Abstract
Stroke is the leading cause of disability and the third leading cause of death in the United States. The brain attack coalition (BAC), whose members belong to several professional medical societies, formed a working group to explore the factors and elements that are associated with better clinical outcome after acute stroke. In the year 2000, the BAC published the recommendations for primary stroke centers (PSC). The primary goals for the PSC are to improve and to standardize stroke care. Convinced by the compelling data on the PSC, the Joint Commission on Accreditation of Healthcare Organization adopted the BAC recommendations and started certifying hospitals as designated PSCs. Many hospitals are already certified and numerous others are currently seeking certification. The BAC is now working on the recommendations for a comprehensive stroke center. The nihilism which dominated the stroke field has finally been replaced by remarkable progress and better understanding of stroke and stroke treatment.