THE TREATMENT OF ACUTE STROKE PATIENTS ON THE STROKE UNIT - FIRST EXPERIENCES WITH AN ACUTE STROKE UNIT IN GERMANY

We studied the effects of stroke unit care in an acute Neurology depar tment on the outcome and the length of hospital stay in acute stroke p atients. After an emergency evaluation on admission including CCT, ult rasound studies and ECC the patients were treated on a specialist stro ke unit for an average 3.9 days. For 48 +/- 24 h monitoring of blood p ressure, EGG, pO(2) and transcranial Doppler sonography was instituted . Stroke unit treatment reduced the length of hospital stay from an av erage 15.8 days in the time period before institution of the stroke un it to 12.9 days. This effect was especially marked in patients with ac ute occlusion of major intracranial arteries (before stroke unit treat ment: n = 33; hospital stay 22.5 days; after stroke unit treatment: n = 54; hospital stay 13.9 days), Clinical deterioration in acute ischem ic stroke was related to reduction of cerebral blood flow velocities d ue to blood pressure changes or space occupying effects. Monitoring on the stroke unit allowed immediate treatment of systemic hypotension, cerebral edema or cardiac arrhytmias. Transcranial Doppler sonography revealed HITS in 6/55 acute stroke patients without new clinical sympt oms. Monitoring on the stroke unit improved the specific care for acut e stroke patients. The length of hospital stay was reduced after strok e unit care.