Alan Charles Cameron, MB ChB, BSc (Hons), MRCP
On World Stroke Day 2018, we are fortunate to have many therapies that reduce the burden of stroke, including intravenous thrombolysis, endovascular therapy, acute stroke unit care, primary and secondary prevention, and multi-modality rehabilitation. We have recently discovered that the substantial benefits achieved with intravenous thrombolysis and endovascular therapy can extend to imaging-selected patients with wake-up stroke, whilst dual anti-platelet therapy with aspirin and clopidogrel is associated with maximum benefit and lowest risk in the first 21 days after high-risk TIA or minor stroke. However, access to effective treatments for stroke remains limited in many developed countries, and basic aspects of stroke care are not available in many developing countries. There is clear global and regional variation in access to stroke care when we speak with colleagues and friends from around the world.
We must strive towards implementing proven effective therapies across the spectrum of stroke care within our daily practice, including acute management, prevention and rehabilitation. We can achieve this goal through international collaboration and action plans such as the World Stroke Campaign and the Global Stroke Bill of Rights. The hashtag #UpAgainAfterStroke empowers stroke survivors to access treatments and care that will allow them to live a meaningful life after stroke. World Stroke Day is a call to action for stroke professionals worldwide to act as advocates for our patients and advance stroke policies to ensure healthcare systems deliver therapies across the spectrum of stroke care that will improve outcomes. If we respond to this call, we will defeat the global burden of stroke and empower survivors to get #UpAgainAfterStroke.