Andrew Micieli, MD
Cooley SR, Zhao H, Campbell BCV, Churilov L, Coote S, Easton D, Langenberg F, Stephenson M, Yan B, Desmond PM, et al. Mobile Stroke Units Facilitate Prehospital Management of Intracerebral Hemorrhage. Stroke. 2021.
The phrase “time is brain” refers to the rapid identification and potential administration of reperfusion therapy (thrombolysis and/or endovascular therapy) in the setting of ischemic stroke. However, this phrase is also applicable to intracerebral hemorrhage (ICH). At the present time, treatment of ICH is targeted at early diagnosis with neuroimaging followed by therapy targeted at preventing hematoma expansion. This includes early lowering of blood pressure, reversal of coagulopathy or anticoagulation, critical care management and potential surgical options. Time is critical, as hematoma expansion is a strong determinant of neurological deterioration and worse clinical outcomes. This treatment paradigm lends itself well to the mobile stroke unit (MSU).