title: Pre-hospital ct diagnosis of subarachnoid hemorrhage.
abstract: BACKGROUND
  Subarachnoid hemorrhage (SAH) is associated with higher mortality in the acute phase than other stroke types. There is a particular risk of early and devastating re-bleeding. Patients therefore need urgent assessment in a neurosurgical department, and the shorter the time from symptom onset to diagnosis the better.
  
  
  METHODS
  The Norwegian Acute Stroke Pre-hospital Project (NASPP) has developed a Mobile Stroke Unit (MSU) model, which is staffed with anesthesiologists also trained in pre-hospital clinical assessment of acute stroke patients and interpretation of computerized tomography (CT). The MSU was operated on-call from the local dispatch center in a rural area 45-160 km away from a neurosurgical department. Two patients presented with clinical symptoms and signs compatible with SAH. In both cases, the CT examination confirmed the diagnosis of SAH. Both were transported directly from patient location to the regional neurosurgical department, saving at least 2-2.5 h of pre-neurosurgical time.
  
  
  CONCLUSIONS
  The Norwegian MSU model staffed with anesthesiologists can rapidly establish an exact diagnosis of SAH, which in a rural area significantly reduces time to neurosurgical care.
  
  
  BACKGROUND
  Study data are retrospectively registered in ClinicalTrail.gov. NCT03036020 Unique Protocol ID: NASPP-2 Brief Title: The Norwegian Acute Stroke Prehospital Project Overall Status: Completed Primary Completion Date: January 2016 [Actual] Verification Date: January 2017.
authors.affiliation: The Norwegian Air Ambulance Foundation, Holterveien 24, 1448, Drøbak, Norway. maren.ranhoff.hov@norskluftambulanse.no.
authors.forename: Maren Ranhoff
authors.initials: MR
authors.lastname: Hov
authors.affiliation: Department of Anaesthesiology, Østfold Hospital, Sarpsborg, Norway.|Department of Neurology, Østfold Hospital, Sarpsborg, Norway.
authors.forename: Annette
authors.initials: A
authors.lastname: Ryen
authors.affiliation: The Norwegian Air Ambulance Foundation, Holterveien 24, 1448, Drøbak, Norway.|Department of Neurology, Østfold Hospital, Sarpsborg, Norway.
authors.forename: Katrine
authors.initials: K
authors.lastname: Finsnes
authors.affiliation: Department of Neurology, Østfold Hospital, Sarpsborg, Norway.
authors.forename: Janne
authors.initials: J
authors.lastname: Storflor
authors.affiliation: The Norwegian Air Ambulance Foundation, Holterveien 24, 1448, Drøbak, Norway.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lindner
authors.affiliation: Department of Radiology, Østfold Hospital, Sarpsborg, Norway.
authors.forename: Jostein
authors.initials: J
authors.lastname: Gleditsch
authors.affiliation: The Norwegian Air Ambulance Foundation, Holterveien 24, 1448, Drøbak, Norway.|Department of Neurology, Oslo University Hospital, Rikshospitalet, Norway.
authors.forename: Christian Georg
authors.initials: CG
authors.lastname: Lund
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units; D009664:Norway; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging*; D019112:Teleradiology; D014057:Tomography, X-Ray Computed
keywords: Cerebral CT; MSU; Neurosurgery; Pre-hospital; Stroke diagnostics; Subarachnoid hemorrhage