Neurological symptoms and disorders requiring emergency care

If the patient suffers from an acute symptom that refers to a serious illness, the prehospital emergency care transports the patient to the correct treatment location by ambulance. In the HUS area, emergency examination and treatment of neurological symptoms is provided at Meilahti, Peijas, Jorvi, Hyvinkää, Lohja, Porvoo and Länsi-Uusimaa hospitals. Neurological Emergency Clinic operates at Meilahti Tower Hospital, and whenever necessary, the patient is transferred there.

Serious neurological emergencies for which prehospital emergency care transports the patient for an immediate assessment to the neurology emergency clinic include:

- Cerebrovascular disorders in which the typical symptom is an acute, unilateral paralysis, hanging corner of the mouth and/or speech difficulties.

• If the patient suffers from a threatening cerebral infarction, he or she is administered intravenous thrombolytic therapy that aims to open the blocked vein and prevent permanent destruction of brain tissue. In some cases, an attempt can be made to remove the clot that blocks the vein in an angiography procedure in
  co-operation with an interventional radiologist.
• If the patient suffers from a cerebral hemorrhage, its cause is clarified and the best possible treatment selected. In most cases, the best treatment for an intracerebral hemorrhage is conservative and the neurologist tries to prevent the escalation of the bleed with a range of therapeutic measures. An operation performed by a neurosurgeon is necessary only rarely if the bleed causes a life-threatening complication and the patient’s prognosis for recovery is considered good as such.
• If the bleed is caused by a structural anomaly of the brain or cerebral blood vessels or a tumour the patient may benefit from surgical treatment and further treatment is agreed with a neurosurgeon. 

- Prolonged epileptic seizures or seizures in which the convulsions do not stop spontaneously or with the help of drugs administered by the paramedics.

• An anaesthesiologist and neurologist care for the patient together. Adequate respiration and circulation is ensured, the patient is administered medication that prevents epileptic discharges, and a neurologist clarifies the cause of the seizure. In some cases, the situation may even require long-term mechanical ventilation in the intensive care unit.

- In most cases, sudden unconsciousness with no clear cause requires the co-operation of a neurologist, an anesthesiologist and an internal medicine specialist to clarify the cause and provide treatment.

In addition, patients arrive for an emergency neurological assessment based on a referral from their own physician in many other situations requiring emergency assessment and treatment.