TY - JOUR
T1 - Detection of Large Vessel Occlusion Stroke in the Prehospital Setting: Electroencephalography as a Potential Triage Instrument
AU - van Meenen, Laura C. C.
AU - van Stigt, Maritta N.
AU - Siegers, Arjen
AU - Smeekes, Martin D.
AU - van Grondelle, Joffry A. F.
AU - Geuzebroek, Geertje
AU - Marquering, Henk A.
AU - Majoie, Charles B. L. M.
AU - Roos, Yvo B. W. E. M.
AU - Koelman, Johannes H. T. M.
AU - Potters, Wouter V.
AU - Coutinho, Jonathan M.
N1 - Copyright: This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
PY - 2021/7/1
Y1 - 2021/7/1
N2 - A reliable and fast instrument for prehospital detection of large vessel occlusion (LVO) stroke would be a game-changer in stroke care, because it would enable direct transportation of LVO stroke patients to the nearest comprehensive stroke center for endovascular treatment. This strategy would substantially improve treatment times and thus clinical outcomes of patients. Here, we outline our view on the requirements of an effective prehospital LVO detection method, namely: high diagnostic accuracy; fast application and interpretation; user-friendliness; compactness; and low costs. We argue that existing methods for prehospital LVO detection, including clinical scales, mobile stroke units and transcranial Doppler, do not fulfill all criteria, hindering broad implementation of these methods. Instead, electroencephalography may be suitable for prehospital LVO detection since in-hospital studies have shown that quantification of hypoxia-induced changes in the electroencephalography signal have good diagnostic accuracy for LVO stroke. Although performing electroencephalography measurements in the prehospital setting comes with challenges, solutions for fast and simple application of this method are available. Currently, the feasibility and diagnostic accuracy of electroencephalography in the prehospital setting are being investigated in clinical trials.
AB - A reliable and fast instrument for prehospital detection of large vessel occlusion (LVO) stroke would be a game-changer in stroke care, because it would enable direct transportation of LVO stroke patients to the nearest comprehensive stroke center for endovascular treatment. This strategy would substantially improve treatment times and thus clinical outcomes of patients. Here, we outline our view on the requirements of an effective prehospital LVO detection method, namely: high diagnostic accuracy; fast application and interpretation; user-friendliness; compactness; and low costs. We argue that existing methods for prehospital LVO detection, including clinical scales, mobile stroke units and transcranial Doppler, do not fulfill all criteria, hindering broad implementation of these methods. Instead, electroencephalography may be suitable for prehospital LVO detection since in-hospital studies have shown that quantification of hypoxia-induced changes in the electroencephalography signal have good diagnostic accuracy for LVO stroke. Although performing electroencephalography measurements in the prehospital setting comes with challenges, solutions for fast and simple application of this method are available. Currently, the feasibility and diagnostic accuracy of electroencephalography in the prehospital setting are being investigated in clinical trials.
KW - diagnosis
KW - electroencephalography
KW - ischemic stroke
KW - transportation
KW - triage
UR - http://www.scopus.com/inward/record.url?scp=85111788968&partnerID=8YFLogxK
U2 - https://doi.org/10.1161/STROKEAHA.120.033053
DO - https://doi.org/10.1161/STROKEAHA.120.033053
M3 - Article
C2 - 33940955
SN - 0039-2499
VL - 52
SP - e347-e355
JO - Stroke
JF - Stroke
IS - 7
ER -