Background: A mobile stroke unit (MSU) enables acute stroke treatment at the emergency site. Its neuroradiological capabilities are enhanced by automated CT scan analysis using e-ASPECTS, a software that calculates the electronic Alberta Stroke Program Early CT Score.

Methods: The feasibility of integrating e-ASPECTS into an ambulance was assessed in 15 consecutive cases.

Results: Implementation into the MSU was feasible, with e-ASPECTS values aligning with conventional neuroradiologic assessments. Three cases highlighted its benefits: (1) confirming the absence of early infarct signs supported prehospital thrombolysis; (2) a high e-ASPECTS value guided intra-arterial treatment and triage to a comprehensive stroke center for large-vessel occlusion; (3) a score of 10 demonstrated robustness against artefacts in a patient with cerebral microangiopathy and macroangiopathy.

Conclusions: e-ASPECTS integration into MSU-based stroke management is feasible and supports both treatment decisions and hospital triage.