• J Masjuan Vallejo.
• Neurologia. 2009 Jun 1; 24 (5): 285-7.

IntroductionIntravenous fibrinolysis in the first 3 hours from the onset of the symptoms and admission to a Stroke Unit (SU) are fundamental cornerstones of the acute ischemic stroke treatment. Intravenous fibrinolysis in Spain has been performed by the neurologists since the beginning of the century within the safety registries. The number of patients treated and accredited centers have progressively increased in recent years.DevelopmentThe SITS-MOST registry showed its efficacy and safety in the usual clinical practice. Spain contributed 11.9% of the patients and we now know that our results are comparable to those of the rest of the world. Although the percentage of patients still treated compared to the total of stroke patients is low, this can be expected to increase significantly with the increase of the therapeutic window and as some of the current and so controversial contraindications disappear.ConclusionsFibrinolysis has served to dynamize the Care regarding Stroke in Spain through the creation of the Regional Health Care Plans and the SU. The SU is the best treatment of stroke since they improve the morbidity-mortality with a favorable cost/efficacy balance, reducing the complications and dependence. Most of the strokes (including transient ischemic attacks and cerebral hemorrhages) benefit from them. The SU is the basis from which the number of fibrinolyses can be increased, where general cares can be applied and where new therapeutic measures such as Neuro-Interventionism, Tele-Medicine or the development of new drugs can be implemented. The publication of the National Strategy in Stroke by the Health Care Ministry is a unique opportunity to improve neurological care of stroke. No one more than the neurologists know how to treat stroke and up to now, we are the only specialists who have demonstrated that we know how to apply intravenous fibrinolysis.

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