Editor–Julien Bogousslavsky highlights the need for further trials of thrombolysis in patients presenting soon after the onset of acute ischaemic stroke.1 However, before randomisation the patient must have computed tomography to exclude intracranial haemorrhage as the cause of the stroke. Computed tomography has not been widely available in the United Kingdom.2 Accident and emergency departments are well placed to perform the initial triage and assessment of patients presenting with acute stroke, but a selective audit suggested that access to computed tomography in these departments was patchy.3 We …