How is the golden window for stroke counted? Thrombolysis, thrombectomy and Hong Kong's emergency arrangements

Last updated: 2026-09-13

Key point: stroke is a medical emergency. An article published on 10 March 2026 by Professor Leung Wai-hong, Chairman of the Hospital Authority's Central Committee on Stroke Service, reminds the public that on noticing stroke symptoms they should immediately call 999 for help and attend an Accident & Emergency Department. That article gives the treatment window for thrombolysis as within 4.5 hours of onset, and the optimal time for thrombectomy as generally within 6 hours; which treatment is suitable has to be assessed by the medical team. These times are not time you may wait, and they do not mean that beyond a certain number of hours there is no chance of treatment. (The article is published in Chinese only; the passages from it in this article are this site's translation.) Hospital Authority

Some patients may have a longer treatment window. The American Heart Association / American Stroke Association 2026 guideline summary explains that some patients with unknown time of onset, or 4.5 to 9 hours from onset, may be considered for thrombolysis after selection by advanced imaging; the association's patient material also explains that suitable patients with large vessel occlusion may receive thrombectomy up to 24 hours from onset, based on imaging assessment. These are this site's summaries of international material. They are not a service guarantee by every hospital in Hong Kong for every case, and they are not a threshold for deciding for yourself whether treatment is possible. 2026 guideline summary, thrombectomy patient material

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#What is a stroke? What is actually happening inside the body?

A stroke is a medical emergency; it happens because a blood vessel in the brain is blocked or has burst, cutting off the blood supply to part of the brain. A spokesman for the Department of Health put it this way in a press release dated 29 October 2021:

Stroke is a medical emergency, which occurs when the blood supply to part of the brain is cut off, usually because the artery of the brain is blocked by a clot or ruptures. Without the oxygen and nutrients carried by blood, brain cells die and it can lead to brain damage with various degrees of disability (such as limb weakness, speech impairment, memory loss, paralysis on one side of the body), and even death.

In other words, a stroke is not the sort of discomfort captured by "high blood pressure makes you dizzy"; it is a process in which brain cells are dying. That death is irreversible — and everything said about "time" is about this.

Stroke divides into two main types. The Hospital Authority article of 10 March 2026 states: "Stroke cases in Hong Kong are predominantly ischaemic (blockage of a cerebral blood vessel), accounting for about 85% of the total." (this site's translation)

The Hospital Authority's SmartPatient patient information, which carries no date, states:

Depending on its causes, stroke is mainly divided into two types:
Ischemic stroke: it is caused by cerebral thrombosis (a blood clot forms inside the vessels of the brain) and is relatively common, more than 70% of strokes belong to this type.

The same page describes haemorrhagic stroke as: "it is caused by the bursting of a blood vessel inside the brain. Most often, it is associated with persistent high blood pressure." The undated introduction to stroke page of HKU Stroke, at the LKS Faculty of Medicine of the University of Hong Kong, prints "Ischaemic stroke (80%)" and "Haemorrhagic Stroke(20%)". These two educational pages differ from the summary proportion in the 2026 Hospital Authority article; this article sets out the local picture using the dated and more recent article, while keeping the source of each undated educational page, without treating them as a single consistent time series and without concluding from this that there is any dispute between the institutions.

Why does the distinction matter? Because the two types are treated differently. The joint announcement of the Fire Services Department and the Hospital Authority of 12 December 2025 states: "Strokes can be generally classified into two types, namely hemorrhagic stroke and ischemic stroke. Treatment approaches differ for patients with each type." Thrombolysis and thrombectomy, discussed below, concern ischaemic stroke.

Who most needs to know: people with an older person at home, or who themselves have high blood pressure, diabetes, high cholesterol or atrial fibrillation. The Department of Health's Population Health Survey 2020-22 (the Part II report, released on 26 April 2023) measured a prevalence of hypertension of 29.5% among the population aged 15 to 84 (against 27.7% in the 2014-15 survey), diabetes 8.5% and hypercholesterolaemia 51.9%. Those three percentages come from the health examination part of the survey: the same release states that the survey "interviewed more than 16 000 land-based non-institutional persons aged 15 or above from more than 7 400 domestic households in Hong Kong, and among them over 2 000 respondents further completed the health examination". The same release also states: "Among those with hypertension, more than 40 per cent were not aware of having raised blood pressure until attending the PHS health examination".

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#Why can you not use a single number of hours to decide whether a stroke can still be treated?

The type of treatment, the symptoms, the imaging results and the time of onset all bear on the choice together. The 4.5 hours and 6 hours in the 2026 Hospital Authority article above refer to thrombolysis and thrombectomy respectively; international guidelines provide a longer treatment window for some selected patients. A treatment window describes the conditions under which a treatment can be considered. It is not permission to wait until the limit before seeking care.

