BACKGROUND AND PURPOSE Intravenous tissue plasminogen activator improves outcome after ischemic stroke when given within 3 hours of symptoms onset in carefully selected patients. However, only a small proportion of acute stroke patients are currently eligible for thrombolysis, mainly because of excessive delay to hospital presentation. We sought to determine the factors associated with early ad...

The Stroke and Neurovascular Program at the Medical College of Wisconsin and Froedtert Hospital, in Milwaukee, is a comprehensive, interdisciplinary center for stroke medicine. The program encompasses an acute stroke team, a neuro-intensive care unit, a stroke care unit, and a stroke rehabilitation program. The staff includes specialists with fellowship training in stroke, neurocritical care, n...

BACKGROUND Acute cerebral stroke is a common problem that is frequently associated with dysphagia resulting in an increased risk of aspiration pneumonia, complication, and mortality. METHODS A literature review was carried out using the search terms 'stroke unit and endoscopy', 'stroke unit and dysphagia', and 'stroke unit and gastroenterology'. RESULTS Only few papers focus on the role of ...

Arrival Time to Stroke Unit as Crucial a Measure as Arrival Time to Emergency Department To the Editor: We concur with Alexandrov in her recent editorial that “late arrival to the hospital after the onset of acute stroke symptoms is a plague of unheralded proportion. . . ”.1 We are currently conducting a large multicenter, clustered randomized trial in 19 acute stroke units in NSW, Australia.2 ...

BACKGROUND AND PURPOSE Early supported discharge from a stroke unit reduces the length of hospital stay. Evidence of a benefit for the patients is still unknown. The aim of this trial was to evaluate the long-term effects of an extended stroke unit service (ESUS), characterized by early supported discharge. The short-term effects were published previously. METHODS We performed a randomized co...

BACKGROUND Treatment at stroke units is superior to treatment at other types of wards. The objective of the present study is to determine the effect size of stroke unit care in subgroups of patients with stroke. This information might be useful in a formal priority setting. METHODS All acute strokes reported to the Swedish Stroke Register from 2001 through 2005 were followed until January 200...

OBJECTIVE Data about the distribution of stroke severity and its correlates are sparse. In a population-based approach, we determined the NIH Stroke Scale Score (NIHSSS) and studied associations with demographic variables, stroke unit care, etiology, the onset assessment interval (OAI), and the rate of thrombolysis. METHODS We performed a databank-based post-hoc analysis of data ascertained d...

BACKGROUND There is still a considerable delay between the onset of symptoms and arrival at a stroke unit for most patients with acute stroke.The aim of the study was to describe the feasibility of a pre-hospital diagnosis of stroke by an emergency medical service (EMS) nurse in terms of diagnostic accuracy and delay from dialing 112 until arrival at a stroke unit. METHODS Between September 2...

From the Stroke Unit and Department of Neurology (A.C., A.S., R.S.), the Neuro­ interventional Unit and Department of Neuroradiology (L.V., E.B.), and the Bio­ statistics Service and Hematology De­ partment (M.N.), Niguarda Ca’ Granda Hospital, Milan; the Stroke Unit and Department of Neurology, Carlo Poma Hospital, Mantua (A.C.); and the Epide­ miology and Medical Statistics Section, Departmen...