Enhancing Stroke Care Worldwide: Identifying Barriers and Bridging Gaps for Improved Prognosis

Stroke is one of the leading causes of death and long-term disability worldwide. Modern reperfusion therapy improves the outcome of ischemic stroke, however, only a small proportion of stroke patients receive it. Despite high-quality clinical studies indicating this treatment in stroke units significantly improves stroke outcomes and decreases mortality, modern stroke care, including before and during clinical stages, remains a challenge in most countries. Hemorrhagic stroke (intracerebral hemorrhage) carries even higher mortality, and yet until just 2 years ago, guidelines were sparse, leaving decisions such as reversal of anticoagulation, timing of DNR, and whether to use certain therapies ambiguous at best. One of the most important points to improving stroke care is the identification of gaps and barriers that would be highly relevant to enhancing prognosis outcomes. While some barriers are “local factors”, international cooperation is also needed to identify and solve regional problems, for example, the discussion regarding the advantage of “drip and ship” and the “mothership” model is still open and another unresolved question is the time before (re)initiation of anticoagulants in cardioembolic stroke patients. This collection welcomes manuscripts supported by the Journal – comprised of original research, brief research report, review, and mini-review – pertaining, but not limited to the following themes: • Prehospital protocols for stroke, including any differentiation between hemorrhagic and ischemic stroke. • Layperson awareness regarding recognition of stroke signs. • Barriers to access the reperfusion treatment (thrombolysis) or reversal of anticoagulation agents at local, regional, and national levels. • Recognition of stroke/stroke mimics • Implementing staff training • Stroke management in different countries