Stroke and its disability have deserved the notoriety of a severe and potentially lethal condition, whose treatment is still challenging. The widely craved result of saving as much as possible from the neural tissue and eventually reviving what is thought to be in the ischemic penumbra – if not already dead and gone – is the outcome every clinician is dreaming of. There are several reviews on the issue, which have discussed several options of achieving neuroprotection in acute ischemic stroke. Of course, reviews are not and do not pretend to be exhaustive; new drugs enter repeatedly in the scene. We would limit our comments on some of the pharmacological agents, that although seem to be worldwide available, are still looking for obtaining the citizenship in the therapeutic armamentarium of acute ischemic stroke.

The deleterious health effects of ethanol abuse are widely known and a diversity of medical conditions appear with excessive consumption. Acute and chronic abuse have different clinical characteristics, although severe intoxications are rare among alcoholics of a long career, where the systemic complications will dominate the symptomatology. While the medical focus acutely will mostly stay on the nervous and circulatory effects, gastrointestinal complications that will come up chronically (liver, pancreas, bowel dysfunction) need proper consideration. Ethanol will affect gastrointestinal functionality through a triple action, directly on the epithelial cell and the secretory activity, by altering the motility and in the long-term scope, through promoting carcinogenesis. Medical teams dealing with acute and chronic ethanol intoxication or abuse must be aware of the multiple effects it shows, and perform a prompt diagnosis as well as appropriate intervention.

Stroke while driving is an uncommon occurrence, but which might have serious medical and legal implications. While still reported casually and with very few systematized studies, sources underscore mainly the neurological picture and risk factors that will lead herein. Car crashes follow as a rule the event of the stroke. We describe the case of a middle-aged patient that had an incomplete loss of the car control, with a crash of minor severity and with no external signs of trauma. In spite that the patient underwent successfully a thrombectomy intervention, he presented continuously with refractory hypotension. The clinical picture raised suspicions of an internal blood loss and whole body angiography detected the rupture of the mesenteric artery. This sequence of events (stroke while driving – crash – seatbelt injury – mesenteric rupture) is probably not reported before, but mechanistically an unlucky combination to be kept in mind while dealing with such cases.