Abstract Background and aims The aim of this study was to analyze key issues in the delivery of care to patients with acute cerebrovascular accidents (CVA) based on clinical observations at the emergency department of City Clinical Hospital No. 7 in the Yunusabad district of Tashkent. Methods A retrospective analysis was conducted of 324 stroke cases registered during the author's emergency shifts over a period of three years (1–2 shifts per week). The study evaluated stroke type, mode of patient transport, time to hospital presentation, availability of neuroimaging, and organizational/structural limitations. Results - Ischemic stroke was observed in 282 cases (87.1%), hemorrhagic stroke in 42 cases (12.9%), including subarachnoid hemorrhage in 5 cases (1.7%); - 266 patients (82%) were transported by emergency medical services (EMS), while 58 (18%) arrived independently (via private transport, assistance from bystanders, etc.); - 218 patients (67.2%) presented within the therapeutic window (≤4.5 hours); 106 (32.8%) presented beyond the window, indicating low public awareness of stroke symptoms; - No access to free neuroimaging (CT or MSCT) was available within the hospital setting (0%); - Thrombolytic therapy and mechanical thrombectomy were not performed; - A shortage of dedicated stroke unit beds was observed, impeding timely hospitalization; - Due to the absence of an in-house neurosurgery team, surgical interventions for hemorrhagic stroke were unavailable or delayed, worsening patient outcomes. Stroke care in Tashkent shows major structural deficits: limited neuroimaging, absent reperfusion therapy, insufficient stroke beds, and lack of surgical care. Urgent system-wide reforms are needed to implement modern stroke management. Conflict of interest Abdullaev Zafarjon Khikmatillaevich : nothing to disclose
Z. Abdullaev (2026) studied this question.
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