[Stroke unit: the best treatment for stroke patients]

Area of Science:

• Neurology
• Cardiovascular Medicine
• Public Health

Background:

• Intravenous fibrinolysis within 3 hours of symptom onset and admission to a Stroke Unit (SU) are critical for acute ischemic stroke treatment.
• Neurologists in Spain have safely administered intravenous fibrinolysis for decades, with increasing patient numbers and accredited centers.
• Spain's contribution to the SITS-MOST registry confirms the efficacy and safety of fibrinolysis in clinical practice, comparable to global results.

Discussion:

• The adoption rate of fibrinolysis remains low but is expected to rise with extended therapeutic windows and fewer contraindications.
• Stroke Units (SUs) are pivotal in stroke care, demonstrating improved morbidity-mortality, cost-effectiveness, and reduced complications.
• SUs facilitate the expansion of fibrinolysis and serve as hubs for implementing novel treatments like neuro-interventionism and telemedicine.

Key Insights:

• Fibrinolysis has spurred the development of regional stroke care plans and SUs in Spain.
• Stroke Units offer superior stroke management, improving patient outcomes and reducing long-term disability.
• Neurologists are uniquely positioned to lead stroke care, including the administration of intravenous fibrinolysis.

Outlook:

• The National Strategy in Stroke presents a significant opportunity to enhance neurological stroke care.
• Further research and policy changes can increase fibrinolysis utilization and improve patient access to advanced stroke treatments.
• Integration of new therapies within SUs will be crucial for future stroke management.