ABSTRACT
Objective: Herein, we report a patient with acute cerebral infarction with a favorable prognosis after being managed by a general physician with support from the telestroke program.Patient and Methods: An 85-year-old man was transferred to a regional hospital due to sudden onset of dysarthria and left hemiparesis. As no neurosurgeons or neurologists were available in that hospital or area, the patient was examined by a general physician who diagnosed him with cardioembolic stroke on the left middle cerebral artery territory. The physician consulted a stroke specialist using the telestroke system; with the support from the telestroke program, the physician administered thrombolytic therapy 4 hours and 10 minutes after the onset of symptoms.Results: The patient’s National Institutes of Health Stroke Scale score improved from 9 to 3 and he was subsequently transferred to the stroke center. However, the occluded left middle cerebral artery had already re-canalized. His hemiparesis completely improved one week after the onset.Conclusion: A telemedicine system for general physicians is indispensable in areas without accessible stroke specialists as it provides access to a standard of care for hyper-acute stroke patient assessment and management, and helps improve neuroprognosis.
ABSTRACT
<b>Introduction</b> : Intravenous rt-PA therapy for acute ischemic stroke patients within 4.5 hours after onset is approved and effective, but is difficult to implement in depopulated areas because of geographical conditions and lack of medical specialists.<br><b>Methods</b> : From February 2013 to February 2014, 75 acute ischemic stroke patients were transferred to our hospital, four (5.3%) of which were subjected to the “drip and ship” method of rt-PA infusion using a telemedicine system for emergency medicine (k-support). We examined the time course after onset and the treatment outcome of these four cases<br><b>Results</b> : Four cases had rt-PA infusion started in the depopulated area. ln one case, recanalization of occluded vessels was demonstrated resulting in improved clinical symptoms. <br><b>Conclusion</b> : The “drip and ship” method of rt-PA infusion using a telemedicine system for emergency medicine (k-support) may be a safe and ideal treatment in depopulated areas.
ABSTRACT
Effective treatments of acute ischemic stroke include the specialist wards (stroke units) with multidisciplinary treatment team receiving treatment and intravenous thrombolytic therapy.However,only a few patients can receive these treatments.Telestroke can improve the thrombolytic rate of acute ischemic stroke on site in hospitals for lacking of specialists and enable stroke care maintained at a high level in rural areas.This article reviews telestroke in the treatment of acute ischemic stroke and the roles of nurses in telestroke.