Adult stroke summary.

Strokes are the third leading cause of death in the United States. The incidence of strokes in this country is staggering, with nearly 795,000 people suffering a new stroke or repeated stroke every year. Given the time-sensitive nature of treatment and the expertise needed to make these critical decisions, significant changes have been made to stroke care. Regionalization of stroke care was not widely considered prior to the National Institute of Neurological Disorders and the Stroke (NINDS) recombinant tissue plasminogen activator (rtPA) trial. The systems of care concept consist of healthcare providers’ first detection of strokes signs and symptoms and ultimately rapid admission to a stroke unit for definitive care. The ‘‘D’s of Stroke Care’’ define major steps in the diagnosis and treatment of strokes: