Table 2. Proposed Components of Comprehensive Stroke Center (7).

Recommendation	Optional
Personnel with expertise in the following areas
Vascular neurology	Neuroscience intensive care
Vascular neurosurgery	Nursing director for stroke program
APN
Vascular surgery
Diagnostic radiology/neuroradiology
Interventional/endovascular physician(s)
Critical care medicine
Physical medicine and rehabilitation
Rehabilitation therapy (physical, occupational, speech therapy)
Staff stroke nurse(s)
RT
Swallowing assessment
Diagnostic techniques
MRI with diffusion	MR perfusion
MRA/MRV	CT perfusion
CTA	Xenon CT
Digital cerebral angiography	SPECT
TCD	PET
Carotid duplex U/S
Transesophageal echo
Surgical and interventional therapies
CEA (IA)
Clipping of intracranial aneurysm	Stenting/angioplasty of extracranial vessels*
Placement of ventriculostomy	Stenting/angioplasty of intracranial vessels*
Hematoma removal/draining
Placement of intracranial pressure transducer
Endovascular ablation of IAs/AVMs
IA reperfusion therapy
Endovascular Rx of vasospasm
Infrastructure
Stroke unit†
ICU	Stroke clinic
Operating room staffed 24/7	Air ambulance
Interventional services coverage 24/7	Neuroscience ICU
Stroke registry
Educational/research programs
Community education	Clinical research
Community prevention	Laboratory research
Professional education	Fellowship program
Patient education	Presentations at national meetings

^*Although these therapies are currently not supported by grade IA evidence, they may be useful for selected patients in some clinical settings. Therefore, a CSC that does not offer these therapies should have an established referral mechanism and protocol to send appropriate patients to another facility that does offer these therapies;

^†stroke unit may be part of an ICU.

Rx indicates therapy.