Public education material from different periods is not suited to being treated as competing standards for today. The table below keeps the wording of the Hospital Authority SmartPatient page, the HKU Stroke page and a New Territories East Cluster service presentation, so that the reader can tell the sources apart. The New Territories East presentation refers in its text to 2018 to 2019 and describes the service arrangements of that time; the cluster is itself part of the Hospital Authority. The "3 hours" or "6 hours" wording in undated educational pages cannot override the more recent Hospital Authority material above or the evidence for an extended treatment window in selected patients.

#What did material from different periods say? Six rows of historical and educational text

The table below compares the wording of three pieces of educational or service material, and is not a table of current clinical practice. Rows ① to ⑤ concern treatment; row ⑥ concerns the transfer criteria in that old presentation. The 2026 Hospital Authority material and the international guideline above give the more recent background on treatment windows.

The three pieces of material apply in different contexts. SmartPatient writes "three to four and a half hours", HKU Stroke writes "4.5 hours"; the difference in wording is not enough to establish a clinical disagreement between the institutions. The New Territories East presentation's "3 hours" treatment window and 1.5-hour transfer criterion reflect the 2018 service design its own text describes, not a territory-wide rule for today. The date clues for each piece of material are listed at the end of this article.

The time limit is not the only condition. Immediately after "three to four and a half hours", the same Hospital Authority page sets out a run of limitations:

Nevertheless, receiving thrombolytic therapy does not guarantee complete recovery. The thrombolytic agent would also increase the risk of developing intracerebral heamorrhage by ten times, and limited the use of this therapy.
Moreover, the thrombolytic therapy is not applicable to all stroke patients. Patients are required to conduct a treatment eligibility assessment, by neurologist. If the degree of stroke is mild, the risk of bleeding in thrombolytic therapy might outweigh the benefit of recanalization.
Therefore, timely medical attention and medical team's clinical assessment are very important. After the thrombolytic therapy, patients would be closely monitored, and their blood pressure would be managed to reduce the risk of intracerebral haemorrhage.

This site's summary: SmartPatient stresses at the same time timely medical attention, the medical team's assessment, and close monitoring and blood pressure control after treatment. The risks and the possible benefits of treatment have to be weighed case by case.

The risk figure quoted above belongs to that piece of educational material alone. SmartPatient does not set out the comparison base for the "ten times"; HKU Stroke separately writes of an approximately 7% risk of intracerebral haemorrhage, but neither page sets out study populations and definitions that can be compared directly. These figures are not a risk prediction for any individual. The 2026 guideline still supports treating suitable patients as quickly as possible.

The HKU Stroke educational page also notes that treatment has to take account of the time of arrival at hospital and the bleeding risk:

Patients who arrive too late at the hospital may not be eligible for these treatments since the risk of a poor outcome from tPA or mechanical thrombectomy (most often life-threatening bleeding in the brain), may outweigh any potential treatment benefits.

Being within the usual treatment window does not mean a given treatment is necessarily suitable; being beyond the usual treatment window is equally not something on which you can decide for yourself that there is no chance of treatment. That is assessed by a doctor on the symptoms, the imaging and other conditions.

Why the race against time? The same HKU Stroke page explains the importance of early treatment in terms of neuron loss:

It should also be noted that for every minute that an acute ischaemic stroke is not treated, approximately 1.9 million neurons in the brain are lost. Anyone with sudden onset of stroke symptoms should immediately attend their nearest Accident and Emergency Department so that appropriate treatment can be given within the effective treatment time window.

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#What are the warning signs of stroke? How do you remember "FAST"?

The mnemonic the Department of Health publishes in English is "FAST". The following is the text of the Department of Health's press release of 29 October 2025, set out line by line as that release lays it out:

Members of the public should remember the warning signs of stroke and act "FAST":
face drooping: asymmetrical facial expressions;
arm weakness: limb weakness on one side of the body;
speech difficulties: difficulties in communicating with others; and
time: call for immediate medical assistance to save lives.

The English edition of the Centre for Health Protection's Non-Communicable Diseases Watch for October 2025 uses the same device: "Be familiar with the warning signs of stroke and act 'FAST'—'F'ace drooping, 'A'rm weakness, 'S'peech difficulties, 'T'ime to call for medical assistance if indicated."

⚠️ The Traditional Chinese edition of the same publication uses a different mnemonic, not a translation of "FAST". The Chinese edition of Non-Communicable Diseases Watch for October 2025 uses the four characters 談笑用兵, standing for difficulty in expression or speech, asymmetry of facial expression, weakness of the limbs on one side, and seeking help quickly. (This site's note: the two mnemonics do not correspond item for item, and this article will not render either one as a translation of the other. This is the English edition and it uses the "FAST" of the English pages of the Department of Health and the Centre for Health Protection.)

