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Updated: Jul 11, 2026

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
Published on: July 21, 2013
Large Vessel Occlusion Stroke Detection in the Prehospital Environment
Lauren Patrick1, Wade Smith1, Kevin J Keenan2
1University of California San Francisco, 505 Parnassus Ave, S784, San Francisco, CA 94122, USA.
Purpose Of Review:
Endovascular therapy for acute ischemic stroke secondary to large vessel occlusion (LVO) is time-dependent. Prehospital patients with suspected LVO stroke should be triaged directly to specialized stroke centers for endovascular therapy. This review describes advances in LVO detection among prehospital suspected stroke patients.
Recent Findings:
Clinical prehospital stroke severity tools have been validated in the prehospital setting. Devices including EEG, SSEPs, TCD, cranial accelerometry, and volumetric impedance phase-shift-spectroscopy have recently published data regarding LVO detection in hospital settings. Mobile stroke units bring thrombolysis and vessel imaging to patients.
Summary:
The use of a prehospital stroke severity tool for LVO triage is now widely supported. Ease of use should be prioritized as there are no meaningful differences in diagnostic performance amongst tools. LVO diagnostic devices are promising, but none have been validated in the prehospital setting. Mobile stroke units improve patient outcomes and cost-effectiveness analyses are underway.
Related Concept Videos
Ischemic Stroke l: Introduction
Hemorrhagic Stroke l: Introduction
Hemorrhagic Stroke ll: Pathophysiology

