[The latency of hospital admission in an acute cerebral accident]

Variable time is the main limiting factor of the current possibilities of treatment of patients with acute cerebral attack. Different authors have demonstrated the need for prompt hospital arrival: the concept of therapeutic window, the possibility of treatment with thrombolytic and neuroprotector drugs, the possibility of receiving adequate support therapy, treatment in an ictus unit, the need for appropriate differential diagnosis and the socioeconomic consequences which all of the above represent. However, at present the arrival of patients to hospital is excessively delayed due to different demographic, organizational, educational and medical factors and, in addition, intrahospital delays are produced in the diagnosis and treatment of these patients. The main factor for these delays is the indecision of the patient in going to the hospital and the best way of forwarding the latency of arrival is rapid request of emergency transportation. To shorten the time of patient care different factors related to the detection, transportation, emergency unit screening, attainment of complementary tests, protocols of diagnostic and therapeutic decision and the administration of specific treatments should be attended. Fortunately, recent contributions have demonstrated the efficacy of treatments in the first hours of evolution and therefore special emphasis should be given to the variable time since, in cases of acute cerebral attack, "time is brain".