脳卒中専門医制度とそのあるべき姿

Abstract

Recent advances of diagnosis and therapy have been promoting the improvement of clinical outcomes in stroke patients. However, procedures for diagnosis and therapy have been complicated according to the advance, and the sufficient knowledge and medical ability are required in the stroke treatment. Stroke care unit (SCU) has been introduced to emergency medical centers in Japan, but its criterion has not been fully established especially for medical staffs. The guideline for stroke management will be published by the joint committee in the next year. For acute stroke patients, it is desirable that the medical specialist carry out the treatment according to the established guideline in SCU. Applying SCU for the improvement of the clinical outcome, the medical specialist is necessary for carrying out the complicated stroke treatment and the management of medical team in SCU.For the stroke management in a local community, the medical specialist in SCU is suitable for the role of establishing the cooperative medical care system with hospitals and pre-hospital teams.In the present time, stroke patients are treated in neurosurgical department, neurological department, cardiological department, emergency medical department or other departments. Only a small number of hospitals have SCU. Therefore, the level of stroke treatment should be standardized between those departments. For this purpose, the system of medical specialist for stroke treatment is available.The establishment of the board qualified system for medical specialist for stroke treatment is required to improve the clinical outcome of stroke patients and necessary in the effective management of SCU. The name of board qualified strokologist is appropriate for such a medical specialist.