Potential of Mobile Stroke Units to Acutely Treat Intracerebral Hemorrhage: Blake Buletko, MD

WATCH TIME: 6 minutes

"Sometimes, intracerebral hemorrhage has happened because people are on medications that could predispose them to forming bleeds, so anticoagulant medications. With our mobile stroke unit, we have the ability to administer reversal agents for some of those medications they may be on."

Mobile stroke units (MSUs) have become increasingly popular in recent years with more institutions looking to adopt this type of timely care for pre-hospital stroke treatment. As compared with conventional emergency medical services, MSUs help facilitate quicker thrombolysis times and improved functional outcomes in ischemic stroke; however, the literature on the experience for patients with intracerebral hemorrhage in MSUs is limited.

At the 2024 International Stroke Conference (ISC), held February 7-9, in Phoenix, Arizona, researchers from Cleveland Clinic presented findings from a retrospective analysis of patients with acute intracerebral hemorrhage triaged by MSU or EMS from January 2018 to December 2022. Led by Blake Buletko, MD, the trial showed that a majority (77%) of MSU patients received anti-hypertensive medications while in the MSU. Additionally, times from door to CT completion (14 vs 33 min; P = .000), anticoagulation reversal (99 vs 139 min; P = .013), anti-hypertensive medication administration (21 vs 45 min; P = .020) and goal blood pressure (35 vs 31 min; P = .000) were significantly faster in the MSU cohort.

All told, these findings highlighted the impacts MSUs have on patients with acute intracerebral hemorrhage, a patient cohort that vastly differs from ischemic stroke in terms of treatment options, said Buletko. Buletko, a vascular neurologist and director of the residency program at Cleveland Clinic, sat down with NeurologyLive® to discuss the data, including the most notable takeaways clinicians should be aware of. In addition, he provided context on the treatment needs and goals for those presenting with intracerebral hemorrhage, and how MSUs may be used for this patient population going forward.

Click here for more coverage of ISC 2024.

REFERENCE
1. Zhang A, Askari E, Huang M, et al. Mobile stroke units enable hyperacute interventions for intracerebral hemorrhage. Presented at: International Stroke Conference; February 7-9, 2024; Abstract WMP78