[Is hospital admission urgent in stroke?]

To review the evidence that strokes need urgent hospital admission.

The need for urgent hospitalization varies with stroke type. Immediate hospital admission it is unquestionable for subarachnoid hemorrhage and probably also for intracerebral hemorrhages. An acute CT can disclose non-vascular pathology, an hemorrhage or early infarct signs. Being examined by a neurologist within six hours from onset improves outcome. How early should a cardioembolic stroke be anticoagulated is still a matter of debate. Aspirin and nadroparine given within 48 hours improve acute ischemic stroke outcome. A 10% benefit on functional outcome was obtained by IV rtPA, given within three hours. The majority of acute stroke trial with neuroprotectors have a six hours windows design, but the percentage of patients arriving hospital within that interval is variable.

Early hospital admission of acute stroke is beneficial. An educational effort is needed to increase early hospital referral of acute stroke patients.