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PP52 Early clinical features and portable devices for the pre-hospital identification of intracerebral haemorrhage: a scoping review
  1. Mohammed Almubayyidh1,2,
  2. Ibrahim Alghamdi1,3,
  3. Adrian Parry-Jones1,4,
  4. David Jenkins1
  1. 1The University of Manchester, Manchester, UK
  2. 2King Saud University, Riyadh, Saudi Arabia
  3. 3King Khalid University, Abha, Saudi Arabia
  4. 4Northern Care Alliance NHS Foundation Trust, Salford, UK


Background Early recognition of intracerebral haemorrhage (ICH) in the pre-hospital setting would facilitate the initiation of important interventions and destination decisions to improve patient outcomes. This scoping review aimed to identify early clinical features and portable devices that can help pre-hospital personnel in distinguishing ICH from other suspected strokes.

Methods MEDLINE, EMBASE, and CENTRAL were searched via Ovid from inception to August 2022 using keywords such as stroke, intracerebral hemorrhage, differential diagnosis, detection, clinical features, prehospital, emergency, imaging, technology, and their associated terms or synonyms. Two independent reviewers screened titles, abstracts, and full-text articles against the eligibility criteria and performed data extraction.

Results Overall, 6,803 articles were screened for applicability. Of these, 25 studies were included in the analysis; 15 studies reported on early clinical features, and 10 considered portable devices. Prior ICH (n=3), as well as severe neurological deficits (n=6) and higher blood pressure levels (n=11) at onset, were found to be associated with the presence of ICH. Alternatively, a history of atrial fibrillation (n=7) and coronary artery disease (n=6) was less common in ICH patients. Five technologies were found for ICH detection: microwave imaging technology, volumetric impedance phase shift spectroscopy, transcranial ultrasound, near-infrared spectroscopy, and electroencephalography. Microwave and ultrasound imaging technologies demonstrated their capability for differentiating ICH from other causes of suspected strokes.

Conclusion This study has discussed potential clinical features for detecting ICH, but a meta-analysis would be useful to provide further insight. Microwave and ultrasound imaging techniques showed promising results in detecting ICH; however, the five technologies are in the early stages of development and need to be tested for their ability to differentiate between stroke subtypes and non-stroke diagnoses.

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