Electroencephalography for the triage of stroke patients in the ambulance.

Endovascular thrombectomy (EVT) is standard treatment for acute ischemic stroke
(AIS) if there is a large vessel occlusion in the anterior circulation (LVO-a).
Because of its complexity, EVT is performed in selected hospitals only.
Currently, approximately half of EVT eligible patients are initially admitted
to hospitals that do not provide this therapy. This delays initiation of
treatment by approximately an hour, which decreases the chance of a good
clinical outcome. Direct presentation of all patients with a suspected AIS in
EVT capable hospitals is not feasible, since only approximately 7% of these
patients are eligible for EVT. Therefore, an advanced triage method that
reliably identifies patients with an LVO-a in the ambulance is necessary.
Electroencephalography (EEG) may be suitable for this purpose, as preliminary
studies suggest that slow EEG activity in the delta frequency range correlates
with lesion location on cerebral imaging. Use of dry electrode EEG caps will
enable relatively unexperienced paramedics to perform a reliable measurement
without the EEG preparation time associated with *wet* EEGs. Combined with
algorithms for automated signal analysis, we expect the time of EEG recording
and analysis to eventually be below five minutes, which would make stroke
triage in the ambulance by EEG logistically feasible

To develop and validate an algorithm based on dry electrode cap EEG data that
accurately determines the likelihood of an LVO-a in patients with a suspected
AIS in the ER.

Validation of several existing algorithms and development of one or more new
algorithms; selection of algorithm with best diagnostic accuracy for
validation.

There are no risks or benefits for patients in this trial involved.