From 2005, this is something that should be updated every year. The US is falling down on this because if something like this exists it is well hidden.
http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=000093098&Ausgabe=231961&ProduktNr=224153&filename=000093098.pdf
The first page and a half out of 8 pages.
About one million strokes occur each year in the European
Union [1] . Indeed, about 25% of men and 20% of
women can expect to suffer a stroke if they live to be 85
years old. As a cause of death worldwide, stroke is second
only to coronary heart disease [2] .
Although stroke is a major cause of death, mortality
data underestimate its true burden. This is chronic disability.
Since stroke causes disability more often than
death, stroke patients frequently require long hospital
stays followed by ongoing support in the community, or
nursing home care. Stroke is consequently a major drain
on health care funding. Stroke is the number one cause of
disability in the European Union.
The total incidence of stroke is projected to increase
considerably over the next two decades. This is because
of the rapid increase in the elderly population. It is predicted
that stroke will account for 6.2% of the total burden
of illness in 2020 [3] . Thus, without more effective
strategies for the prevention, treatment, and rehabilitation
of stroke, the cost of this disease will increase dramatically.
The European Commission hosted a European Stroke
Workshop in Brussels on October 25, 2005, gathering top
European experts in clinical stroke management, basic
forefront of basic and clinical stroke research, having
made seminal contributions to stroke pathophysiology
and clinical management of stroke.
This ‘first wave’ of stroke research produced relevant
animal models of cerebral ischemia that allowed the identification
of mechanisms that contribute to tissue damage.
It is now recognized that the critical reduction of blood
supply to an area of the brain leads to a complex cascade
of events, which evolves over time and space. This knowledge
has opened the possibility to intercept this cascade
therapeutically. In animal models of stroke, brain tissue
can be successfully protected from damage. However, attempts
to translate these findings into clinical practice
have not yet been successful, although recently positive
results have been obtained in clinical trials with the free
radical scavenger NXY-059.
Only recently has it been understood that the capacity
of the nervous system for regeneration, including the formation
of neurons in adulthood, is greater than previously
believed. This has opened new horizons for the treatment
of stroke utilizing strategies to induce the brain’s
own mechanisms of protection and regeneration. Moreover,
this has led to treatment with stem cells of various
sources, which have successfully restored brain function
after experimental stroke.
Impressive developments have occurred in stroke trial
methodology and in new treatment approaches. Aspirin
and other antiplatelet agents are now used in secondary
stroke prevention, as well as anticoagulants for the subgroup
of patients who experience a stroke from a cardiac
source of emboli. Blood pressure lowering after stroke and
transient ischemic attack (TIA) helps to prevent recurrent
stroke and cardiac events. Accumulating evidence also
suggests that statins have a prominent role in secondary
prevention of stroke. Endarterectomy for symptomatic
high-grade stenosis of the carotid artery has proven to
protect against new ipsilateral stroke.
Experiences from research on interventions to combat
acute stroke are mixed. We now know that only a
short therapeutic window of a few hours is available for
reopening the blood supply to the ischemic brain. This
has resulted in calls upon programs to increase public
awareness and to improve the prompt availability of
stroke care through well-organized services. Tissue plasminogen
activator (t-PA) is the only drug approved by
the EMEA for intravenous thrombolysis of acute ischemic
stroke.
The establishment of thrombolysis as the first successful
therapeutic strategy in acute stroke, the development
of novel noninvasive brain imaging strategies, as well as
advances in trial design and hyperacute patient recruitment
have raised the hope that we will be able to protect
the brains of patients with stroke in the near future. Current
trials take advantage of second-generation thrombolytics
with lesser side effects on the vasculature and brain
parenchyma. Moreover, imaging technologies like perfusion-
and diffusion-weighted MRI allow the identification
of tissue at risk and can be used to identify patients
in whom brain protective therapy is likely to be successful.
A ‘second wave’ of combined efforts in basic and clinical
stroke research can now capitalize on these promising developments.
European research is in an excellent position to make
significant advances in the field of stroke. Core skills of
established centers of excellence in basic research provide
ample opportunities when combined with the EU ethos
for collaboration and interdisciplinarity. Collaborative
efforts of European stroke researchers can draw on already
existing networks, established in large part by EU
funding.
The Stroke Workshop participants identified the following
research fields in which a European research offensive
can be highly successful on an immediate to intermediate
time scale.
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