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Semin Respir Crit Care Med 2017; 38(06): 713-717
DOI: 10.1055/s-0037-1607994
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Bringing Emergency Neurology to Ambulances: Mobile Stroke Unit

Ritvij Bowry
1   Department of Neurology and Neurosurgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
,
James C. Grotta
2   Mobile Stroke Unit and Stroke Research, Clinical Innovation and Research Institute, Memorial Hermann–Texas Medical Center, Houston, Texas
› Author Affiliations
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Publication History

Publication Date:
20 December 2017 (online)

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Abstract

Ischemic stroke results from blocked arteries in the brain, with earlier thrombolysis with intravenous tissue plasminogen activator (tPA) and/or mechanical thrombectomy resulting in improved clinical outcomes. Mobile Stroke Unit (MSU) can speed up the treatment with tPA and facilitate faster triage for patients to hospitals for mechanical thrombectomy. The first registry-based MSU study in Germany demonstrated faster treatment times with tPA using a MSU, a higher proportion of patients being treated within the first “golden hour,” and a suggestion of improved 3-month clinical outcomes. The first multicenter, prospective, randomized clinical trial comparing MSU versus standard care was started in 2014 after the launch of the MSU in Houston, TX, demonstrating the feasibility and safety of MSU operation in the United States, and reliability of telemedicine to evaluate stroke patients for tPA eligibility. Although conclusive evidence from clinical trials to support MSUs as being cost effective and improving clinical outcomes is still needed, there are a myriad of other clinical and research applications of MSUs that could have profound implications for managing patients with neurological emergencies.

Keywords

stroke - thrombectomy - telemedicine - thrombolysis - prehospital - ambulance - neurological emergencies
 

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