The European Stroke Organisation (ESO) Guidelines

European Stroke Initiative (EUSI) recommendations for the management of ischemic stroke and transient ischemic attack, initially published in 2000 and updated in 2003 (1–3). Since then, the ESO has begun the process of implementing a new standard-ized system for the production and presentation of evidence-based clinical guidelines. The ESO guidelines committee agreed on two major developments: use of the Grading of Recommen-dations Assessment, Development and Evaluation (GRADE) system (4–7); and the transition to a model in which several guideline documents deal with specific topics of interest called modules rather than a single document on a large topic. The GRADE system has a series of advantages over other systems that include clear separation between quality of evidence and strength of recommendation, explicit comprehensive criteria for downgrading and upgrading quality of evidence ratings,