthusiasts. Since then, it has been regularly heldevery year, late in May or early in June. Over all these years,the Course has grown into a significant meeting of emi-nent professionals in the field of stroke from various coun-tries.This years Course was attended by more than thirtyparticipants from Zagreb, Osijek, Karlovac, Koprivnica,Slavonski Brod, Vinkovci, Bjelovar, Dubrovnik, Sisak, Split,ibenik, Labin (Croatia), Munich, Heidelberg (Germany),Ljubljana (Slovenia) and Sarajevo (Bosnia and Herzegov-ina).The Course began on Monday with registration of theparticipants and introductory lecture, in which CourseDirector, Professor Vida Demarin, presented a brief histo-ry of the Course, work of the Croatian Society for Preven-tion of Stroke as a Course co-organizer, and participationActa clin Croat, Vol. 41, No. 3, 2002 273Acta clin Croat 2002; 41:271-276 Newsof physicians from the University Department of Neurol-ogy, Sestre milosrdnice University Hospital, at congressesand symposia in Croatia and abroad during the precedingyear. Then, Dr. Marina Roje-Bedekoviæ from Zagreb pre-sented the development and achievements of Dubrovnikmedicine through centuries.This was followed by Professor Vida Demarins presen-tation of news in the field of hormone replacement thera-py (HRT) with special reference to recent dilemmas aboutthe role of HRT in the prevention of stroke.Professor Miljenko Kalousek from Zagreb presentedcomparison of digital subtraction angiography (DSA) andmagnetic angiography in the diagnosis of intracerebralaneurysms, emphasizing the reliability of the latter. Thesession was closed by an interesting case report, present-ed by Dr. Vlasta Vukoviæ from Zagreb.management of stroke patients has been considered, fromthe treatment at intensive care units for life threatenedpatients, treatment at stroke units for patients undergo-ing systemic thrombolysis, through treatment at speciallyorganized stroke centers where other patients would betreated by use of general medical care. This days work wasclosed with the interesting lecture by Dr. Veronika Maas-berg from Munich on novelties in the treatment of patientswith open foramen ovale and stroke.The next day began with Professor Roman Haberleslecture on medicamentous and interventional therapy forcarotid disease, followed by the lecture given by Dr. Mar-jan Zaletel from Ljubljana on stroke, carotid lesions andthrombolysis. Professor Vida Demarin held an interestinglecture on the role of functional transcranial Doppler(fTCD). Then, Dr. Marina Roje-Bedekoviæ presentedThe next day began with a review lecture given by Dr.Stefan Schwab from Heidelberg, on indications and prob-lems associated with anticoagulant therapy, emphasizingnumerous unsolved dilemmas related to this therapy.Then, Dr. Kai Aulich and Dr. Marijana Bosnar-Puretiæ pre-sented the management of patients with intracerebralhemorrhage in Munich and Zagreb, respectively. Theworking part of the meeting was continued by a lecturedelivered by Professor Roman Haberl from Munich on theGerman concept of stroke units, followed by a lecture onthe use of systemic thrombolysis in German stroke units,given by Dr. Cristine Wenzelburg from Munich. These twolectures concluded that in Germany, systemic thromboly-sis was still used in too small a number of patients withischemic stroke. Therefore, a stratified approach in thechanges in blood flow velocity measured by TCD in pos-terior cerebral artery in a patient with subtotal stenosis andocclusion of carotid artery after visual stimulation. Dr.Marijana Bosnar-Puretiæ described changes in blood flowvelocity measured by TCD in posterior cerebral artery ina patient with vertebral artery occlusion. Assist. ProfessorZlatko Trkanjec from Zagreb delivered a lecture on tele-neurology with special reference to the use of teleneurol-ogy methods in the management of stroke patients.On the next day, Professor Vida Demarin spoke on theuse of the HOPE study results in the prevention of stroke.Assisst. Professor Dragutin Kadojiæ from Osijek held a lec-ture on the frequently neglected emotional disturbancesafter stroke. Dr. Marijana Bosnar-Puretiæ presented prelim-inary results of a study on the possible relationship be-274 Acta clin Croat, Vol. 41, No. 3, 2002Acta clin Croat 2002; 41:271-276 Newstween weather factors and prevalence of stroke. Assist.Professor Zlatko Trkanjec spoke about the results obtainedby the analysis of data from the questionnaire for strokepatients, collected from various Croatian hospitals during2001. The last lecture was held by Dr. Marinko Dikanoviæfrom Slavonski Brod, who presented epidemiologic data onstroke patients treated at Dr. Josip Benèeviæ General Hos-pital in Slavonski Brod from 1996 till 2001.This years Course was closed by a round table on theprevention, diagnosis and treatment of stroke patients,during which the participants presented their own expe-rience from their particular settings.Besides interesting lectures, a number of workshops onthe various aspects of prevention, diagnosis and care ofstroke patients were organized during the Course. Theworkships enriched the Course events by providing anopportunity for fruitful discussion on the many as yet in-completely clarified issues related to stroke.The Course ended with the closing words by Profes-sor Vida Demarin, Director of the Course, who thanked theparticipants for having come to Dubrovnik, and expressedher wish and hope for the next gatherings in the years tocome. The Course participants were presented their cer-tificates of attendance.The condensed, rich and multifaceted professionalprogram of the Course was accompanied by social andculture events, providing the participants with pleasantopportunities for friendly and unformal gathering.The Interuniversity Center Dubrovnik organized aparty for all participants of this and all other courses heldat the same time. Ms. Berta Dragièeviæ, secretary of theInteruniversity Center Dubrovnik, reminded the partici-pants of the 30th anniversary of the existence of the Inter-university Center Dubrovnik, celebrated this year, andexpressed her hope that the Center, after many difficul-ties encountered over all these years, would continue todevelop as a venue of information and knowledge exchangeamong different settings. Zlatko Trkanjec

11th European Stroke Conference Genève

Abstract

Similar works

Full text

Available Versions

HRČAK - Portal of Croatian Scientific and Professional Journals

Hrčak - Portal of scientific journals of Croatia