Abstract Background and aims Rapid recognition and treatment are critical for intracerebral haemorrhage (ICH) and acute ischaemic stroke (AIS). However, comparative evidence on prehospital symptom presentation, pathways, and time metrics remains limited. Methods We retrospectively analysed AIS and ICH cases among patients with suspected stroke identified by the Emergency Medical Dispatch Centre (EMDC) in Western Norway (2021-2022). Data were obtained from EMDC records and the Norwegian Stroke Registry. Outcomes included symptom profiles, prehospital time intervals, and functional independence (modified Rankin Scale 0-2) at 3 months. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for ICH versus AIS. Analyses for functional independence were adjusted for stroke severity (NIHSS), onset-to-admission time, premorbid function, and risk factors. Results Among 1,161 strokes, 998 (86%) were AIS and 168 (14%) ICH. ICH patients had greater stroke severity (median NIHSS 7 vs 3; p 0.001) and higher odds of reduced consciousness (OR 4.03;2.73–5.93), neglect (2.75;1.91–3.97), and hemianopia (3.15;2.18–4.54), but lower odds for upper limb paresis (0.59;0.42–0.82) and dysarthria (0.75;0.63–0.89). Prehospital time intervals were similar between groups, including onset-to-EMDC contact (43 versus 50 minutes; p = 0.64), ambulance response (10 versus 10 minutes; p = 0.55), and on-scene time (13 versus 12 minutes; p = 0.31). Direct EMDC contact was more frequent in ICH (OR 1.83;1.18–2.83). Odds of functional independence were lower in ICH (OR 0.34;0.17–0.66). Conclusions ICH patients exhibited greater stroke severity and distinct symptoms than AIS. Despite similar delays, outcomes were poorer, highlighting the need for targeted dispatcher strategies and pathway optimisation. Conflict of interest Nedim Leto: nothing to disclose Elisabeth Farbu: nothing to disclose Paul Barach: nothing to disclose Conrad Arnfinn Bjørshol: nothing to disclose Martin Kurz: nothing to disclose Annette Fromm: nothing to disclose Christopher Bjerkvig: nothing to disclose Soffien Ajmi: nothing to disclose Thomas Lindner: nothing to disclose
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Nedim Leto
Elisabeth Farbu
Paul Barach
European Stroke Journal
University of North Carolina at Chapel Hill
Haukeland University Hospital
Stavanger University Hospital
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Leto et al. (Fri,) studied this question.
www.synapsesocial.com/papers/69fd7f86bfa21ec5bbf08043 — DOI: https://doi.org/10.1093/esj/aakag023.1454