Distance Is Brain: Reflections of a Young Neurologist

Neurological care is highly time-sensitive, yet many patients first present to a non-university regional hospital located far from specialized centers. This editorial reflects on the role of regional neurology in the early recognition, assessment, and coordination of care for acute and subacute neurological disorders. Stroke illustrates this challenge most clearly, as delays in recognition, imaging, transfer, and reperfusion treatment may directly affect outcome. However, the same problem extends to other neurological conditions, including suspected multiple sclerosis, spinal cord disease, severe headache, recurrent seizures, and rapidly progressive neuromuscular weakness. In these situations, clinical urgency may be evident before advanced diagnostic resources are available. Non-university regional hospitals, therefore, represent a critical first point in the neurological care pathway rather than a peripheral component of the system. Strengthening referral pathways, emergency neurological training, imaging access, ambulance coordination, communication with tertiary centers, and teleconsultation may reduce the clinical consequences of distance. Improving regional neurological care is not only a logistical need but also a matter of equity, particularly for patients living outside major urban centers.