Mobile stroke unit use for prehospital stroke treatment-an update.

Abstract

Acute ischemic stroke is atreatable disease. Moreover, there is increasing evidence supporting mechanical recanalization for large-vessel occlusion, even beyond astrict time window. However, only small numbers of patients receive causal treatment. One of the main reasons that patients do not receive causal therapy is their late arrival at the correct target hospital, which, depending on the type of stroke, is either aregional stroke unit or acomprehensive stroke center for interventional treatment. In order to triage patients correctly, afast and complex diagnostic work-up is necessary, allowing astroke specialist to decide on the best therapy option. As treatment possibilities become more comprehensive with the need for individualized decisions, the gap between treatment options and practical implementation is increasing. The "mobile stroke unit" concept encompasses the administration of prehospital acute stroke diagnostic work-up, therapy initiation, and triage to the correct hospital using aspecially equipped ambulance, staffed with ateam specialized in stroke. The concept, which was conceived and first put into practice in Homburg/Saar, Germany, in 2008, is currently spreading with more than 20 active mobile stroke unit centers worldwide. The use of mobile stroke units can reduce the time until stroke treatment by 50% with atenfold increase of patients treated within the first 60 min of symptom onset. The mobile stroke unit concept for acute stroke prehospital management is spreading worldwide. Intensive research is still needed to analyze the best setting for prehospital stroke management.