ABSTRACT
Stroke is a significant economic; social and medical problem all over the world. This article discusses recent developments in stroke management worldwide. We reviewed and highlighted published clinical guidelines from several countries. The current thoughts on stroke care are discussed and summarized in concise and unambiguous terms. Limitation to optimal management in developing countries as well as areas requiring development and research are highlighted. It should be possible to utilize this in stimulating the development of management strategies for stroke; customized to the unique health structure in Nigeria. The management of stroke in Nigeria is suboptimal as there are significant deficiencies in the provision of diagnostic; treatment; rehabilitation and support services. The limited resources; manpower shortage; lack of organized stroke unit; neuro-imaging facilities; ambulance services; education of patients and general practitioners as well as impracticable use of thrombolytics are contributory. Training of stroke experts in collaboration with experts in the developed world with provision of neuro-imaging facilities would improve the outlook of stroke management in Nigeria. The focus in Nigeria must be on preventive strategies and ways to harness local resources in the acute treatment of stroke patients. Health education of the community with emphasis on control of the predisposing factors would reduce the burden of stroke in the country. Risk factor management should begin in childhood; with emphasis on exercise; nutrition; weight and blood sugar control; avoidance of tobacco and excessive alcohol; as well as effective treatment of hypertension and hyperlipidaemia