Abstract
Our department is located in the Tsugaru area of Aomori Prefecture, which has a population of about 600,000. There are few neurosurgical centers that can treat patients presenting with stroke, head trauma, and other disorders. In this report, we describe the usefulness of telemedicine using an imaging transfer system for aneurysmal subarachnoid hemorrhage.
Imaging transfer systems have been installed at our hospital and 11 regional hospitals in the Tsugaru area. We studied 572 patients with subarachnoid hemorrhage who transferred using the imaging transfer system and admitted directly from January 2001 to August 2007. We studied Hunt and Kosnik grade on admission, treatment, Glasgow outcome scale, and the place of re-rupture. Most patients were transferred and treated with direct surgery and endovascular embolization in the telemedicine group. In the telemedicine group, Hunt and Kosnik grade and Glasgow outcome scale were significantly better than in the direct-admission group. Re-rupture was suspected in 38 cases (6.6%). And 71.4% of re-ruptures occurred in an ambulance in the direct-admission group. On the other hand, in the telemedicine group 42.9% of re-ruptures occurred during transport to the primary hospital and during transfer from the primary hospital to our hospital.
There were not many severe patients in the telemedicine group compared with the direct-admission group. The final outcome in the telemedicine group was better than in the direct-admission group. These findings indicate that telemedicine using an image transfer system is useful in the treatment of subarachnoid hemorrhage.
