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The Imperative to Develop Dedicated Stroke Centers
H. J. M. Barnett, MD;
Alastair M. Buchan, BM, BCh
JAMA. 2000;283:3125-3126.
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Older practitioners (including one of the authors of this Editorial) will recall the days when patients with stroke were either treated at home or admitted to the hospital for compassionate observation. Neurologists made efforts to localize lesions and confirm functional areas of the brain and brainstem and described many vascular syndromes. Because the individual patient gained little, if anything, from these exercises, there was a public and professional aura of therapeutic helplessness surrounding stroke. Fortunately, those days are over. Optimism about the benefits of treatment coupled with a sense of urgency to deal quickly with every patient with stroke has swept away that nihilism.
Coronary care units were introduced in the 1950s and spread rapidly because they saved lives. These units provided the models for intensive care units concentrating on respiratory enhancement, later for the introduction of trauma units, and . . . [Full Text of this Article]
Author Affiliations: The John P. Robarts Research Institute and The University of Western Ontario, London, Ontario (Dr Barnett); and the Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta (Dr Buchan).
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