Mobile Stroke Unit project

About the Mobile Stroke Unit project

The Mobile Stroke Unit (MSU) is a doctor's car equipped with a head X-ray CT device and a remote communication system, making it possible to diagnose stroke and start treatment at the scene of an emergency call or at the meeting point with an ambulance. Recent comparative clinical trials have shown that early diagnosis and initiation of treatment from the onset of symptoms leads to better patient outcomes, as well as cost-effectiveness.

 MSU was first operational in the world in Homburg, a regional city in southwestern Germany, in 2008 by Dr. Fassbender of Saarland University. In 2012, the excellent results were announced, and soon operations began in the country's capital, Berlin. Since then, it has spread mainly in large cities in the United States, and is currently in use in over 30 regions around the world.

The in-vehicle X-ray CT can perform angiography (CTA) and perfusion imaging. Meanwhile, head CT using microwaves has also been developed in Australia and other countries. It can also be installed on regular ambulances and helicopters. As for treatment with MSU, the treatment for cerebral infarction, tPA, is currently being replaced with Tenecteplase. In addition, clinical trials of a new hemostatic drug for cerebral hemorrhage are about to be conducted. MSU also covers head injuries. Therefore, collaboration between the stroke department and the emergency department is essential.

In Japan, in 2012, the MSU Project Team, led by our hospital's Department of Neurology, was established and is working to introduce and operate the system, but it has not yet been put into practical use. The details are summarized in the paper below.

We are a member of the Ibaraki Mobile Medical Support Organization, a general incorporated association, with the aim of introducing MSU to various regions based on the concept of "early diagnosis and treatment start and better treatment results" for stroke. We are working with support. Although it may take some time to introduce it to Japan, we will continue our activities with the aim of realizing MSU.

paper

• “Nationwide Questionnaire Survey on Mobile Stroke Unit - Challenges and Prospects”
  Masahiko Hiroki, Motoshi Kono, Masaki Misawa Journal of the Japanese Society of Emergency Medicine: Survey and Report 2022 Volume 25, Issue 4, p. 694-703

• “Issues and prospects for the introduction and operation of MSU in Japan”
  Masahiko Hiroki, Motoshi Kono, Masaki Misawa Journal of the Japanese Society of Emergency Medicine: Review 2022 Vol. 25 No. 5 p. 767-781

• "Latest trends in mobile stroke unit and its in-vehicle diagnostic equipment"
  Masahiko Hiroki, Yutaka Kono, Masaki Misawa Stroke: Review 2023 Vol. 45 No. 5 p. 369-380

• “Mobile stroke unit: Usefulness and problem solving in Japan”
  Masahiko Hiroki, Masaki Misawa Japanese Clinical Practice: Review 2023 Vol. 81 No. 9 p. 1425–1433

• "Practical status and social background of current mobile stroke units worldwide: A survey and investigation"
  Original paper Masahiko Hiroki, Mototsugu Kohno, Yutaka Kohno, Masaki Misawa (Western Journal of Emergency Medicine:accepted)

Click here for the project video (CT-equipped ambulance simulation)

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