There is more than one official list of warning signs. The Fire Services Department's "Stroke" education page prints a separate list of eight items, with no mnemonic:

Common warning signs of stroke
Unilateral numbness/Loss of power
Slurred speech/Aphasia
Facial palsy
Impaired vision/Double vision (diplopia)
Syncope
Severe headache with vomiting
Incontinence
Unconsciousness and, in serious cases, unequal pupil size.

The Department of Health's press release of 29 October 2021 prints seven items, including "Sudden and severe headaches", "Trouble seeing out of one or both eyes" and "Sudden difficulties in swallowing". ⚠️ This article has not merged these lists on its own, and has not written any list of warning signs of its own. If you want one that you can remember, use the Department of Health's "FAST"; if you want a long list, go back to the Fire Services Department's own text.

Symptoms going away does not mean nothing is wrong. The same Fire Services Department page writes, after its list:

Some patients may have a transient attack of the warning signs (as above), lasting for several minutes with complete recovery. Studies have shown that these patients are likely to have a major stroke or cardiovascular event within a year. Therefore, even if these signs have subsided, the patient should undergo medical check-up immediately.

HKU Stroke writes of the same situation (which that page calls a transient ischaemic attack):

A transient ischaemic attack, commonly referred to as a TIA, presents with symptoms of stroke that resolve completely within 24 hours. It is considered a warning sign and 20% of these patients may go on to suffer a stroke over the next 3 months.
Although symptoms of TIA may resolve, it is vital that the underlying causes are identified and appropriate treatment initiated so that patients do not subsequently develop a disabling stroke as a result of silently advancing pathophysiological changes. It is crucial that individuals seek medical help if they develop symptoms suspicious of a TIA.

Who most needs to know: the person who thinks a short rest will sort it out, and the family member who is there but is not sure whether it is a stroke. Both documents point to the same thing: the Fire Services Department writes that "even if these signs have subsided, the patient should undergo medical check-up immediately", and HKU Stroke writes that "It is crucial that individuals seek medical help".

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#What happens after you dial 999? How long does the ambulance take?

The Fire Services Department's performance pledge prints a response time target for ambulances. The text:

Emergency ambulance calls within 12 minutes from the time of call to the arrival of an ambulance at the street address. Our target is to meet this response time in 92.5% of all emergency calls.

⚠️ This is a target, not a guarantee, and it is measured to "the arrival of an ambulance at the street address", not to arrival at hospital. The same page has a separate target for building fire calls (6 minutes in built-up areas); the two are different things and should not be mixed up.

Ambulance personnel assess the patient on the way to hospital, and notify the hospital. The Hospital Authority announcement of 12 December 2025 states:

Since 2021, the HA and the FSD have collaborated to implement the Pre-hospital Stroke Notification mechanism on a territory-wide basis. The FSD's ambulance personnel will perform a pre-hospital stroke assessment before patients arrive at the hospital, utilising standardised medical evaluations to determine if the patient exhibits suspected acute stroke symptoms. In case a patient is assessed as requiring notification, the ambulance personnel will immediately call the Accident and Emergency Department (AED) of the public hospital concerned, enabling the hospital's stroke team to make advance arrangements for examination and treatment.

From 15 December 2025 there is an extra step in New Territories East and New Territories West: conveying the patient directly to a designated hospital. The same announcement states that patients preliminarily assessed by ambulance personnel as having suspected large vessel occlusion will be taken from Sha Tin, Tai Po and North districts directly to Prince of Wales Hospital, and from Tuen Mun and Yuen Long districts directly to Tuen Mun Hospital; the announcement also states that both parties will "actively consider extending the Scheme to other Clusters in an orderly manner". This December 2025 announcement describes two clusters; this article does not treat it as a complete account of the arrangements in other areas as at today.

But the instruction given to the public is still "nearest". Another paragraph of the same announcement reads:

The HA spokesperson reminded the public that all public hospital AEDs are capable of providing appropriate treatment for stroke patients. If individuals suspect themselves or someone nearby are suffering from stroke, they should promptly attend the nearest AED, where healthcare staff will arrange necessary assessments and examinations. Members of the public calling the FSD's ambulance service for assistance are also advised to co-operate with the professional assessments and judgments conducted by the ambulance personnel, who will convey patients to a suitable hospital for further diagnosis.

⚠️ This article does not advise anyone to choose a hospital for themselves or to "pick the one with thrombectomy". The official instruction is to attend the nearest Accident & Emergency Department and to co-operate with the ambulance personnel's decision.

There is one thing family members can do. The steps set out on the Fire Services Department's "Stroke" education page include "Keep clam & call '999' to summon an ambulance.", "Do not allow any food or drink." and "Record the time discovering the warning signs of stroke, and inform ambulance personnel on their arrival." ⚠️ Recording the time bears directly on every time figure above — the New Territories East presentation states that the nurse must "Confirm onset time with patient and relatives". ⚠️ This article does not reproduce the steps on that page relating to the patient's position, and gives no positioning instructions of any kind; the Fire Services Department's "Stroke" first aid knowledge page and its "How to call an ambulance" page print different wording on position, and this article will not merge the two or pick one to stand for the official position.

