Community use of intravenous tissue plasminogen activator for acute stroke- Results of the brain matters stroke management survey

Background ann Purpose-Little is known of neurologists' viewpoints regardin g intravenous tPA use or institutional readiness to evaluate potential thro mbolytic candidates. Il Methods-Surveys were distributed at the Brain Matters Stroke Management Wor kshops held in 16 cities in the United States. Results-Intravenous tPA was administered by 46.9% of responding neurologist s. Almost 30% (29.9%) of surveyed neurologists were "very convinced" of its efficacy, whereas 61.6% were "very concerned" about the risk of intracrani al hemorrhage, Only half of the respondents believed their institutions cou ld meet all NINDS-recommended stroke-evaluation time targets. Conclusions-Neurologists' enthusiasm for the efficacy of intravenous tPA is tempered by their concern about intracranial hemorrhage, Institutional rea diness for evaluating acute stroke patients is not optimized.