During all but the last 5 years of the 20th century, life was rather simple for health care planners who were concerned with care for patients with stroke. There was no proven effective treatment; therefore, no special guidelines were required. Stroke care changed significantly in 1995, when intravenous (IV) tissue plasminogen activator (tPA) was found to be an effective treatment when given soon after stroke onset. With the intent of improving care, hospitals were encouraged to develop primary stroke centers (PSCs) that had sufficient medical personnel, technology, and protocols that would enable them to deliver IV tPA efficiently.
Caplan LR. Primary Stroke Centers vs Comprehensive Stroke Centers With Interventional Capabilities: Which Is Better for a Patient With Suspected Stroke? JAMA Neurol. 2017;74(5):504–506. doi:10.1001/jamaneurol.2017.0006
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