Going in by ambulance does not put you at the front of the queue. The text of the Fire Services Department's ambulance service FAQ:

Q4 : Would one receive earlier medical consultation when he/she is conveyed by ambulance to the Accident & Emergency Department of hospital?
Ans: No. All Accident & Emergency Departments in hospitals of the Hospital Authority have adopted the triage system, which classify patients according to their conditions. Despite being conveyed by ambulances, patients may be classified as semi-urgent or non-urgent by hospital staff, who may then need to wait for a longer time.

⚠️ This is the Fire Services Department's general answer about Accident & Emergency triage, and the page nowhere mentions stroke. For suspected stroke, the same announcement of 12 December 2025 separately sets out the Pre-hospital Stroke Notification mechanism: ambulance personnel call the Accident & Emergency Department concerned before the patient arrives, "enabling the hospital's stroke team to make advance arrangements for examination and treatment"; and in the New Territories East and New Territories West clusters, patients assessed as having suspected large vessel occlusion are taken directly to a designated hospital. This article places the general answer and this announcement side by side, and will not use either to judge whether anyone should call an ambulance.

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#What stroke treatment services does Hong Kong actually have now?

Thrombolysis is available at every public hospital Accident & Emergency Department, 24 hours; thrombectomy is available at seven hospitals, 24 hours, since March 2025. The text of the joint announcement of the Fire Services Department and the Hospital Authority of 12 December 2025:

For ischemic strokes, all public hospital AEDs currently offer 24-hour IVT services. Since March of this year, PWH, TMH, Princess Margaret Hospital, Queen Elizabeth Hospital, Kwong Wah Hospital, Queen Mary Hospital, and Pamela Youde Nethersole Eastern Hospital have also been providing 24-hour IAT services, supporting stroke patients across Hong Kong through a comprehensive service network.

⚠️ This article lists those seven hospitals because the government announcement says so, not as a recommendation and not to tell anyone to choose one. The instruction the same announcement gives the public is to attend the nearest Accident & Emergency Department.

⚠️ The Hospital Authority's SmartPatient patient information page prints no date, and its content plainly predates that announcement; this article does not use that page's description of how widely thrombectomy is available locally as the current position. This article's account of the service network and of the latest progress rests, respectively, on the announcement of 12 December 2025 and on the Hospital Authority article of 10 March 2026 below.

Queen Mary Hospital and Tuen Mun Hospital already have nationally accredited stroke centres. The Hospital Authority article of 10 March 2026 states that the two hospitals set up Hong Kong's first nationally accredited stroke centres at the end of 2025, and that Prince of Wales Hospital is preparing to do so within 2026. (this site's translation) This is the progress that article sets out, and is not a judgement of the current position drawn from the planning language of the 2024 or 2025 Policy Address.

There are more recent figures on the treatment pathway too. The same Hospital Authority article reports that the proportion of acute ischaemic stroke patients receiving thrombolysis rose from about 10% in 2019 to over 15% in 2025; that the median time from arrival at the Accident & Emergency Department to the start of thrombolysis was shortened from 68 minutes in 2021 to 58 minutes in 2025; and that for thrombectomy it fell from 110 minutes to 93 minutes. (this site's translation) These are treatment rates and process indicators for the service as a whole, not the chance that any particular patient is suitable for thrombolysis, nor a guarantee of waiting time. Hospital Authority, page 1

The closing paragraph of the same article separately reports that the percentage of stroke patients dying within one year fell from 24.6% to 16.4%. (this site's translation) That sentence does not separately set out the patient groups, sample sizes or risk adjustment methods behind those two percentages; this article sets them out as that article states them, does not write them up as any individual's prognosis, and does not calculate for itself the extent to which any treatment reduces the risk of death.

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#How many people have a stroke in Hong Kong each year? There is a figure here to be careful with

The death figures exist, and come from the Centre for Health Protection itself. Row 4 of "Number of registered deaths by leading cause of death, 2001 - 2025", "Cerebrovascular diseases (ICD-10: I60-I69)", gives for the last five years 3 126 in 2021, 3 057 in 2022, 3 048 in 2023, 2 911 in 2024 and 2 786 in 2025. The table notes "# Provisional figures.", and the # is printed on the column heading for 2025, meaning the whole 2025 column is provisional. The same table also notes: "The figures are based on deaths registered under the Births and Deaths Registration Ordinance (Cap. 174, Laws of Hong Kong) during the specified period."

Doing the arithmetic (this site's calculation from the same table): that table gives all-cause registered deaths in 2025 (provisional) as 51 750 and cerebrovascular diseases as 2 786, that is 5.38%. The 2 911 for 2024 divided by all causes of 52 366 gives 5.56%. The table itself notes that it is "(Ranking according to the number of registered deaths in 2025)". Three causes rank above cerebrovascular diseases in 2025: malignant neoplasms 15 368, pneumonia 11 260 and diseases of heart 6 593; immediately below comes "External causes of morbidity and mortality" at 2 106. ⚠️ Both percentages are this site's calculation from that table's figures; the table itself prints no percentages.

