LAUSR

DOI:10.1097/WCO.0000000000000784 The past decade has been exciting for stroke clinical care and research. The field has seen tremendous advances in prevention, acute care, and rehabilitation of the ischemic stroke patient, in particular. In prevention, for example, the role of monitoring for atrial fibrillation in patients with unexplained ischemic strokes has been demonstrated in observational studies and clinical trials [1,2]. For acute care in ischemic stroke, recent trials demonstrated the benefits of mechanical thrombectomy for selected patients with evidence of small infarcts and large territories of the brain still at risk [3,4]. As a result, recent guidelines from the American Heart Association/American Stroke Association (AHA/ASA) now recommend consideration of treatment of selected patients up to 24 h after stroke symptom onset [5]. And in rehabilitation, long the ‘black box’ in stroke management, a recent study demonstrated the feasibility of using telerehabilitation – or rehabilitation provided remotely using video communication – as a way of improving outcomes after stroke [6]. Guidelines for stroke rehabilitation have also been published by the AHA/ASA [7]. Despite these important clinical advances, however, many questions persist. This issue of Current Opinion in Neurology will address several of these remaining hot topics, with a focus on stroke causes, biomarkers, and outcomes, areas closest to my experience as a neurovascular epidemiologist. The authors, all leading experts in stroke research and care, were selected for their expertise, reputations, and geographic diversity. Three of the articles included here will address emerging or controversial risk factors, including sleep apnea, patent foramen ovale, and subclinical atrial fibrillation, all areas with recent important data and changes in thinking. Another discusses the potential role of RNA profiles as a biomarker diagnostic of stroke and its subtypes. The role of inflammation and the immune system in contributing to poststroke dementia, an extremely exciting new direction in stroke research, is approached from both the clinical and translational research side in one of the articles. Finally, the importance of a mysterious childhood stroke condition, focal cerebral arteriopathy, is discussed,