Danielle de Sa Boasquevisque, MD
Stroke is a leading cause of death and a major source of disability worldwide. A Brazilian study performed by Martins and colleagues found that the percentage of hospitals with stroke centers, Emergency Medical Services (EMS), telemedicine, and endovascular services increased significantly between 2008 and 2017, after implementing a task force on stroke by neurologists with the assistance of the Brazilian Ministry of Health. However, these hospitals, equipped with specialized stroke centers, were concentrated in dense urban areas, neglecting the impoverished areas.
Now, the Brazilian Stroke Network aims to expand this model already tested in the urban regions to other parts of the country. Using mobile health technology and telemedicine, it has successfully provided the patients direct access to senior neurologists, who can diagnose complex cases and recommend treatment, hence shortening door-to-needle time and achieving better functional outcomes after stroke. However, it is still too expensive to be implemented nationwide.