The journal Stroke celebrates its 40th year and there is much to be proud of based on prior accomplishments. I begin my 5-year term as Editor-in-Chief inheriting a flourishing, successful and highly respected journal that has thrived under the leadership of Dr Vladimir Hachinski, who has served as Editor-in-Chief for the past 10 years. During Dr. Hachinski’s term the number of manuscripts submitted yearly has doubled to just over 2800 and the impact factor has risen by a point to 6.5. Additionally, publishing ahead of print began, as did a completely electronic manuscript submission system. Translation of Stroke into 7 languages increased the submission and publication of manuscripts, and the number of subscriptions, from these regions. An author-mentoring program for non-native English speakers was initiated along with a waiver of page charges for authors from many less developed countries. These accomplishments, along with many others too numerous to enumerate, have marked the stewardship provided by Dr Hachinski and will provide a sustainable legacy for the field of cerebrovascular disorders. Dr Hachinski can be described as an internationalist with insightful ideas who has strived to be inclusive and innovative. I submit that he has excelled by providing all of his visionary initiatives and I offer him my thanks, and those of our entire community, for ceding me a successful and highly regarded journal. I also thank the prior editors Drs Miliken, McDowell, Barnett, Reinmuth and Dyken for their efforts that provided a strong foundation over the first 30 years of Stroke.
Going forward, we have many opportunities and challenges to address. The cerebrovascular field has achieved many preclinical and clinical advances over the past 4 decades (too numerous to enumerate) along with a tremendous growth in the number of invested professionals and the volume of innovative research. We understand much more about the pathophysiology of the gamut of disorders we treat than we did 5 or 10 years ago. The tools available to accurately diagnosis and treat our patients have evolved at a pace so rapid, it could barely be imagined by the pioneers in the field. The ability to offer preventative, acute, and restorative therapies for ischemic stroke has progressed, although not as quickly or extensively as many would like. Much more work needs to be done. Procedures such as carotid surgery and stenting, aneurysm coiling, and decompressive hemicraniectomy are of proven value. Evidence-based therapies for the treatment of intracerebral hemorrhage and intracranial atherosclerosis remain lacking, as well as for many other cerebrovascular disorders. Systems of care have evolved significantly. The benefits of organized systems of stroke care delivery and stroke units are clear, but their widespread implementation within the United States and internationally remains a challenge. Basic and clinical research expand at ever increasing rates as evidenced by the dramatic increase in the number of manuscripts submitted to Stroke, along with the proliferation of stroke meetings and associated presentations. Stroke serves a critical and unique role in disseminating information to the community involved in cerebrovascular clinical care or research. It is my intention to foster growth and innovation while expanding the international scope of the journal to support implementation of best practices, dissemination of important research, and discussion of where the field is headed.
Yet, in the attempt to achieve these lofty goals many challenges must be confronted. The traditional model of medical publishing is under siege from several directions, and the financial viability of the enterprise is being severely tested. Stroke, along with its sister AHA journals, will try to creatively and innovatively address these important challenges. The resources allocated to Stroke have limitations. The journal has a total annual page allotment of 3000, resulting in a current manuscript acceptance rate in the upper teens. Since this is unlikely to change in the immediate future, I will implement a rapid triage manuscript system to ensure that resources are directed toward the manuscripts most likely to be published. I anticipate that approximately 50% of submitted manuscripts will be rejected after a rapid preliminary review by a senior editor and one additional reviewer with relevant expertise. A formal written review of triaged manuscripts will not be provided and appeals will not be entertained, except under very unusual circumstances. The remaining 50% of submitted manuscripts will undergo a formal review by 2 or more reviewers with relevant expertise, consistent with current practice. It is anticipated that less than 40% of these manuscripts will ultimately be accepted. The current total word limit of 4000 will not be increased. However, the availability of on-line data supplements linked to the PDF file of the published manuscript will be enhanced. The use of data supplements for complex figures/tables as well as complete methodology will be strongly encouraged. This will save space for material that is truly essential in the print version of articles and provide additional space for other important material. Many other journals have successfully adopted this approach. Figures will be limited to a maximum of 4 panels and size standardization requirements are provided in the updated instructions for authors. Please read these updated author instructions carefully and adhere to them. For manuscripts that cannot adequately convey their requisite information within the stringent 4000 word limit, an alternative would be to purchase additional pages at a fixed cost per 1000 words above the limit. This may not be feasible for some authors, but does provide an alternative for submission of lengthier manuscripts, as these purchased pages do not count against the yearly page allocation. Of course, if additional resources become available in the future, the word limitation and page allocation may expand, leading to a more favorable situation for all.
The challenges are many and the opportunities are great. I and my fellow senior group of editors, Drs Karen Furie, Pierre Amarenco, Kennedy Lees, Eng Lo, Wolf Schaebitz, and Lawrence Wong, look forward to working with you to face both challenges and opportunities. All of us related to Stroke—readers, contributors, editors, and editorial board members, staff, and the sponsor—must recognize and embrace them so we can make Stroke as successful as possible. The cerebrovascular field is dependant on the continued evolution and growth of its most important journal. We ask all of you for your understanding, forbearance, and help. We can, and will, accomplish our goals together.
The opinions expressed in this editorial are not necessarily those of the editors or of the American Heart Association.