ArticleBMC neurology2026
Diagnostic and therapeutic gaps in recurrent stroke management: real-world insights from a Ghanaian hospital-based registry.
Article in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRecurrent strokes account for up to 1 out of 4 strokes in Low-and-Middle-Income-Countries (LMICs), culminating in worsening of outcomes. International guidelines recommend subtype-specific etiological workup to help tailor strategies for prevention of recurrence after an index stroke. However, huge gaps in secondary stroke prevention persist in LMICs.
objectivesWe aimed to assess the extent of diagnostic evaluation (for risk-factor and underlying etiological identification) and treatment approaches among recurrent stroke patients in a Ghanaian tertiary hospital.
methodsThis was a cross-sectional study among recurrent stroke cases admitted to Komfo Anokye Teaching Hospital between 2023 and 2025. The data was analyzed using SPSS Version 28.
resultsRecurrent strokes accounted for 17.8% of all stroke admissions over 2 years, with ischemic strokes comprising 76.2% of these recurrent events. Hypertension was the most dominant modifiable risk factor among both ischemic and hemorrhagic subtypes, 97.0% and 92.1% respectively, (p = 0.297). Only a minority of ischemic stroke patients (12.6%) had sufficient diagnostic evaluation to allow definitive etiological classification according to the TOAST framework. Only 7.9% of hemorrhagic strokes underwent Computed tomography angiography (CTA)/ Magnetic resonance angiography (MRA) to evaluate for structural causes. Most ischemic stroke patients were prescribed a statin (93.7%) and an antiplatelet, while anticoagulant therapy was used only in a minority of patients (3.91%). Carotid endarterectomy or carotid stenting was not performed for any of the ischemic stroke patients.
conclusionOur findings highlight significant gaps in recurrent stroke evaluation and management in the Ghanaian setting. Standardized algorithms for secondary stroke prevention and treatment are urgently needed to mitigate recurrence.
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