• STROKE

Have you ever visited a restaurant, asked for the menu, only to find out that there were no main courses on offer? Such a scenario would seem unimaginable. And so similarly, could one conceive of neurology without stroke? Indeed, the renowned Canadian stroke neurologist Dr C Miller Fisher stated that neurology could be learnt ‘stroke by stroke’.1 While previously, neurology services in the UK were not universally involved in stroke management, the tide is turning, as evidenced by a manuscript that describes stroke as a career option for neurologists, published in the current issue of Practical Neurology.2 However, despite progress, there remain complex issues confronting the further development of stroke services in the UK.

Reading through the career options manuscript, Pereira and colleagues suggest that no single specialty embraces stroke in the UK, and that patients who had a stroke are less often treated by a neurologist in the UK and Ireland, when compared with the other countries.2 Reasons for this are not articulated—perhaps UK centres have become separated from acute medicine, including acute stroke. If so, does the community know that neurologists are not managing stroke? In the absence of truly multidisciplinary assessment, undertaken by teams that include neurologists trained in stroke, there follows a risk that endovascular stroke services could be deployed by radiologists, treating vascular territories not responsible for clinical presentations. While undoubtedly, stroke can …