Randomized clinical trials and observational studies suggest that sev-
eral elements of a stroke center would improve patient care and outcomes. Key ele-
ments of primary stroke centers include acute stroke teams, stroke units, written care
protocols, and an integrated emergency response system. Important support services
include availability and interpretation of computed tomography scans 24 hours everyday
and rapid laboratory testing. Administrative support, strong leadership, and continu-
ing education are also important elements for stroke centers. Adoption of these rec-
ommendations may increase the use of appropriate diagnostic and therapeutic mo-
dalities and reduce peristroke complications. The establishment of primary stroke centers
has the potential to improve the care of patients with stroke.