Compact neuromonitoring device spots large vessel occlusion in ED

A portable neuromonitoring device, which utilizes electroencephalography and somatosensory-evoked potentials, detects large vessel occlusion (LVO) in emergency department (ED) patients with suspected stroke, demonstrating superior accuracy to prehospital stroke scales, according to a study.

The results were based on device data obtained from suspected patients with stroke enrolled prospectively via a convenience sample in eight EDs within 24 hours of symptom onset. Researchers integrated LVO discriminative signals into a binary classifier.

A total of 109 patients were included, among whom 25 had LVO (23 percent), 38 had non-LVO ischaemic stroke (35 percent), 14 had haemorrhages (13 percent), and 32 had stroke mimics (29 percent).

When compared against all prehospital scales at their predetermined high probability LVO thresholds, the portable device achieved superior sensitivity (80 percent, 95 percent confidence interval [CI], 74–85) and similar specificity (80 percent, 95 percent CI, 77–83).

Furthermore, the device discriminated LVO from stroke causes with significantly higher accuracy (C-statistic=0.88).

The present data have important clinical implications, as early detection of LVO stroke should optimize endovascular therapy and improve outcomes. Also, currently used clinical stroke severity scales for LVO identification have variable accuracy.

Further studies are required to validate the portable device’s potential as an LVO triage aid in prehospital undifferentiated stroke populations.