The Department of Health's press release of 29 October 2025 puts it this way: "Stroke is the fourth most common cause of death in Hong Kong, with 2 911 registered deaths (provisional figure) last year. Among them, 7.7 per cent were people aged 55 or below."

The more recent public hospital service figure is over 19 000 in 2025. Page 1 of the Hospital Authority article of 10 March 2026 states: "Public hospitals received over 19 000 stroke-related cases last year." (this site's translation) By the date of the article, "last year" means 2025. That sentence uses the term "stroke-related cases" and does not separately define an all-age number of new strokes, a number of distinct patients or a number of admissions; it cannot be taken as the territory-wide total of new strokes for that year.

Older adult acute stroke admission figures rest on a different basis again. The text of the Government's answer to a Legislative Council written question (14 November 2018):

(2) There are over 13 000 adult cases of admission to public hospitals due to acute strokes every year.

A press release of 27 October 2022 from the HKU medical faculty, analysing the Hospital Authority's Clinical Data Analysis and Reporting System, separately states: "the total number of new stroke cases admitted to hospitals under Hospital Authority remained similar at around 13,000 – 13,500 per year during the past 20 years".

⚠️ "Adult cases of admission to public hospitals" is a service figure. By definition it excludes private hospital cases, cases not admitted and paediatric cases, so it is not the number of people in Hong Kong who have a stroke each year. This article does not write that figure up as an incidence rate or a "total number of cases", and does not subtract or divide the older admission figures against the 2025 "stroke-related cases" to infer growth in the number of people affected.

There is also a prevalence figure, computed in an entirely different way. The English edition of the Centre for Health Protection's Non-Communicable Diseases Watch for October 2025 states: "According to the Population Health Survey 2020-22 conducted by the Department of Health, 0.8% of persons aged 15 or above reported that they had doctor diagnosed stroke. The prevalence increased with age, showing a notable rise among persons aged 75 years or above." ⚠️ That 0.8% is having "had" a diagnosis — a lifetime prevalence, not a count of new cases within a year. It and the annual admission figure above are computed in two different ways; they cannot be converted into one another and should not be put side by side as if they were the same thing.

Young stroke has its own incidence figure, but it covers only ages 18 to 55. The same HKU medical faculty press release: "the crude incidence of young stroke has sharply increased from 41.8 per 100,000 people in 2001 to 54.7 per 100,000 in 2011 and 59.7 per 100,000 in 2021". The same press release also states that the risk factor percentages come from 431 stroke patients aged 18 to 55 admitted to Queen Mary Hospital and Ruttonjee Hospital between September 2019 and August 2022.

"About 25,000 people have a stroke each year" appears in a university event press release. The University of Hong Kong's press release "WeRISE: Stroke Family Empowerment Project and World Stroke Day 2018" (29 October 2018) introduces a stroke family support project of the HKU Sau Po Centre on Ageing, and states in the text: "In Hong Kong, around 25,000 people suffer from stoke each year", with a footnote attached to that sentence that reads only "Department of Health. 2017" plus a major causes of death web address. That event release does not set out how the incidence figure was calculated or what population it covers, and the footnote is not enough to establish it as an official annual statistic for new strokes.

The material set out above consists, respectively, of public hospital service cases, adult admission cases, prevalence of ever having been diagnosed, and the incidence of young stroke in ages 18 to 55. This article does not provide an annual total or incidence rate covering all ages and all new stroke cases in Hong Kong, and does not convert any of these differently defined figures into one another.

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#What happens after discharge? What rehabilitation and community services are arranged?

The Hospital Authority states that starting rehabilitation training early matters, and that rehabilitation is done by a multi-disciplinary team. The text of the "Treatments in rehabilitative stage" section of SmartPatient:

The aim of the rehabilitation treatments is to ensure best recovery of the patients' daily life activity functions. Although not all physical functions can be fully restored, the aim of "self-adaptation" can be attained. It is very important to start rehabilitation training as soon as possible.

The same page describes the make-up of the team: "A medical team comprising a number of different professionals provides acute treatment, rehabilitation care, physical therapy, occupational therapy, speech therapy, medical social work services and clinical psychological services etc for the purpose of preventing complications and preparing the patient for receiving rehabilitation treatments after the condition of the patient stabilizes."

There is a written route from hospital into the community. The text of an answer to a Legislative Council oral question (26 June 2024):

Fourthly, as regards community rehabilitation, DHCs have established referral mechanisms with various clusters of the Hospital Authority, and DHCs will provide rehabilitation and follow-up services for referred patients with stroke, hip fracture or post-acute myocardial infarction. The accumulative service attendance of the community rehabilitation programme was around 34 000 as at March 31 this year.

