When a person develops stroke symptoms, doctors must first assess whether these symptoms are the result of bleeding inside the brain (hemorrhagic stroke). If so, chances are that this person will require emergent brain surgery. However, hemorrhagic strokes are usually diagnosed after a CT of the brain is performed in the emergency room of the hospital where a person is transported for treatment. But not every hospital is equipped to manage emergent brain surgery, and many smaller hospitals must transfer such patients to larger ones where the right personnel and equipment for the surgical management of hemorrhagic strokes are available around the clock. Unfortunately, these transfers come at a price as they are costly, dangerous, and lead to significant delays in treatment. Wouldn't it be better if these transfers could be avoided?

Almost 10 years ago researchers reported the ability to accurately differentiate between hemorrhagic and non-hemorrhagic strokes using a technique called transcranial color-coded duplex sonography (TCCDS). This technique is performed using equipment that could be carried, and easily handled inside of any ambulance. Because of this, some stroke specialists have proposed TCCDS as a tool to expedite the diagnosis of stroke before a patient's destination hospital is chosen. In this way, when hemorrhagic strokes are diagnosed in the field, possibly under the remote supervision of a physician, the patient can be brought to the appropriate hospital for treatment.

Nonetheless, despite the fact that TCCDS is routinely used by most hospitals, no studies have been performed to investigate whether its use inside an ambulance can in fact expedite treatment of dangerous hemorrhagic strokes. Hopefully studies will be designed in the near future to test whether this technology is everything it promises to be for the early diagnosis of dangerous hemorrhagic strokes.

Further reading on the diagnosis and treatment of stroke:
Stroke Centers Provide Superior Care for Stroke Patients
Acute stroke teams for acute stroke patients
How are strokes treated?