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What is a Comprehensive Stroke Center?

The Golden Three-Hour Window


Updated July 29, 2008

What is a Comprehensive Stroke Center?


Photo © A.D.A.M.

In the late 1990s, researchers tested t-PA, a potent blood thinner for the treatment of acute stroke. The results were encouraging, showing significant recovery in those people who were treated with it, although this benefit was only seen when tPA was given within the first three hours after the onset of stroke symptoms.

In the years that followed, it became increasingly clear that unless a system was in place to quicken the transportation, triaging and diagnostic testing of stroke patients, most people who could benefit from this treatment would invariably miss this 3-hour window.

Then, in 2000, a group of stroke experts from the Brain Attack Coalition (BAC) proposed the creation of two types of stroke centers, which would give "ultrarapid" stroke care: primary and comprehensive stroke centers. These centers would provide the stabilization and treatment of most acute strokes, with the exception of those which require special surgical techniques or equipment. Patients with these uncommonly dangerous strokes could then be transferred to the second type of stroke center, a comprehensive stroke center, which are typically the largest and best-equipped hospitals in a given geographical area that can treat any kind of stroke or stroke complication.

Hospitals earn the title of "comprehensive stroke center" by having personnel with expertise in the following areas:

Diagnostic techniques

Surgical and interventional therapies


Educational/research programs

  • Community education
  • Community prevention
  • Professional education
  • Patient education

Dion JE., Management of ischemic stroke in the next decade: stroke centers of excellence. J Vasc Interv Radiol. 2004 Jan;15(1 Pt 2):S133-41

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