Telestroke is the application of telemedicine in stroke care. Hence, teleconsultation means the performance of consultation by a remotely located expert through the use of high-quality videoconferencing. Remote evaluation of stroke patients via telemedicine is increasingly utilized, particularly in neurologically underserved areas. It is usually based on video examination and evaluations of brain scans via teleradiology. Scientific analyses have demonstrated the reliability of neurological assessments via videoconference. Teleradiology using electronically transmitted original imaging data is potentially equivalent to onsite assessment. Telemedicine consultation including video examination and teleradiology improves accuracy of acute stroke treatment decisions compared to telephone-based consultation. Telemedicine is already frequently used to extend the benefits of intravenous thrombolysis to patients in nonspecialized hospitals. Beyond thrombolysis, telemedicine can be used for immediate decision making in acute stroke, e.g. for triage of patients who might benefit from interventional treatments not available at the referring hospital. However, improved clinical outcomes of stroke patients have only been investigated and shown when telemedicine was combined with the Stroke Unit concept based on specialized stroke wards and organized stroke care. More scientific evaluation is needed in the fields of cost effectiveness, quality management and implementation of further technological innovations. There are still insufficient data about the use of telemedicine in stroke prevention, rehabilitation and post-stroke care.
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