Multidisciplinary approach to acute stroke management : Geneva stroke clinical pathway

The presenting thesis is divided into three main sections: SECTION I The first section is dedicated to a comprehensive literature review of two major topics concerning stroke: the epidemiology of stroke and its risk factors and the clinical pathway of stroke patient. The epidemiology data are included for understanding the burden of stroke and its consequences in the western and developing countries. The overview of stroke patients‘ clinical pathway organisation details the pre-and in –hospital phases and enlightens the importance of multidisciplinary approach to the stroke patient management. SECTION II In the first part, the Geneva specific stroke itinerary is discussed and fractioned according to time intervals dedicated to each part of the clinical pathway with the accent on the emergency and stroke unit care. All details are graphically presented by personal data. In the second part, the specific local thrombolysis protocol is briefly explained with a detailed personal graphical support. In the third part, the specific role of “neuro-cardiologist” is briefly exposed. In Geneva University Hospital, the emergency, neurology and cardiology departments share the same cardiologist specialised in a stroke; this characteristic is unique among Swiss stroke units. SECTION III In this section, the author's scientific contribution to the field of stroke is included and presented as originally published article