Madam, - Dr Niall O'Brien's letter of January 2nd, calling attention to the underdevelopment of stroke services in Ireland is very welcome.
Each year stroke kills an estimated 2,000 Irish citizens, about the same number as lung, breast, and bowel cancer combined. Among stroke victims who survive, an estimated 5,000 a year are left with permanent neurological disability.
If these outcomes were caused by an infectious disease it would be considered an epidemic and intense efforts would be made to improve the situation. Yet there is little public debate on how we care for those who suffer a stroke.
One suspects that this is largely because of a widespread assumption that stroke occurs almost inevitably as a consequence of ageing and that no effective treatment exists. Aside from its questionable ethics, this assumption is wrong on both counts.
Firstly, stroke is not confined to older adults, but affects the entire population. About 2,000 young and middle-aged Irish adults suffer a stroke each year. Secondly, stroke can be prevented, treated, and sometimes completely cured.
An estimated 3,000 strokes a year could be prevented by a national plan, modelled on the successful Heartwatch programme. Providing hospital care in stroke units could prevent 1,400 cases of death and disability annually. It is of great concern that only two of the 37 acute hospitals in Ireland today have established stroke units.
New "clot-busting" emergency treatment can provide a complete cure if delivered within three hours, but it is not available to eligible Irish patients due to a lack of trained stroke consultants.
Senior politicians and health administrators have been informed about these facts for several years. In response, a national expert group has been established to examine options to improve stroke care. While this is a welcome first step, it is not a substitute for immediate implementation of proven measures that are widely available internationally.
Immediate action is needed in 2007 to establish stroke units in all acute Irish hospitals and to hire hospital consultants trained in emergency stroke treatment. - Yours, etc,
Dr PETER KELLY, Consultant Neurologist, Director, Stroke Service, Mater University Hospital, Dublin 7.