• S Walter, I Q Grunwald, and K Fassbender.
• Neurologische Klinik, Universität des Saarlandes, Kirrbergerstraße 1, 66421, Homburg, Deutschland. silke.walter@uks.eu.
• Radiologe. 2016 Jan 1; 56 (1): 28-31.

Clinical Issue And Diagnostic StandardsThe management of acute stroke patients suffers from several major problems in the daily clinical routine. In order to achieve optimal treatment a complex diagnostic work-up and rapid initiation of therapy are necessary; however, most patients arrive at hospital too late for any type of acute stroke treatment, although all forms of treatment are highly time-dependent according to the generally accepted "time is brain" concept.Diagnostic InnovationsRecently, two randomized clinical trials demonstrated the feasibility of prehospital stroke diagnostic work-up and treatment. This was accomplished by use of a specialized ambulance, equipped with computed tomography for multimodal imaging and a point-of-care laboratory system.PerformanceIn both trials the results demonstrated a clear superiority of the prehospital treatment group with a significant reduction of treatment times, significantly increased number of patients treated within the first 60 min after symptom onset and an optimized triage to the correct target hospital.Achievements And Practical RecommendationsCurrently, mobile stroke units are in operation in various countries and should lead to an improvement in stroke treatment; nevertheless, intensive research is still needed to analyze the best framework settings for prehospital stroke management.

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