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Introduction In February 2024, South Korea faced an unprecedented medical crisis due to the mass resignation of resident doctors, severely disrupting emergent and essential medical services. This crisis had a significant impact on the accessibility and referral patterns of acute hemorrhagic stroke care.Aim of study We aimed to evaluate changes in the number and regional distribution of patients with acute hemorrhagic stroke admitted to a single cerebrovascular-specialty hospital before and after the crisis.Method This retrospective study analyzed patients diagnosed with acute intracranial hemorrhage (ICH) and subarachnoid hemorrhage (SAH) who visited a single cerebrovascular-specialty hospital in South Korea. Patients were divided into two groups based on the onset of the medical crisis: Pre-crisis (Before February 2024) and Post-crisis (After February 2024). We compared the features between groups, such as referral patterns, regional distribution of patients, and time-related parameters.Abstract A55 Figure 1Results This study included 344 patients with acute hemorrhagic stroke (245 ICH, 99 SAH): 130 in the Pre-crisis group and 214 in the Post-crisis group. Referrals from outside the regional area significantly increased after the crisis (p < 0.001), while direct visits to Pohang remained stable. Onset-to-operation and onset-to-arrival times were longer in the Post-crisis group, but hospital arrival-to-operation time showed no significant delay.Abstract A55 Figure 2Conclusion This study provides a piece of evidence that the 2024 South Korean medical crisis significantly impacted acute hemorrhagic stroke care accessibility. The notable increase in referrals from outside the regional area suggests a growing disparity in emergent hemorrhagic stroke care, likely due to the shortage of specialists in peripheral hospitals.Conflict of Interest Yes Medtronics