Table of Contents

Part I : Understanding Your Goals : The What, Why and Who.
1. Essential Basics.
1.1 What Is Stroke?.
1.2 What Happens During a Stroke?.
1.3 Why Set Up a Stroke Service?.
1.4 Understanding the Penumbra Concept.
1.5 Pathophysiology of Thrombosis.
1.6 Understanding That "Time Is Brain".
1.7 What Is a Stroke Pathway?.
1.8 Where Should Stroke Care Take Place?.
1.9 What Is a Stroke Unit?.
1.10 What Is Decompressive Craniectomy?.
1.11 What Is Neuroprotection in Stroke?.
2. Guidelines and Regulations.
2.1 Sources of Supporting Information.
2.2 Guidelines.
3. Who Can Support This Project?.
3.1 Expertise.
3.2 Funding.
4. Basic Milestones in Stroke Treatment.
4.1 Acute Phase.
4.2 Post-acute Phase.
5. Defining Your Priorities.
6. Walking the Steps and Defining Your Own Pathway and Goals on the Way.
6.1 Step 1 : Pre-hospital Care.
6.2 Step 2 : Patient Evaluation.
6.3 Step 3 : Imaging and Diagnosis.
6.4 Step 4 : Primary Stroke Treatment.
6.5 Step 5 : Advanced Stroke Treatment.
6.6 Step 6 : Post-acute Care/Supporting Treatment.
7. Bringing Your Goals into Shape.
8. Examples of Treatment Pathways.
8.1 Imaging Pathways.
9. Specific Pathways in Special Cases.
9.1 Basilar Artery Thrombosis.
9.2 Signs of a Major Vessel Occlusion (MCA/ICA).
9.3 Portable CT Scanners.
9.4 DSA with Interventional Treatment as a Primary Choice.
9.5 Integrated Magnetic Resonance Imaging and X-Ray Angiography.
10. Future Concepts in Stroke Treatment.
10.1 MSU : The Concept of a Mobile Stroke Unit.
10.2 New Strategies for Reduction of the Door-to-Needle Times.
10.3 The Acute Vascular Imaging Concept Using Integrated Imaging.
11. Strategic/Business Management.
11.1 Things to Consider in a Budget.
11.2 Staffing.
11.3 Who Manages Your Project.
11.4 Project Management Plan.
Part II : Planning.
12. Establishing Whom and What You Need in the Stroke Pathway.
12.1 Who Are the Key Parties in a Stroke Service?.
12.2 Meeting Resistance.
12.3 Who Are the Key Parties That Need to be Informed?.
13. Establishing Your Resources (Equipment, Staff, Space).
13.1 Determining Non-personnel Resources.
13.2 Determining Personnel Resources.
14. Budget and Time Frame.
14.1 Benefit-Cost Analysis.
15. Risk Assessment and Management.
16. The Team.
16.1 Setting Up a Project Team.
16.2 Defi ning Team Members' Roles and Responsibilities.
Part III : Getting Started.
17. Work Packages.
18. Work Groups.
18.1 Pre-hospital Phase.
18.2 Acute Phase.
18.3 Post Treatment Phase.
Part IV : Evaluation.
19. Monitoring.
19.1 Project Performance.
19.2 Times and Outcomes.
20. Marketing.
20.1 Dissemination.
20.2 Redefining Your Goals (e.g., Expand Service).
21. Closing Remarks.