Non-invasive sensor technology for prehospital stroke diagnosis: Current status and future directions

The diagnosis of stroke in the prehospital environment is the subject of intense interest and research. There are a number of non-invasive external brain monitoring devices in development that utilize various technologies to function as sensors for stroke and other neurological conditions. Future increased use of one or more of these devices could result in substantial changes in the current processes for stroke diagnosis and treatment, including transportation of stroke patients by emergency medical services.

The present review will summarize information about 10 stroke sensor devices currently in development, utilizing various forms of technology, and all of which are external, non-invasive brain monitoring devices.

Ten devices are discussed including the technology utilized, the indications for use (stroke and, when relevant, other neurological conditions), the environment(s) indicated for use (with a focus on the prehospital setting), a description of the physical structure of each instrument, and, when available, findings that have been published in peer-reviewed journals or otherwise reported. The review is organized based on the technology utilized by each device, and seven distinct forms were identified: accelerometers, electroencephalography (EEG), microwaves, near-infrared, radiofrequency, transcranial doppler ultrasound, and volumetric impedance phase shift spectroscopy.

Non-invasive external brain monitoring devices are in various stages of development and have promise as stroke sensors in the prehospital setting. Some of the potential applications include to differentiate stroke from non-stroke, ischemic from hemorrhage stroke, and large vessel occlusion (LVO) from non-LVO ischemic stroke. Successful stroke diagnosis prior to hospital arrival could transform the current diagnostic and treatment paradigm for this disease.