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Updated: Aug 16, 2026

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Published on: January 15, 2017
Stroke units, tissue plasminogen activator, aspirin and neuroprotection: which stroke intervention could provide the
Amanda K Gilligan1, Amanda G Thrift, Jonathan W Sturm
1Department of Neurology, Austin and Repatriation Medical Center, Heidelberg, Australia.
Background:
Although a number of acute stroke interventions are of proven efficacy, there is uncertainty about their community benefits. We aimed to assess this within a defined population.
Methods:
Eligibility for tissue plasminogen activator (tPA), aspirin, stroke unit management and neuroprotection were assessed among incident stroke cases within the community-based North East Melbourne Stroke Incidence Study.
Results:
Among 306,631 people, there were 645 incident strokes managed in hospital. When eligible patients were extrapolated to the Australian population, for every 1,000 cases, 46 (95% CI 17-69) could have been saved from death or dependency with stroke unit management, 6 (95% CI 1-11) by using aspirin, 11 (95% CI 5-17) or 10 (95% CI 3-16) by using tPA at 3 and 6 h, respectively.
Conclusions:
Although tPA is the most potent intervention, management in stroke units has the greatest population benefit and should be a priority.
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