The establishment of a telestroke service using multimodal CT imaging decision assistance: “Turning on the fog lights”

Publication date: March 2017 Source:Journal of Clinical Neuroscience, Volume 37 Author(s): Jelle Demeestere, Claire Sewell, Jennifer Rudd, Timothy Ang, Louise Jordan, James Wills, Carlos Garcia-Esperon, Ferdinand Miteff, Venkatesh Krishnamurthy, Neil Spratt, Longting Lin, Andrew Bivard, Mark Parsons, Christopher Levi Telestroke services have been shown to increase stroke therapy access in rural areas. The implementation of advanced CT imaging for patient assessment may improve patient selection and detection of stroke mimics in conjunction with telestroke. We implemented a telestroke service supported by multimodal CT imaging in a rural hospital in Australia. Over 21months we conducted an evaluation of service activation, thrombolysis rates and use of multimodal imaging to assess the feasibility of the service. Rates of symptomatic intracranial haemorrhage and 90-day modified Rankin Score were used as safety outcomes. Fifty-eight patients were assessed using telestroke, of which 41 were regarded to be acute ischemic strokes and 17 to be stroke mimics on clinical grounds. Of the 41 acute stroke patients, 22 patients were deemed eligible for thrombolysis. Using multimodal CT imaging, 8 more patients were excluded from treatment because of lack of treatment target. Multimodal imaging failed to be obtained in one patient. For the 14 treated patients, median door-imaging time was 38min. Median door-treatment time was 91min. A 90-day mRS ⩽2 was achieved in 40% of ...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research