Background and Aims: Different obstacles are perceived to administrate intravenous thrombolysis (IVT) in acute ischemic stroke (AIS). Some of them are specific to Algeria. The rate of IVT in AIS in Bab El Oued University Hospital is < 2%. We aim to identify the causes of this low rate and propose solutions to improve it. Methods: We conducted a prospective observational study at Bab El Oued University Hospital between April 2017 and October 2018. This study included 415 acute stroke patients admitted to the hospital. A standardized questionnaire was administered for all patients. The eligibility of patients with early presentation for IVT was judged according to standard guidelines. We identified causes of delayed presentation of patients and obstacles to IVT. Results: 290 patients (70%) arrived at hospital after 4.5h from onset. The main causes of delayed presentation were: ignorance of patients and their relatives about symptoms of stroke or acute intervention for stroke 184/290 (63%), and misdiagnosis or non-directing to acute intervention by the first physician examining patient 90/290 (31%). 68 patients (16%) arrived within 4.5h from onset, only 23 patients were thrombolysed. Missing the therapeutic window was the main cause of non eligibility of AIS patients for IVT. Conclusions: A comprehensive action plan based on public awareness and training program for hospital staff must be a priority to improve the rates of IVT in AIS patients admitted in the emergency room of Bab El Oued University Hospital. N/A
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