Developing Systems of Care for Stroke in Resource-limited Settings

Semin Neurol. 2024 Apr;44(2):119-129. doi: 10.1055/s-0044-1782617. Epub 2024 Mar 21.

Abstract

Although stroke prevention and treatment strategies have significantly advanced in recent years, implementation of these care elements in resource-limited settings can be challenging, since the burden of stroke is higher and access to stroke care is lower. Barriers to stroke care in resource-limited settings include insufficient prevention, reduced awareness of stroke symptoms, limited prehospital care and lack of triage systems, limited access to comprehensive stroke centers, inadequate personnel education, lack of staff and resources, as well as limited access to neuroimaging, thrombolytics, mechanical thrombectomy, neurosurgical care, and rehabilitation. Here, we suggest strategies to improve stroke care in these settings, including public health campaigns, protocols for prehospital notification, organized flow to specialized stroke centers, development of dedicated stroke units, and utilization of telemedicine and telerehabilitation. We also highlight the role of international organizations and governments in reducing the global burden of stroke.

MeSH terms

  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Resource-Limited Settings*
  • Stroke* / therapy
  • Triage / methods

Substances

  • Fibrinolytic Agents