title: [Mission (im)possible : Setting up a neurological center 12,000 km away with telemedicine].
abstract: BACKGROUND
  Specialized neurological treatment decreases the mortality and morbidity of stroke patients. In many regions of the world an extensive coverage is not available. The cooperation between the Krankenhaus Nordwest (KHNW, Frankfurt, Germany) and the Government of Brunei Darussalam describes the set-up process of a specialized neurological center, including stroke unit, science and rehabilitation center.
  
  
  OBJECTIVE
  The aim of this project called to teach to treat - to treat to teach was to set up a center of excellence in neurology in Brunei Darussalam over a distance of 12,000 km. Treatment options were elucidated by teaching and taught by case examples.
  
  
  METHODS
  The construction of the Brunei Neuroscience Stroke and Rehabilitation Center (BNSRC) began in July 2010. To overcome the large distance between the department of neurology and neuroradiology at the KHNW and the BNSRC, a telemedical network was established. We provided daily teleteaching for all professions involved in patient care as well as 24/7 availability of teleneurological services from Germany to support the local team on site.
  
  
  RESULTS
  In the BNSRC unit over 1000 patients with ischemic and hemorrhagic stroke and all the various acute neurological conditions were treated from July 2010 until July 2016 as inpatients and over 5000 were treated as outpatients. Since 2010, a total of 52 patients with stroke were treated by thrombolysis within the thrombolytic window and 81 hemicraniectomies were performed.
  
  
  CONCLUSIONS
  The project has shown that it is possible to convey specialized neurological knowledge over large distances to provide significant benefits for patients and caregivers.
authors.affiliation: Klinik für Neurologie, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, 60488, Frankfurt, Main, Deutschland. meyding-lamade.uta@khnw.de.
authors.forename: U
authors.initials: U
authors.lastname: Meyding-Lamadé
authors.affiliation: Klinik für Neurologie, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, 60488, Frankfurt, Main, Deutschland.
authors.forename: E M
authors.initials: EM
authors.lastname: Craemer
authors.affiliation: Medizinische Fakultät, Ludwig-Maximilians-Universität München, München, Deutschland.
authors.forename: E K
authors.initials: EK
authors.lastname: Lamadé
authors.affiliation: Klinik für Neurologie, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, 60488, Frankfurt, Main, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Bassa
authors.affiliation: Klinik für Neurologie, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, 60488, Frankfurt, Main, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Enk
authors.affiliation: Klinik für Neurologie, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, 60488, Frankfurt, Main, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Ilsen
authors.affiliation: Klinik für Neurologie, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, 60488, Frankfurt, Main, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Jacobi
authors.affiliation: Klinik für Neurologie, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, 60488, Frankfurt, Main, Deutschland.
authors.forename: V
authors.initials: V
authors.lastname: Jost
authors.affiliation: Klinik für Neurologie, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, 60488, Frankfurt, Main, Deutschland.
authors.forename: M W
authors.initials: MW
authors.lastname: Lorenz
authors.affiliation: Klinik für Neurologie, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, 60488, Frankfurt, Main, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Mohs
authors.affiliation: Klinik für Neurologie, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, 60488, Frankfurt, Main, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Schwark
authors.affiliation: Klinik für Neurologie, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, 60488, Frankfurt, Main, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Zimmerlein
authors.affiliation: Geschäftsführung, Krankenhaus Nordwest, Frankfurt, Main, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Gottschalk
authors.affiliation: Neurologische Klinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: Hacke
authors.affiliation: Klinik für Neuroradiologie, Krankenhaus Nordwest, Frankfurt, Main, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Kress
mesh_terms: D002010:Brunei; D003194:Computer-Assisted Instruction / Q000379:methods; D020375:Education, Distance / Q000458:organization & administration*; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D005858:Germany; D009462:Neurology / Q000193:education* / Q000458:organization & administration*; D012047:Rehabilitation Centers / Q000458:organization & administration*; D000071939:Stroke Rehabilitation
keywords: Administration; Education; Neurology; Neuroradiology; Stroke