Note that stroke is listed first of those three conditions. ⚠️ The "accumulative service attendance ... around 34 000" is cumulative attendances as at 31 March 2024, not a number of people, and is not specific to stroke — the same sentence covers three conditions.

On what District Health Centres charge, this article will not quote a price. What the District Health Centre website publishes is: registration and membership are free ("Registration and membership are free. The membership is lifelong."); there is a cap on the number of subsidised sessions ("Beyond the maximum number of subsidised sessions, the client has to pay the fees charged by the Network Service Provider."); individual allied health services require a referral except for Chinese medicine ("Individual allied health services require medical referral from the Family Doctor. Self-referral will be accepted for Chinese medicine services."); and Elderly Health Care Vouchers may be used to pay for services. ⚠️ Neither the District Health Centre "General Public" page quoted here nor the two Legislative Council answers (14 November 2018 and 26 June 2024) prints a co-payment amount for stroke rehabilitation services. This article therefore quotes no amount; the actual fees are as published by the centre concerned.

Who most needs to know: carers whose family member has just been admitted with a stroke and who are beginning to think about what happens after going home. This section is about which routes exist, not which is cheapest; this article has no information on price.

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#Common questions

• Is there really only three hours in which a stroke can be treated? No. The Hospital Authority article of March 2026 gives the general treatment window for thrombolysis as within 4.5 hours of onset and the optimal time for thrombectomy as generally 6 hours; international material also explains that some patients may use a longer treatment window after selection by imaging. Old service presentations are not today's territory-wide clinical threshold. The Hospital Authority's instruction on calling for help is to dial 999 immediately and attend an Accident & Emergency Department.
• If I get to hospital within the time limit, will I definitely be given the thrombolysis injection? No. SmartPatient explains that thrombolysis is not applicable to all patients, that a neurologist must assess eligibility, and that after treatment close monitoring and blood pressure control are needed. The risk of intracerebral haemorrhage has to be weighed together with the benefit of treatment, and the decision cannot rest on risk figures from a general educational page alone.
• Should I go to one of the seven hospitals with thrombectomy, or to the nearest Accident & Emergency Department? The instruction the Government's announcement gives the public is: the nearest. The Hospital Authority spokesperson wrote in the announcement of 12 December 2025 that people "should promptly attend the nearest AED", and that "all public hospital AEDs are capable of providing appropriate treatment for stroke patients"; if calling an ambulance, people "are also advised to co-operate with the professional assessments and judgments conducted by the ambulance personnel". This article does not advise anyone to choose a hospital for themselves.
• Is the mnemonic "FAST" or 談笑用兵? In English it is "FAST". The Traditional Chinese and English editions of the Centre for Health Protection's Non-Communicable Diseases Watch for October 2025 are the same publication, but the Chinese edition uses 談笑用兵 and the English edition uses "FAST", and the two do not correspond item for item. This is the English edition and it uses the "FAST" printed on the English pages of the Department of Health and the Centre for Health Protection, without rendering either mnemonic as a translation of the other.
• The symptoms lasted ten minutes and then went away — do I need to see a doctor? The Fire Services Department's "Stroke" page states that even when such signs subside "the patient should undergo medical check-up immediately", and states that such patients "are likely to have a major stroke or cardiovascular event within a year". HKU Stroke also writes that for such patients "20% of these patients may go on to suffer a stroke over the next 3 months", and that although "symptoms of TIA may resolve, it is vital that the underlying causes are identified and appropriate treatment initiated", concluding that "It is crucial that individuals seek medical help".
• How many people have a stroke in Hong Kong in a year? The Hospital Authority article of 10 March 2026 states that public hospitals received over 19 000 stroke-related cases in 2025. That is a public hospital service figure, not a defined territory-wide total of new strokes for the year; the older figure of over 13 000 adult acute stroke admissions from 2018 rests on a different basis again. On deaths, the Centre for Health Protection's cause-of-death table records 2 786 registered deaths from cerebrovascular diseases in 2025 (provisional figures).
• How long does the ambulance take after I dial 999? The Fire Services Department's performance pledge target is arrival at the street address within 12 minutes of the call, with a target achievement rate of 92.5%. That is a target, and it is measured to arrival at the scene, not arrival at hospital.

Related article: 〈Waiting for a public specialist appointment and getting worse — can you ask to be seen earlier?〉

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#What this article covers

• Scope of the material: the sources at the end are grouped into treatment windows and current services, and Hong Kong background. Where this article notes that a document does not set something out, that is limited to the named documents concerned and does not mean that other official material does not exist.

• This article does not use any single number of hours to decide whether an individual patient can be treated. It distinguishes the more recent Hospital Authority material, the international guideline summary, and older educational and service material. International treatment windows are not a service commitment by every hospital in Hong Kong to every patient.

