RT Journal Article SR Electronic T1 Set up and run a thrombolysis service for acute stroke JF Practical Neurology JO Pract Neurol FD BMJ Publishing Group Ltd SP 145 OP 151 DO 10.1136/jnnp.2010.211615 VO 10 IS 3 A1 Keith W Muir A1 Tracey Baird YR 2010 UL http://pn.bmj.com/content/10/3/145.abstract AB Intravenous thrombolysis significantly improves the chance of independent recovery from ischaemic stroke but its benefit is strongly time dependent: present evidence supports effectiveness when delivered up to 4.5 h after symptom onset but the chance of recovery is twice as great when it is given within 90 min compared with 3–4.5 h. Delivery of treatment to a high proportion of patients is possible but requires clinicians to optimise systems for patient transfer, clinical and radiological assessment. A high proportion of patients with stroke already present to UK hospitals within the treatment time window even without specific public awareness or prehospital triage. Establishing a service requires dialogue with all those involved in the patient pathway, including ambulance dispatchers, paramedics, emergency department staff, radiology and colleagues in acute medicine. Most acute stroke teams cross traditional medical disciplines. Thrombolysis should ideally be delivered within an integrated service that seamlessly includes acute stroke unit care and rehabilitation.