RESUMO
Despite all efforts that have been made stroke is a burden and remains one of the most devastating neurological diseases. Treatment of patients on a Stroke Unit improves stroke prognosis and is recommended for all patients with acute stroke. In rural areas population-wide implementation of Stroke Units is extremely challenging. Therefore the Telemedical Project for integrated Stroke Care (TEMPiS) was established in 2003 as a TeleStroke network to overcome this barrier in Southeast Bavaria/Germany. TEMPiS was one of the very early telemedical stroke networks worldwide and was evaluated intensively during its implementation phase between February 2003 and December 2005. It was shown to be effective in providing safe and extended thrombolysis and in improving stroke outcome. TEMPiS hereby has always been concentrating on the key features of the network: 1. implementation of stroke wards in each hospital, 2. usage of standard operating procedures (SOP), 3. center-based and on-site training, 4. quality management and 5. 24/7 availability of teleconsultations. The TeleStroke Unit network TEMPiS is an example of how the challenges of area-wide implementation of Stroke Units in rural areas can be met. Stroke Units supported by telemedicine, so-called TeleStroke Units, can perform high quality level of acute stroke care and should always be considered in regions, where implementation of standard Stroke Units is not feasible.