A review of the role of stroke units in the modern day management of stroke--implications for stroke care in Singapore.

Among the strategies to combat stroke, an important cause of mortality and morbidity in Singapore, is the establishment of stroke units. Stroke units are characterised by a geographical co-location of stroke patients or care by a mobile multidisciplinary stroke team of specialists; the provision of 24-hour CT scanning, laboratory, monitoring, neurology and neuroradiology services, and availability of neurosurgical and angiography services is recommended. Stroke intensive care units are expensive to run and do not reduce mortality-however, they may have a role for the aggressive management of carefully selected patients. Non-intensive stroke and rehabilitation units have been shown to reduce mortality, morbidity, institutionalisation, and even length of stay and healthcare costs. They facilitate better utilisation of resources, audit, teaching and clinical research. As the number of stroke patients in Singapore is expected to rise, with minor reorganisation, all Singapore hospitals should be able to establish their own stroke units.