The UK needs to boost stroke services quickly or they will remain western Europe's worst, says a leading doctor.
Professor Hugh Markus, of London's St George's Medical School, said care was poorly organised, the British Medical Journal reported.
He said research showed hundreds more people die or are left dependent on carers in the UK for every 1,000 strokes compared with other countries.
The government said great improvements had been made in the last decade.
It comes after a Lancet study published earlier this week showed the UK had one of the worst records for cancer survival in Europe.
Strokes happen when the blood supply to parts of the brain is interrupted, either through a burst blood vessel, or a vessel blocked by a blood clot.
Strokes are the third most common cause of death in the UK, accounting for more than 60,000 deaths a year.
A National Audit Office report in 2005 suggested that 550 deaths could be avoided, and an extra 1,700 patients make a full recovery if care was better organised.
Changes could also deliver a £20m annual saving to the NHS, it suggested.
Professor Markus said that, in contrast with other European countries, stroke was seen as a "Cinderella" subject, and patients not treated with sufficient priority.
"A major challenge is to change the perception of stroke, both among health professionals and the public, so that stroke is viewed as a condition that requires emergency action," he said.
He pointed out that the latest audit of stroke care carried out by the Royal College of Physicians found that fewer than two-thirds of people admitted for stroke in England, Wales and Northern Ireland were given a bed on a specialist stroke unit.
He said that scans should also be taken at the earliest possible moment.
"In many European countries it is performed on admission in the A&E department, while in the UK many units struggle to provide it within 24 hours."
Fewer than half of patients get a scan within 24 hours, according to the audit.
Joe Korner, from the Stroke Association, said that it had been concerned about the UK's poor record for years.
He said: "But it is vital that stroke gets the priority and investment it needs - without investment hundreds will die needlessly.
"Public awareness of stroke also needs to be increased so that people can recognise the warning signs of a stroke and dial 999 immediately.
"It is unacceptable that at the present time, for people who have a stroke in the UK, their prospects are far bleaker than in other countries."
Health Minister Dawn Primarolo said that a Stroke Strategy was currently out to consultation.
"In the last 10 years, the treatment of stroke in the NHS has progressed rapidly.
"More patients than ever before are being seen by stroke specialists, numbers of stroke deaths are falling, and advancing medical understanding gives every prospect for a real revolution in stroke treatment over the next few years."