• This article does not provide an annual total or incidence rate covering all ages and all new stroke cases in Hong Kong. It has separately set out the 2025 public hospital stroke-related cases, the older adult admission figures, the ever-diagnosed prevalence from the Population Health Survey, and the 18-to-55 incidence from the HKU study. The "around 25,000 people each year" in the 2018 university event release is also given with its source and the limits of its method, and is not treated as an established official incidence total.

• This article quotes no amount for District Health Centre stroke rehabilitation services. Neither the District Health Centre "General Public" page nor the two Legislative Council answers (14 November 2018 and 26 June 2024) prints the relevant co-payment; the actual fees are as published by the centre concerned.

• This article gives no patient positioning or first aid posture instructions. The Fire Services Department's "Stroke" first aid knowledge page and its "How to call an ambulance" page print different wording on position; this article will not merge the two, and will not pick one to stand for the official position.

• This article does not claim that the 999 ambulance service is free. None of the four Fire Services Department web pages quoted here prints the word "free" in respect of the Department's own emergency ambulance service (the only place "free" appears on those four pages is the FAQ statement that the Department offers free CPR & AED Courses); nor does this article claim that a charge applies.

• Progress on stroke centres rests on the dated Hospital Authority article. That Queen Mary and Tuen Mun Hospitals set up accredited centres at the end of 2025 comes from the article of 10 March 2026; this article does not describe all seven thrombectomy hospitals as accredited stroke centres.

• This article uses the ranking in the Centre for Health Protection's registered deaths table, and does not cite other government pages' other statements of where stroke ranks among causes of death.

• This article has not written or merged any list of stroke warning signs of its own. Each list is quoted as printed, with the institution and document that printed it identified.

• This article does not compare or recommend any hospital, clinic or doctor. The list of seven hospitals is reproduced from the text of the government announcement.

• This article does not provide medical advice, and cannot judge whether any individual situation is urgent.

• This is the English edition. The Traditional Chinese edition is the authoritative version of this article. Quotations above are reproduced from the official English text published by the Government of the Hong Kong Special Administrative Region, not translated by this site — with one exception, which is marked at each occurrence: the Hospital Authority article of 10 March 2026 by the Chairman of the Central Committee on Stroke Service is published in Chinese only, and the passages taken from it are this site's translation.

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This is health information, not medical advice.

#Sources

#Treatment windows and current services

• Leung Wai-hong, Chairman of the Central Committee on Stroke Service, Hospital Authority, 〈改善服務活用科技掌握治療黃金時間　公立醫院持續提升中風救治水平〉 ("Improving services and applying technology to seize the golden hour for treatment: public hospitals continue to raise the standard of stroke care", title translated by this site) (10 March 2026), pages 1-2: https://www.ha.org.hk/haho/ho/cc/2823c.pdf. Published in Chinese only; passages quoted in this article are this site's translation.
• American Heart Association, 2026 acute ischaemic stroke guideline summary (26 January 2026), points 3, 6 and 7: https://professional.heart.org/en/science-news/2026-guideline-for-the-early-management-of-patients-with-acute-ischemic-stroke/top-things-to-know. The account in this article is this site's summary.
• American Stroke Association, "Ischemic Stroke (Clots)", Mechanical Treatment to Remove the Clot: https://www.stroke.org/en/about-stroke/types-of-stroke/ischemic-stroke-clots. The account in this article is this site's summary.

