Mobile Stroke Unit (MSU): The Future of Acute Stroke Treatment?

Waldo R. Guerrero*

Mobile Stroke Unit (MSU): The Future of Acute Stroke Treatment?

Time is the key factor in brain survivability in acute stroke treatment.
The therapeutic effects of intravenous recombinant tissue Plasminogen
Activator are highly dependent on time.

Stroke patients presenting within the first 60 minutes, or the golden hour, are the
most likely to benefit from recanalization therapy.

Thus, making rapid clinical and imaging evaluation of stroke patients of upmost importance
and very difficult to complete within the golden hour time window.

Based on Get with the Guidelines-Stroke Program (April 2003 to October 2009),
less than one-third of patients treated with IV rtPA have door-to-needle times of less than 60 minutes.

However, the delivery of care to a stroke victim is complex and involves pre-hospital
and in-hospital stages. Once the patient arrives in a hospital, the recommended door-to-needle
time is less than 60 mins.

Despite combined efforts to streamline procedures in hospitals to provide treatment
as soon as possible, most places are challenged to stay within this time window.

In fact, most patients are still treated with considerable delay and very few of them
receive intravenous tissue Plasminogen Activator (tPA) within 90 mins after symptom onset.

While the number needed to treat in order to achieve a modified Rankin Scale of 0-1 is only 4.5
when treatment is provided within 90 mins, it raises to 9 between 90 and 180 mins and
exceeds 14 by 4.5 h.

Mobile Stroke Unit (MSU): The Future of Acute Stroke Treatment?

Neuro Open J. 2015; 3(1): e1-e4. doi: 10.17140/NOJ-3-e005