STROKE patients in Malaysia are losing critical time before reaching hospitals, with poor awareness of symptoms, transport difficulties and delays in accessing specialist care continuing to hamper treatment.
A new regional report has identified delays before patients reach stroke centres as one of the biggest weaknesses in Malaysia’s stroke care pathway.
The report, Strengthening Stroke System Readiness Across ASEAN, is based on input from stroke specialists across six Southeast Asian countries, including Universiti Malaya Medical Centre senior consultant neurointerventional radiologist and endovascular neurosurgeon Prof Dr Khairul Azmi Abd Kadir.
In Malaysia, specialists pointed to a combination of factors behind the delays.
Many patients and their families do not recognise stroke symptoms early enough, while transport difficulties can further eat into the limited window available for treatment.
Patients who arrive at hospitals may also face further delays when they need to be transferred to facilities with the expertise and equipment to provide more advanced treatment.
The problem is particularly pronounced outside major urban centres, where access to specialist stroke services remains limited.
Malaysia has one neurologist for every 323,000 people, according to figures cited in the report, with most specialists concentrated in cities.
The shortage comes as the country faces a growing burden of stroke, alongside rising rates of diabetes, obesity and high cholesterol and an ageing population.
Stroke is currently the country’s third leading cause of death.
Malaysia has expanded its capacity to treat stroke over the past decade, including the establishment of dedicated stroke units and greater access to intravenous thrombolysis, which uses medication to break up blood clots.
Mechanical thrombectomy, a procedure used to physically remove clots from blocked blood vessels in the brain, is also available at selected specialist centres.
But better treatment options at hospitals do little if patients arrive too late.
The report noted that some hospitals still route stroke patients through emergency departments before they undergo computed tomography (CT) scans, adding another potential delay to diagnosis and treatment.
It called for eligible patients to be able to bypass the emergency department and proceed directly for CT imaging, alongside clearer and more consistent imaging protocols between hospitals.
Emergency medical services should also be better equipped to recognise stroke symptoms and alert receiving hospitals before patients arrive, the specialists said.
For patients requiring thrombectomy, a more coordinated referral system could help shorten transfer times.
One model highlighted in the report is a “hub-and-spoke” system, where regional hospitals identify patients who require specialist intervention and transfer them quickly to designated stroke centres.
Artificial intelligence could also help doctors identify severe strokes more rapidly and alert specialist teams ahead of a patient’s arrival.
However, specialists stressed that technology alone will not solve the problem.
What matters, they said, is how well the different parts of the system work together — from the moment stroke symptoms are recognised to emergency transport, brain imaging, treatment and, where necessary, transfer to a specialist centre.
The report said strengthening those links would be key to reducing treatment delays and improving outcomes for stroke patients in Malaysia. - September 3, 2026
