Assess clinical outcomes of patients diagnosed with intracranial hemorrhage (ICH) on Mobile Stroke Unit (MSU).

ICH is associated with significant morbidity and mortality. MSU provides a unique opportunity to assess patients in the hyperacute phase of ICH.

We conducted a retrospective review of ICH patients from a single MSU between May 2018 to December 2019. Patient demographics, clinical characteristics, ICH etiology and discharge functional status were recorded. Initial neurological assessment on MSU was compared to exam on arrival to the Emergency Department (ED).

Seventeen patients with ICH were included in analysis; mean age was 63; 77% male and 82% black. 41% had ICH in the basal ganglia, and 70% had intraventricular hemorrhage on first scan on MSU. Etiology of ICH was hypertension in 71% of cases. Mean first blood pressure recorded on MSU was 210/116 (SD 46/21) mmHg and ED was 201/112 mmHg (SD 42/21). Median GCS was 14 (13-14) on MSU and 10 (8-14) in ED; median ICH volume was 19 mL (13-48) on MSU and 21 mL (13-47) in ED. Median time from symptom onset to MSU scan was 53 minutes (26-200). 27% had ICH expansion whereas 33% had IVH expansion.  GCS decline of  > 2 between MSU and ED was seen in 47%. GCS decline was associated with larger ICH volume in MSU (48mL IQR 32-64.5 vs. 13.8mL IQR 8-16.5, p=0.008). 82% had mRS 4-6 at discharge. 59% received anti-hypertensive treatment (labetalol or nicardipine) on MSU.

Large proportion of patients showed neurological decline (ND) between MSU and ED compared to existing literature. This could be due to diagnosing patients in the very early time window on MSU. Higher ICH volumes were associated with risk for early ND before arrival to ED. Cause for ND should be explored using larger sample sizes and therapeutic targets should be identified.