First Automated Stroke Imaging Evaluation via Electronic Alberta Stroke Program Early CT Score in a Mobile Stroke Unit

Grunwald, Iris Quasar and Ragoschke-Schumm, Andreas and Kettner, Michael and Schwindling, Lenka and Roumia, Safwan and Helwig, Stefan and Manitz, Matthias and Walter, Silke and Yilmaz, Umut and Greveson, Eric and Lesmeister, Martin and Reith, Wolfgang and Fassbender, Klaus (2016) First Automated Stroke Imaging Evaluation via Electronic Alberta Stroke Program Early CT Score in a Mobile Stroke Unit. Cerebrovascular Diseases. pp. 332-338. ISSN 1015-9770

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Official URL: http://doi.org/10.1159/000446861

Abstract

Background: Recently, a mobile stroke unit (MSU) was shown to facilitate acute stroke treatment directly at the emergency site. The neuroradiological expertise of the MSU is improved by its ability to detect early ischemic damage via automatic electronic (e) evaluation of CT scans using a novel software program that calculates the electronic Alberta Stroke Program Early CT Score (e-ASPECTS). Methods: The feasibility of integrating e-ASPECTS into an ambulance was examined, and the clinical integration and utility of the software in 15 consecutive cases evaluated. Results: Implementation of e-ASPECTS onto the MSU and into the prehospital stroke management was feasible. The values of e-ASPECTS matched with the results of conventional neuroradiologic analysis by the MSU team. The potential benefits of e-ASPECTS were illustrated by three cases. In case 1, excluding early infarct signs supported the decision to directly perform prehospital thrombolysis. In case 2, in which stroke was caused by large-vessel occlusion, the high e-ASPECTS value supported the decision to initiate intra-arterial treatment and triage the patient to a comprehensive stroke center. In case 3, the e-ASPECTS value was 10, indicating the absence of early infarct signs despite pre-existing cerebral microangiopathy and macroangiopathy, a finding indicating the program’s robustness against artefacts. Conclusions: This study on the integration of e-ASPECTS into the prehospital stroke management via a MSU showed for the first time that such integration is feasible, and aids both decision regarding the treatment option and the triage regarding the most appropriate target hospital.

Item Type: Journal Article
Keywords: Alberta Stroke program early CT score, Electronic ASPECTS, Mobile stroke unit, Stroke, Pre-hospital care
Faculty: Faculty of Medical Science
Depositing User: Unnamed user with email Kimberley.Drummond@anglia.ac.uk
Date Deposited: 18 Jul 2016 14:04
Last Modified: 16 Jun 2017 01:02
URI: http://arro.anglia.ac.uk/id/eprint/700563

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