title: Treatment of ischemic stroke with r-tPA: implementation challenges in a tertiary hospital in Brazil.
abstract: OBJECTIVE
  This paper presents the initial experience with thrombolysis for acute ischaemic stroke at Hospital de Base do Distrito Federal (HBDF), Brazil, and the difficulties associated with the implementation of this treatment.
  
  
  METHODS
  A retrospective study was performed using the medical records of all patients with acute stroke who were treated with intravenous alteplase in our department, between May 2011 and April 2012.
  
  
  RESULTS
  The thrombolytic therapy was administered to 32 patients. The mean time between the ictus and the start of stroke therapy start was 195 (60-270) minutes. Sixteen patients demonstrated a significant clinical improvement (decrease in National Institute Health Stroke Scale [NIHSS] score≥4 points in 24 hours); 6 patients were discharged with an NIHSS score of 0 and 2 demonstrated haemorrhagic transformation.
  
  
  CONCLUSIONS
  The results of our study are similar to those reported in the literature, although we have been dealing with difficulties, such as the lack of a stroke unit.
authors.affiliation: Brazilian Academy of Neurology, Brasília, DF, Brazil.
authors.forename: Elza Dias
authors.initials: ED
authors.lastname: Tosta
authors.affiliation: Serviço de Neurologia, Hospital de Base do Distrito Federal, Brasília, DF, Brazil.
authors.forename: Letícia Costa
authors.initials: LC
authors.lastname: Rebello
authors.affiliation: Serviço de Neurologia, Hospital de Base do Distrito Federal, Brasília, DF, Brazil.
authors.forename: Soraya Soares
authors.initials: SS
authors.lastname: Almeida
authors.affiliation: Serviço de Neurologia, Hospital de Base do Distrito Federal, Brasília, DF, Brazil.
authors.forename: Márcia Silva Santos
authors.initials: MS
authors.lastname: Neiva
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy*; D001938:Brazil; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D020521:Stroke / Q000188:drug therapy*; D062606:Tertiary Care Centers; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator