Telestroke networking offers multiple benefits beyond thrombolysis

Abstract

Patients with acute ischemic stroke (AIS) require immediate attention and stroke expertise, which is rarely offered by community hospitals. Telestroke networks were originally established for delivering thrombolysis to inhabitants of underserved regions where stroke expertise was not available 24/7. Rapidly expanding experience addresses the fact that thrombolysis, when given using telestroke consultation, is as safe and effective as when it is given in a stroke center. Telestroke, without a doubt, increases the number of patients receiving thrombolysis, and thus improves patient outcomes, but additionally these networks together with a comprehensive organization of acute stroke care could bring many other benefits which so far are heavily underused in neurology. These benefits include: shortening hospital stay of patients through advanced care, avoiding a large number of unnecessary patient transfers, identifying specific stroke patients who require urgent interventions or surgery (such as subarachnoid hemorrhage, intraventricular hemorrhage, candidates for craniectomy, or basilar artery occlusion), leading to establishment of stroke units and stroke teams in spoke hospitals and overall improvement of stroke care in spoke hospitals, early diagnosis and proper treatment of stroke and nonstroke patients. Further benefits may be: to facilitate staff recruitment to spoke hospitals, to deliver expertise to developing countries, participation of spoke hospitals to acute stroke treatment trials and stroke prevention trials, and environmental effects. The magnitude of these benefits will become more obvious in the near future because this exciting field is progressing fast. The Finnish experience suggests that telestroke is a versatile tool for improving acute stroke care of inhabitants in underserved regions and it should be made more widely available.