{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T16:52:33Z","timestamp":1784739153023,"version":"3.55.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"vor","delay-in-days":287,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Early diagnosis and triage of patients with ischemic stroke is essential for rapid reperfusion therapy. The prehospital delay may be substantial and patients from rural districts often arrive at their local hospital too late for disability-preventing thrombolytic therapy due to prolonged transport times.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Hallingdal District Medical Centre (HDMC) is located in a rural area of Norway and is equipped with a computed tomography (CT) scanner. We established emergency pathways of CT imaging and thrombolytic treatment of patients with acute ischemic stroke at HDMC. During office hours these pathways were managed by a radiographer and a general physician supported by videoconference from the Primary Stroke Centre. Outside office hours we remotely controlled the CT exam and supported telestroke guided paramedics handling and examining the patients. With a primary aim of demonstrating the feasibility of this de novo concept we enrolled patients in the period 2017\u20132021 into a comparative cohort observational study. We compared patients treated at HDMC (the Rural CT group) to patients from two other rural regions in Norway with similar distances to their local hospital but without access to a rural CT scanner (the Reference group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 86 patients were included in the Rural CT group (mean age 74, 52% male, 43% stroke mimics), and 69 patients were included in the Reference group (mean age 70, 42% male, 28% stroke mimics). Median time from onset of symptoms to completed CT examination was 93\u2009min in the Rural CT group as compared to 240\u2009min in the Reference group (p\u2009&amp;lt;\u20090.05). In patients receiving intravenous thrombolysis time from onset of symptoms to treatment was median 124\u2009min in the Rural CT group and 213\u2009min in the Reference group, p\u2009&amp;lt;\u20090.05. The frequency of thrombolysis for ischemic stroke did not significantly differ between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Combining prehospital rural CT examination with telestroke guided diagnosis and thrombolytic treatment by paramedics may facilitate earlier initiation of thrombolysis for patients with ischemic stroke.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873241267084","type":"journal-article","created":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T09:04:36Z","timestamp":1727514276000},"page":"84-91","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Prehospital computed tomography in a rural district for rapid diagnosis and treatment of stroke"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3223-5122","authenticated-orcid":false,"given":"J\u00f8rgen","family":"Ibsen","sequence":"first","affiliation":[{"name":"Department of Medicine, Ringerike Hospital, Vestre Viken Hospital Trust, Honefoss, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4465-8336","authenticated-orcid":false,"given":"Maren Ranhoff","family":"Hov","sequence":"additional","affiliation":[{"name":"The Norwegian Air Ambulance Foundation, Oslo, Norway"},{"name":"Oslo Metropolitan University, Bachelor of Paramedic, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunn Eli","family":"Tokerud","sequence":"additional","affiliation":[{"name":"Department of Medical Diagnostics, Ringerike Hospital, Vestre Viken Hospital Trust, Honefoss, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Fuglum","sequence":"additional","affiliation":[{"name":"Department of Neurology, Lillehammer Hospital, Sykehuset Innlandet Hospital Trust, Lillehammer, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Linnerud Krogstad","sequence":"additional","affiliation":[{"name":"Vikersund Bad Rehabilitation Centre, Helse S\u00f8r-\u00d8st, Vikersund, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Stugaard","sequence":"additional","affiliation":[{"name":"Department of Medicine, Ringerike Hospital, Vestre Viken Hospital Trust, Honefoss, Norway"},{"name":"Institute for Surgical Research, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hege","family":"Ihle-Hansen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Georg","family":"Lund","sequence":"additional","affiliation":[{"name":"Department of Neurology, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Hall","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,1]]},"reference":[{"key":"2026012113070340400_bibr1-23969873241267084","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/S0140-6736(07)60149-4","article-title":"Thrombolysis with alteplase for acute ischemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational 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Annual Report 2022. 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