title: Telestroke-the promise and the challenge. Part one: growth and current practice.
abstract: Acute ischemic stroke remains a major public health concern, with low national treatment rates for the condition, demonstrating a disconnection between the evidence of treatment benefit and delivery of this treatment. Intravenous thrombolysis and endovascular thrombectomy are both strongly evidence supported and exquisitely time sensitive therapies. The mismatch between the distribution and incidence of stroke presentations and the availability of specialist care significantly affects access to care. Telestroke, the use of telemedicine for stroke, aims to surmount this hurdle by distributing stroke expertise more effectively, through video consultation with and examination of patients in locations removed from specialist care. This is the first of a detailed two part review, and explores the growth and current practice of telestroke, including the specific role it plays in the assessment and management of patients after emergent large vessel occlusion.
authors.affiliation: Department of Stroke Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: F
authors.initials: F
authors.lastname: Akbik
authors.affiliation: Department of Interventional Neuroradiology, Massachusetts General Hospital, Boston, Massachusetts, USA.|Department of Neuroendovascular, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Hirsch
authors.affiliation: Department of Neuroendovascular, Monash University Hospital, Melbourne, Australia.
authors.forename: R V
authors.initials: RV
authors.lastname: Chandra
authors.affiliation: Department of NeuroInterventional Surgery, Radiology Imaging Associates/RIA Neurovascular, Swedish Medical Center, Englewood, Colorado, USA.
authors.forename: D
authors.initials: D
authors.lastname: Frei
authors.affiliation: Department of Neuroendovascular, Massachusetts General Hospital, Boston, Massachusetts, USA.|Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: A B
authors.initials: AB
authors.lastname: Patel
authors.affiliation: Department of Interventional Neuroradiology, Massachusetts General Hospital, Boston, Massachusetts, USA.|Department of Neuroendovascular, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Rabinov
authors.affiliation: Department of Stroke Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: N
authors.initials: N
authors.lastname: Rost
authors.affiliation: Department of Stroke Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: L H
authors.initials: LH
authors.lastname: Schwamm
authors.affiliation: Department of Stroke Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.|Department of Neuroendovascular, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Leslie-Mazwi
mesh_terms: D019468:Disease Management; D006801:Humans; D020521:Stroke / Q000175:diagnosis* / Q000628:therapy*; D017216:Telemedicine / Q000379:methods / Q000639:trends*; D015912:Thrombolytic Therapy / Q000379:methods / Q000639:trends
keywords: History; Stroke; Thrombectomy; Thrombolysis