In the mid nineties, a national concept of stroke-specialised wards (,,stroke units") had been developed by an expert committee of the German Neurological Society. based on elements of the anglosaxon stroke units. The German stroke unit-concept, however, goes beyond the angosaxon one in that it aims at a pathogenetically oriented hyperacute diagnostic wark-up and treatment. This paper describes the further development of the present stroke concept towards an exhaustive management of acute stroke patients in Germany. This is why two different levels of supply are suggested, the Supraregional stroke unit and the Regional stroke unit. The Supraregional stroke unit constitutes a competence center and is the core of a stroke care network located at the top hospitals (,,Maximalversorgung"), and, as a rule, at the neurological department. It requires several structural, technical and staff resources. By contrast, the Regional stroke unit has less technical and staff requirements and is located at middle-level hospitals either in the neurological or internal departments. Good procedural quality in these Regional stroke units will be guaranteed by a stroke-specific high qualification of physicians and other medical staff. By means of this concept, high-level management of acute stroke patients, nation-wide within a stroke unit network will become reality. Regional Stroke Associations are encouraged to further refine stroke management.
