Management and evolutionary profile of ischemic stroke in Morocco: a narrative review

Advances in ischemic stroke diagnosis and treatment are pivotal in reducing its impact worldwide. This study examines ischemic stroke patient management and outcomes in Morocco. A narrative review analyzed ischemic stroke management and outcomes in Moroccan hospitals. From 28 studies, patients typically arrived at imaging departments 26 to 61 hours after symptom onset. Treatment focused on cardiovascular risk factors: Antihypertensives (43% to 67.8%), platelet aggregation inhibitors (16% to 57%), statins (10% to 12%), antidiabetics (13.2% to 47.9%), and thrombolysis (1.94% to 14.7%). Carotid stenosis and hemicraniectomy were less common. National Institutes of Health Stroke Scale scores (NIHSS) improved post-thrombolysis from 10.4-14.8 initially to 9.56 within 24 hours. Modified Rankin scores varied widely, from full recovery (29.65%) to recurrence (14.75%). Acute phase mortality ranged from 1.1% to 16.4%, with 3-month mortality from 4.3% to 32.5%. Improving stroke care in Morocco entails reducing pre-hospital thrombolysis delays and expanding neurovascular units nationwide.