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Neuroscience Institute

AGH Comprehensive Stroke Center

Comprehensive Stroke Center

West Penn Allegheny Health System provides state-of-the-art stroke services at the Allegheny General Hospital (AGH) Comprehensive Stroke Center.

Founded in 1988, AGH's stroke program fulfills the Joint Commission's criteria for a Comprehensive Stroke Center, with advanced capabilities to manage the most complex patients with stroke and intracranial hemorrhage (bleeding in the brain). Furthermore, the center provides NeuroCritical care, endovascular therapies, neurosurgical care and access to clinical trials. The AGH Comprehensive Stroke Center is a multidisciplinary team of board-certified neurologists specializing in stroke, vascular neurosurgeons, and neuro-interventionalists with subspecialty expertise in stroke.

Patients benefit from advanced stroke care resulting in improved survival and reduced disability after suffering a stroke. Acute stroke care is provided by stroke neurologists (24-hour service) at AGH who provide rapid care directly at the bedside or remotely through telemedicine to treat eligible acute stroke patients with intravenous tissue plasminogen activator (rt-PA) “clot busting medication.”

What is a Comprehensive Stroke Center?

The Joint Commission's Certificate of Distinction for Comprehensive Stroke Centers recognizes the nation's preeminent and most capable referral centers for the treatment of complex stroke injuries and cerebrovasculardisease. Achievement of certification signifies that the services provided at  a Comprehensive Stroke Center have the critical elements to achieve long-term success in improving outcomes. The quality care we provide is effectively managed to meet the unique and specialized needs of our stroke patients.

The Joint Commission's Comprehensive Stroke Center Certification program was developed in collaboration with the American Stroke Association and is based on the Brain Attack Coalition's "Recommendations for the Establishment of Comprehensive Stroke Centers."

The following are major services and procedures that the Allegheny General Hospital Comprehensive Stroke Center must have shown competence in to become certified by the Joint Commission as a Comprehensive Stroke Center: 

  • Catheter angiography available on site 24 hours a day, 7 days a week
  • CT angiography available on site 24 hours a day, 7 days a week
  • MR angiography (MRA) available on site 24 hours a day, 7 days a week
  • MRI, including diffusion-weighted MRI, available on site 24 hours a day, 7 days a week
  • Dedicated neuro-intensive care unit (ICU) beds for complex stroke patients
  • Dedicated neuro-ICU beds for complex stroke patients that include staff and licensed independent practitioners with the expertise and experience to provide neuro-critical care 24 hours a day, 7 days a week
  • Access to neurosurgical services (24 hour availability to a brain surgeon)
  • A physician with expertise in interpreting CT or MRI studies must be available within 20 minutes of being asked to read a study (Telestroke and Interventional Neuroradiologist 24 hour availability)
  • Peer review process to review and monitor the care provided to patients with ischemic stroke, subarachnoid hemorrhage and administration of tPA
  • Participate in Institutional Review Board (IRB)–approved, patient-centered stroke research
  • Specialized diagnostic testing including
    • Transcranial Doppler
    • Carotid duplex ultrasound
    • Extracranial ultrasonography
    • Transesophageal and transthoracic echocardiography
  • Post-hospital care coordination for patients
  • Lab tests, EKG, and CT scan of patients with acute stroke completed within 45 minutes of being ordered
  • The Medical organization must have a declared and established commitment for acute stroke care
  • The hospital must have written acute stroke “clinical pathways” or “career maps”
  • An acute stroke team, including a physician and at least one other healthcare professional, must be available around the clock
  • Follow long-term stroke treatment outcomes, and design quality improvement activities
  • Emergency staff must have completed formal training in acute stroke treatments
  • The hospital must have a “stroke unit”
  • There must be a designated stroke center director
  • The stroke team must schedule stroke medical education sessions for stroke staff
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