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

Iris Quasar Grunwald, Andreas Ragoschke-Schumm, Michael Kettner, Lenka Schwindling, Safwan Roumia, Stefan Helwig, Matthias Manitz, Silke Walter, Umut Yilmaz, Eric Greveson, Martin Lesmeister, Wolfgang Reith, Klaus Fassbender

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)332-338
Number of pages7
JournalCerebrovascular Diseases
Volume42
Issue number5-6
Early online date16 Jun 2016
DOIs
Publication statusPublished - Dec 2016

Keywords

  • Alberta Stroke Program Early CT Score
  • Computed tomography
  • Electronic ASPECTS
  • Mobile stroke unit
  • Pre-hospital care
  • Stroke

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