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Review
. 2021 May 27;11(6):488.
doi: 10.3390/life11060488.

How to Improve the Management of Acute Ischemic Stroke by Modern Technologies, Artificial Intelligence, and New Treatment Methods

Affiliations
Review

How to Improve the Management of Acute Ischemic Stroke by Modern Technologies, Artificial Intelligence, and New Treatment Methods

Kamil Zeleňák et al. Life (Basel). .

Abstract

Stroke remains one of the leading causes of death and disability in Europe. The European Stroke Action Plan (ESAP) defines four main targets for the years 2018 to 2030. The COVID-19 pandemic forced the use of innovative technologies and created pressure to improve internet networks. Moreover, 5G internet network will be helpful for the transfer and collecting of extremely big databases. Nowadays, the speed of internet connection is a limiting factor for robotic systems, which can be controlled and commanded potentially from various places in the world. Innovative technologies can be implemented for acute stroke patient management soon. Artificial intelligence (AI) and robotics are used increasingly often without the exception of medicine. Their implementation can be achieved in every level of stroke care. In this article, all steps of stroke health care processes are discussed in terms of how to improve them (including prehospital diagnosis, consultation, transfer of the patient, diagnosis, techniques of the treatment as well as rehabilitation and usage of AI). New ethical problems have also been discovered. Everything must be aligned to the concept of "time is brain".

Keywords: artificial intelligence; diagnosis; ischemia; ischemic stroke; management; plan; rehabilitation; robotics; stroke; treatment.

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Conflict of interest statement

J.F.: Research support: BMBF, BMWi, DFG, EU, Acandis, Medtronic, Microvention, Stryker. Executive functions: University Medical Center Hamburg-Eppendorf, Eppdata GmbH. Stock: Tegus. Consultancy: Acandis, Codman, Cerenovus, Medtronic, Microvention, Penumbra, Route 92, Stryker, Transverse Medical; D.B. (Daniel Behme): None regarding the content of the article, consultant for Phenox, Balt, Vesalio and Acandis; I.V.: Speakers honoraria: Medtronic; K.Z., A.K., L.M., D.B.(Deniz Bulja), J.C., A.A.C., V.D.R., J.-C.G., J.H., O.K.-H., Ö.K., J.L., and E.P. declare no conflict of interest. The funders had no role in the writing of the manuscript.

Figures

Figure 1
Figure 1
(A) NCCT brain scan—ischemic changes in territory of the right middle cerebral artery (insula and basal ganglia) and (B) identical patient—ischemia detected by artificial intelligence (ASPECT score = 8).
Figure 2
Figure 2
Detection of right middle cerebral artery occlusion by artificial intelligence from NCCT scan.
Figure 3
Figure 3
Detection of right middle cerebral artery occlusion by artificial intelligence from CTA. Collateral score = 2.
Figure 4
Figure 4
(A) Perfusion maps with penumbra in right middle cerebral artery territory and (B) relative mismatch = 95.8%.
Figure 5
Figure 5
(A) NCCT scan—intracerebral hemorrhage and (B) intracerebral hemorrhage detected by artificial intelligence.
Figure 6
Figure 6
(A) NCCT scan—subarachnoid hemorrhage and (B) subarachnoid hemorrhage detected by artificial intelligence.

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