title: Prehospital stroke diagnosis and treatment in ambulances and helicopters-a concept paper.
abstract: Stroke is the second common cause of death and the primary cause of early invalidity worldwide. Different from other diseases is the time sensitivity related to stroke. In case of an ischemic event occluding a brain artery, 2000000 neurons die every minute. Stroke diagnosis and treatment should be initiated at the earliest time point possible, preferably at the site or during patient transport. Portable ultrasound has been used for prehospital diagnosis for applications other than stroke, and its acceptance as a valuable diagnostic tool "in the field" is growing. The intrahospital use of transcranial ultrasound for stroke diagnosis has been described extensively in the literature. Beyond its diagnostic use, first clinical trials as well as numerous preclinical work demonstrate that ultrasound can be used to accelerate clot lysis (sonothrombolysis) in presence as well as in absence of tissue plasminogen activator. Hence, the use of transcranial ultrasound for diagnosis and possibly treatment of stroke bares the potential to add to current stroke care paradigms significantly. The purpose of this concept article is to describe the opportunities presented by recent advances in transcranial ultrasound to diagnose and potentially treat large vessel embolic stroke in the prehospital environment.
authors: Department of Radiology, Brain Ultrasound Research Laboratory (BURL), University of California, San Diego, CA, USA. thoelscher@ucsd.edu
authors: Thilo
authors: T
authors: Hölscher
authors: James V
authors: JV
authors: Dunford
authors: Felix
authors: F
authors: Schlachetzki
authors: Sandra
authors: S
authors: Boy
authors: Thomas
authors: T
authors: Hemmen
authors: Brett C
authors: BC
authors: Meyer
authors: John
authors: J
authors: Serra
authors: Jeff
authors: J
authors: Powers
authors: Arne
authors: A
authors: Voie
mesh_terms: D017732:Air Ambulances; D000552:Ambulances; D004632:Emergency Medical Services; D006801:Humans; D020521:Stroke / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D014463:Ultrasonography