Life-saving modern stroke treatment still Dhaka-centric
Experts urge nationwide access to thrombectomy as Bangladesh marks World Stroke Day
Highlights:
- Mechanical thrombectomy can reverse stroke damage if done quickly
- Treatment mostly limited to Dhaka; access outside remains poor
- Awareness gap: many believe stroke causes inevitable paralysis
- Procedure effective up to 24 hours after stroke onset
- Stroke rates rising, affecting even younger Bangladeshis under 50
- Experts urge government expansion, training, and financial subsidies nationwide
Timely treatment can make stroke a curable condition — and in many cases, patients can return to a completely normal life. Experts say the modern procedure known as mechanical thrombectomy has the potential to prevent thousands of premature deaths in Bangladesh.
However, the treatment remains largely Dhaka-centric. Currently, it is regularly performed only at the National Institute of Neurosciences and Hospital (NINS).
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A few private hospitals, such as Bangladesh Specialized Hospital and Ibn Sina Medical College Hospital in Kallyanpur, offer the procedure on a limited scale.
"Every minute matters in stroke," said Dr Humayun Kabir Himu, stroke and interventional neurology specialist at NINS. "The sooner a blocked blood vessel can be reopened, the more brain cells can be saved. Mechanical thrombectomy can rescue a large portion of the brain from irreversible damage."
The procedure is a minimally invasive operation performed in a cath lab.
"Just like in a heart attack, where a stent is placed to restore blood flow in the heart's blocked artery, we remove the clot from a blocked brain vessel in stroke patients using this method," Dr Humayun explained.
He noted that public awareness remains a major barrier. Many people still believe stroke has no treatment and inevitably leads to paralysis. "People must be made aware that early hospital arrival can save both life and brain function," he said.
Treatment window: Up to 24 hours
Research shows that 50% of patients treated successfully with mechanical thrombectomy regain normal life, while mortality drops to only 10%.
Initially, mechanical thrombectomy was believed to be effective only within six hours of stroke onset. But new studies show that in many cases, it can still be beneficial if performed within 16 to 24 hours.
Stroke prevalence rising
A 2024 study by the Department of Public Health and Informatics at Bangladesh Medical University found that about 13.6 out of every 1,000 people in Bangladesh suffer a stroke. Alarmingly, 23% of them are under the age of 50—meaning one in four stroke patients is relatively young.
The study also found the highest incidence among people aged 60–69 years, with 28% of individuals in that age group affected.
According to Bangladesh Bureau of Statistics (BBS) data from the Bangladesh Sample Vital Statistics 2023, stroke is the second leading cause of death in the country.
A separate nationwide survey titled "Prevalence and Risk Factors of Stroke in Bangladesh" (2022) reported that 11.39 per 1,000 people have experienced a stroke, with Mymensingh division showing the highest rate and Rajshahi division the lowest.
Stroke prevalence was also found to be higher in rural areas than urban ones.
Changing lifestyles, rising risks
Dr Md Shafiqul Islam, professor of Neurosurgery at Dhaka Medical College Hospital, said several factors are driving the rise in stroke cases — including stressful urban lifestyles, fast food consumption, physical inactivity, and increasing rates of diabetes and hypertension.
He warned that late-night habits and unhealthy routines are contributing to more strokes among younger people.
"If a stroke occurs, the patient must be taken to the hospital immediately. When a blood vessel is blocked, reopening it as quickly as possible is vital. The first four hours are extremely critical — treatment during this period can fully restore many patients," he said.
Call for govt support
Experts emphasis that the government should expand stroke treatment beyond Dhaka by setting up cath labs in divisional cities, training more interventional neurologists, and offering subsidies for costly procedures like mechanical thrombectomy.
Dr Humayun said, "With timely access to modern treatment, death and disability can be prevented. As the treatment is expensive, government subsidies are essential to make it accessible to all."
Health Secretary Md Saidur Rahman acknowledged the treatment gap both in and outside Dhaka and outlined ongoing efforts.
He said, "Specialised hospitals for cancer, kidney, and cardiac diseases are being established in eight divisional cities, and stroke treatment will be integrated into these facilities."
