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Pre-Hospital Diagnosis in Mobile Stroke Unit
Ramnath Santosh Ramanathan1, Dolora Wisco1, Daniel Vela-Duarte1
1Cerebrovascular Center, Neurological Institute, Cleveland Clinic, 9500 Euclid Ave, S80, Cleveland, OH 44195, United States.
Summary
Mobile stroke units (MSU) treat emergent neurological conditions beyond acute ischemic stroke (AIS). These mobile units effectively manage stroke mimics and intracranial hemorrhages, expanding their pre-hospital treatment capabilities.
Area of Science:
- Neurology
- Emergency Medicine
- Pre-hospital Care
Background:
- Mobile stroke units (MSU) are established for rapid pre-hospital thrombolysis in acute ischemic stroke (AIS).
- MSUs encounter a range of neurological emergencies beyond AIS requiring immediate intervention.
Purpose of the Study:
- To analyze the spectrum of neurological conditions treated by MSUs.
- To evaluate the utility of MSUs in managing non-AIS emergent neurological disorders.
Main Methods:
- Prospective data collection from 221 consecutive MSU encounters.
- Pre-hospital diagnosis using clinical evaluation and neuroimaging on MSU.
- Categorization of diagnoses into AIS, intracranial hemorrhage, and stroke mimics.
Main Results:
- Approximately one-third of MSU encounters involved conditions other than AIS.
- Intracranial hemorrhage accounted for 7% and stroke mimics for 27% of encounters.
- Common stroke mimics included metabolic encephalopathy, seizures, and migraines.
Conclusions:
- MSUs treat a significant proportion of non-AIS emergent neurological conditions.
- The capabilities of MSUs extend to managing intracranial hemorrhage and stroke mimics.
- MSUs offer valuable pre-hospital treatment for diverse critical neurological presentations.
