Neurolink: a neurosurgical wide-area computer network.

A computerized system capable of transmitting digitally formatted images of the central nervous system has been used to develop a neurosurgical wide-area network in western Pennsylvania. This system links remote or primary care hospitals with a large, tertiary-care, Level 1 trauma center for the constant availability of neurosurgical evaluation by receiving and interpreting computed tomography and magnetic resonance images sent via ordinary public telephone lines. This network has been used in over 20 cases to receive and interpret transmitted cranial computed tomographic images consisting of subarachnoid hemorrhage, intracerebral hematoma, cerebral neoplasm, cerebral abscess, cerebrovascular accident, and normal studies. There has been no known instance of false-positive or false-negative interpretation or of a patient being adversely managed by this method. On the contrary, it appears that patient management has been positively affected through the ability of the neurosurgical evaluation to include a review of the radiological studies. The initial experience has led to the conclusion that this network is an effective, accurate, and cost-effective means of delivering neurosurgical care to underserved areas.