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Semin Neurol 2024; 44(02): 119-129
DOI: 10.1055/s-0044-1782617
Review Article

Developing Systems of Care for Stroke in Resource-limited Settings

Gisele Sampaio Silva
1   Department of Neurology, Universidade Federal de São Paulo, São Paulo, Brazil
2   Department of Neurology, Hospital Israelita Albert Einstein, São Paulo, Brazil
,
Eva Rocha
1   Department of Neurology, Universidade Federal de São Paulo, São Paulo, Brazil
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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.

Keywords

stroke - systems of care - resource limited settings - low- and middle-income countries


Publication History

Article published online:
21 March 2024

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