Portable CT increases chance of stroke survival and recovery

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CHICAGO—The availability of a portable eight-slice CT scanner in an emergency room (ER) can significantly increase the number of stroke victims who receive a potentially life-saving treatment, according to a study presented today at the 94th annual meeting of the Radiological Society of North America (RSNA).

“The hospital's acquisition of a portable CT scanner facilitated more rapid assessment of acute stroke patients and is anticipated to increase the number of patients to whom thrombolytic therapy can be administered,” said the study’s lead author, David B. Weinreb, MD, now a resident physician in the department of radiology at Hospital of Saint Raphael in New Haven, Conn.

According to the National Institute of Neurological Disorders and Stroke (NINDS), stroke is the third leading cause of death in the United States, and more than 700,000 cases of stroke are diagnosed annually.

“tPA is usually the only shot we have at clot-induced ischemic strokes,” Weinreb said. “But it needs to be administered in a closely monitored situation, because the drug can have extremely adverse effects in those patients whose strokes are instead due to bleeds.”

NINDS recommends that patients who arrive in the ER with signs of acute stroke undergo CT imaging within 25 minutes.

For the study, Weinreb and colleagues began using a portable CT scanner to assess stroke patients in the emergency room (ER) of North Shore Medical Center-Salem Hospital in Salem, Mass. During the month prior to the acquisition of the portable scanner and for a four-month period following its installation, researchers measured how much time elapsed between a physician order for a head CT and performance of the scan.

Weinreb reported that the availability of the CT scanner in the hospital's ER reduced the time between the order and exam from 34 minutes to 15 minutes, a reduction of 54 percent. Based on simulation modeling, the researchers estimated that this improvement would increase by 86 percent the number of stroke patients able to be treated with thrombolytic therapy within the three-hour window.

According to Weinreb, most stroke patients are taken to relatively small community hospitals where access to CT scanning may be limited. When a CT scanner is available, it is not always in proximity to the ER, making transportation of critically ill patients to the radiology department both difficult and time-consuming.

“A portable eight-slice CT can be easily added and used to accurately identify a head bleed in a stroke or trauma patient,” Weinreb said. “This new technology is able to solve a very important problem for a community hospital, where the majority of stroke victims are being treated.”

Weinreb disclosed that he consults as a medical writer for Neurologica.