A new device worn like a visor can detect emergent large-vessel occlusion in patients with suspected stroke with 92 percent accuracy, report clinical investigators at the Medical University of South Carolina. Endovascular therapy within 24 hours is the standard of care for emergent large-vessel occlusion, but the chance of achieving a good outcome decreases by approximately 20 percent for each hour that passes before treatment.The researchers hope that the device will save valuable time -- especially important in stroke where time is brain -- when it is deployed with emergency medical personnel in the field. This is because the accuracy of the device simplifies the decision made by emergency personnel about where to take patients first, according to Raymond D. Turner, M.D., professor of neurosurgery and chief of the Neuroscience Integrated Center of Clinical Excellence at MUSC.

                    In the study, the VIPS device was deployed with emergency medical personnel in regions served by five Comprehensive Stroke Centers equipped with the endovascular capabilities to treat large-vessel occlusions that underlie severe stroke. Their goal was to use the device to accurately identify severe stroke and then compare the results to established physical examination methods practiced by emergency personnel such as the Prehospital Acute Stroke Severity Scale.Both healthy participants and patients with suspected stroke were evaluated by emergency personnel using the VIPS device. 

          Compared to the neurologists' diagnoses, the device displayed 92 percent specificity -- the ability to detect the difference between patients with severe stroke and those with other conditions such as mild stroke or healthy participants with no brain pathology. This places the VIPS device above standard physical examination tools used by emergency personnel that display specificity scores between 40 and 89 percent.

                  The device's success may be found in its ability to give emergency personnel a clear answer as to whether a patient is experiencing a severe stroke. The VIPS device requires very little training to operate compared to that required to learn standard emergency examination skills, thereby reducing the possibility of human error during emergency diagnosis. If so, the VIPS device could have widespread clinical implications, helping emergency personnel decide whether to take a patient to a comprehensive stroke center or a primary stroke center for treatment.

              Turner likens the use of the VIPS device in detecting severe stroke to the use of electrocardiography (ECG) to definitively detect acute myocardial infarction. He predicts that the device has the potential to be used widely by emergency personnel but also to appear in other public spaces. "This could potentially be something like a defibrillator," said Turner. "You can find out if a patient is having a stroke, just like you can put a defibrillator on a patient to see if they're having a heart attack."