#Hong Kong background

• Centre for Health Protection, Department of Health, "Number of registered deaths by leading cause of death, 2001 - 2025" (the table runs to 2025, with the 2025 column noted as provisional; the page footer prints "Revision Date: 2026/07/29"): https://www.chp.gov.hk/en/statistics/data/10/27/380.html (Last updated: 2026-09-08)
• Department of Health, "DH appeals to public to deepen their understanding of stroke symptoms and lead healthy lifestyles in support of World Stroke Day" (29 October 2025): https://www.info.gov.hk/gia/general/202510/29/P2025102800596.htm (Last updated: 2026-09-08)
• Department of Health, "Public urged to pay attention to stroke signs and lead healthy lifestyle in support of World Stroke Day" (29 October 2021): https://www.info.gov.hk/gia/general/202110/29/P2021102800298.htm (Last updated: 2026-09-08)
• Department of Health, "Public urged to lead active and healthy lifestyle in support of World Stroke Day" (29 October 2024): https://www.info.gov.hk/gia/general/202410/29/P2024102900372.htm (Last updated: 2026-09-08)
• Centre for Health Protection, Department of Health, "Be Stroke Aware: Prevent Early．Detect Timely．Every Minute Counts", Non-Communicable Diseases Watch, 14 October 2025 (English edition): https://www.change4health.gov.hk/en/whats_new/ncd_watch/20251014.html (Last updated: 2026-09-08)
• 衞生署衞生防護中心，《非傳染病直擊》2025 年 10 月號〈關注中風：盡早預防．及時識別．分秒必爭〉（2025 年 10 月 14 日，Traditional Chinese edition）: https://www.change4health.gov.hk/tc/whats_new/ncd_watch/20251014.html (Last updated: 2026-09-08)
• Hospital Authority SmartPatient, "Stroke" (the page carries no self-printed date): https://www.smartpatient.ha.org.hk/en/smart-patient-web/disease-management/disease-information/disease/Stroke (Last updated: 2026-09-08)
• HKU Stroke, LKS Faculty of Medicine, The University of Hong Kong, "Stroke Diagnosis, Treatment and Complications" (the page carries no self-printed date; footer 2021 - 2025): https://www.stroke-en.med.hku.hk/stroke-diagnosis-treated-complications (Last updated: 2026-09-08)
• HKU Stroke, LKS Faculty of Medicine, The University of Hong Kong, "Introduction of Stroke" (the page carries no self-printed date; footer 2021 - 2025): https://www.stroke-en.med.hku.hk/introduction-of-stroke (Last updated: 2026-09-08)
• Alice Ho Miu Ling Nethersole Hospital and North District Hospital, "24 hours intravenous thrombolytic therapy for stroke" presentation (the document prints no date; its text refers to July 2018 and 2018 Q4 / 2019 Q1): https://www3.ha.org.hk/ntec/pdf/24hrs_thrombolysis_service_txt.pdf (Last updated: 2026-09-08)
• Fire Services Department and Hospital Authority, "Fire Services Department and Hospital Authority to launch Pre-hospital Stroke Diversion Scheme" (12 December 2025): https://www.info.gov.hk/gia/general/202512/12/P2025121200541.htm (Last updated: 2026-09-08)
• Hong Kong Fire Services Department, "Stroke" first aid knowledge page (the page footer prints "Revision Date: 04 April 2018"): https://www.hkfsd.gov.hk/eng/education/ambulance_knowledge/stroke.html (Last updated: 2026-09-08)
• Hong Kong Fire Services Department, "Performance Pledge" (the page footer prints "Revision Date: 15 May 2026"; the 12-minute / 92.5% ambulance response target appears in the section of aims the Department has set, which itself prints no year and is not the same list as the separate section on the Department's key targets in 2024): https://www.hkfsd.gov.hk/eng/aboutus/performance.html (Last updated: 2026-09-08)
• Hong Kong Fire Services Department, "Ambulance" frequently asked questions (the page footer prints "Revision Date: 13 August 2026"): https://www.hkfsd.gov.hk/eng/aboutus/faq/faq_amb/ (Last updated: 2026-09-08)
• Hong Kong Fire Services Department, "How to call an ambulance" (the page carries no self-printed date): https://www.hkfsd.gov.hk/eng/source/safety/uambu.htm (Last updated: 2026-09-08)
• Legislative Council, "LCQ8: Prevention of atrial fibrillation", written reply (14 November 2018): https://www.info.gov.hk/gia/general/201811/14/P2018111400567.htm (Last updated: 2026-09-08)
• Legislative Council, "LCQ2: Enhancing the services provided by District Health Centres", reply (26 June 2024): https://www.info.gov.hk/gia/general/202406/26/P2024062600622.htm (Last updated: 2026-09-08)
• Department of Health, "DH releases Population Health Survey Report (Part II)" (26 April 2023): https://www.info.gov.hk/gia/general/202304/26/P2023042600168.htm (Last updated: 2026-09-08)
• LKS Faculty of Medicine, The University of Hong Kong, "HKUMed study reveals over 30% increase in young stroke incidence in Hong Kong, advocating effective management of vascular risk factors such as hypertension" (27 October 2022): https://www.med.hku.hk/en/news/press/20221027-increase-in-young-stroke (Last updated: 2026-09-08)
• The Chief Executive, "The Chief Executive's 2025 Policy Address (11)", paragraph 227 (17 September 2025): https://www.info.gov.hk/gia/general/202509/17/P2025091700290.htm (Last updated: 2026-09-08)
• District Health Centre, "General Public" (the page footer prints "Last Review Date: 1 December 2025"): https://www.dhc.gov.hk/en/general_public.html (Last updated: 2026-09-08)
• The University of Hong Kong, "WeRISE: Stroke Family Empowerment Project and World Stroke Day 2018" press release (29 October 2018): https://www.hku.hk/press/news_detail_18605.html (now redirects to https://lead.hku.hk/article/2018/10/werise-stroke-family-empowerment-project-andworld-stroke-day-2018/; Last updated: 2026-09-08)

Official arrangements may be updated; the announcements of the bodies concerned prevail. This is health information, not medical advice, and it cannot judge whether any individual situation is urgent. If you suspect that you or someone near you is having a stroke, call 999 immediately, or follow the Hospital Authority's instruction and attend the nearest Accident & Emergency Department as quickly as possible.