Table 1

General summary of capabilities of level 1, 2, and 3 centers

Level 1 centerLevel 2 centerLevel 3 center
Offers full spectrum of neuroendovascular therapy (including aneurysm treatment, surgical and endovascular, arteriovenous malformations, arteriovenous fistulas, etc)YesNoNo
Offers endovascular stroke therapyYesYesNo
Offers intravenous tissue plasiminogen activatorYesYesYes
Minimum No of stroke patients per year25010050
Minimum thrombectomy volume per year5050N/A
Dedicated neuro-intensive care unitYesOptionalNot needed
Dedicated stroke unitYesYesYes
Open neurosurgical services on siteYesOptionalNot needed
Geographic restriction?NoYes (should be more than 2 hours' transport time from a level 1 center)No
Inter-facility transfersReceives cases from level 1 and 2 centersWill transfer some cases to a level 1 center. Will occasionally receive transfers from level 3 centers if no level 1 center is available within 2 hours from the level 3 centerHas standardized transfer processes in place with a level 1 center (preferable), or a level 2 center