According to data from the National Health Insurance Fund (NHIF), 26,758 cases of stroke were recorded in Bulgaria between January and July 2026, equivalent to one stroke every 11 minutes, Prof. Dimitar Maslarov, a member of the Management Board of the Brain Health Council Foundation, said at a roundtable entitled “Artificial Intelligence and Stroke – From the First Minutes to a New Life” here on Monday. The event was organised by the Brain Health Council Foundation ahead of World Stroke Day on October 29.
Other topics discussed at the forum included the cost of stroke to patients, society and the healthcare system, the role of artificial intelligence beyond stroke prevention and in the event of a stroke, and new dimensions in stroke care. A calculator for assessing the five-year risk of stroke was also presented.
Maslarov said the number of stroke cases had declined over the past 10 years, from 51,986 in 2016 to 43,006 in 2025. “I am cautiously optimistic about the decline in strokes in Bulgaria, although we know that this clinical pathway covers not only acute strokes,” he said. He added that efforts were producing positive results, citing the introduction this year of a new clinical pathway for transient ischaemic attacks.
One in six deaths in Bulgaria is caused by cerebrovascular disease, four times the European Union average, Arkadi Sharkov, a member of the Management Board of the Brain Health Council Foundation, said. He presented a study drawing on data from Eurostat, the NHIF, the National Centre of Public Health and Analyses, the National Health Information System, the National Statistical Institute and the National Social Security Institute, alongside the authors’ own calculations. Bulgaria’s rate was four times the EU average, Sharkov said.
Stroke also affects people of working age, with men accounting for seven in 10 stroke deaths, he added. One in four patients hospitalised with acute stroke is aged between 18 and 64, while stroke-related conditions rank first among diagnoses in decisions issued by the Territorial Expert Medical Commissions (TELK), which assess disability.
The annual cost of cerebrovascular diseases to the health fund, households and the economy amounts to EUR 472 million, Sharkov said. Of this total, 15% is covered by the health fund, 32% by households and 52% by the economy. As for medication following a stroke, patients pay 78% of the cost, the highest share among common diseases, he said.
Assoc. Prof. Nikolay Velinov, head of the Adult Neurosurgery Department at the Sofia’s Pirogov Hospital, explained how artificial intelligence can help once a stroke has occurred. Organizing treatment for ischaemic stroke is particularly challenging because patients have to go through a lengthy diagnostic process before reaching the treatment room, he said.
A major problem is that patients do not reach the operating room in time because of lengthy transfers from referring hospitals to intervention centres, slow and sequential identification and triage, and delays in the “door-to-puncture” time, Velinov said. The process takes an average of 311 minutes, he added.
Artificial intelligence is to be incorporated into the national programme for ischaemic stroke. The plan is to establish a hospital treatment infrastructure comprising high-tech stroke centres and six specialised high-tech centres equipped with modern equipment. Three centres will be located in Sofia, with one each in Pleven, Plovdiv and Varna. Specialized medical equipment and a unified digital platform will also be provided to 17 regional hospitals across the country. Velinov said hospitals using artificial intelligence software had reported a 23% reduction in treatment times, shorter hospital stays and improved access to care.
Prof. Maslarov presented brain health as an investment in quality of life, outlining new approaches to caring for stroke patients. He presented an integrated brain health strategy structured around three stages: before a stroke, with an emphasis on early prevention, education and risk-factor control, during a stroke, when emergency number 112, triage, AI-supported telestroke services and specialised teams are essential, and after a stroke, when rehabilitation, home-based follow-up and long-term prevention are key.
“Stroke does not begin in hospital,” Maslarov said, adding that when analysing treatment data, it is important to consider not only the number of procedures performed but also how many patients received timely access to them and what the outcomes were.
Regional disparities in access to care depending on where people live are also part of the problem, he said. The solution is a digital network based on common protocols, transport, specialised teams and telestroke services, implemented in six stages: primary prevention, recognition, diagnosis, treatment, recovery and monitoring.
Maslarov cited Berlin as an example, saying that three ambulances there, each worth EUR 1 million, were equipped with mini-scanners that use artificial intelligence to provide a diagnosis inside the ambulance and allow treatment to begin. The aim is to reduce disability, maintain cognitive health, promote active longevity and ease the burden on families and the healthcare system in the future, he said.
Number of Stroke Cases in Bulgaria Declines over Past 10 Years, Expert Says 2026 THE NEWS FROM BULGARIA – NEWS AGENCY 2009-2025 2026-10-12 17:12:00
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