Neurological emergencies represent one of the most urgent and demanding areas of acute medicine. Stroke alone affects 11.9 million people annually worldwide, with incidence increasing by 70% since 1990 and projected to rise further as populations age. The global economic cost of stroke exceeds $890 billion per year and is expected to nearly double by 2050. [1]
Despite the urgency, access to neuroimaging remains structurally constrained. Brain imaging is the essential prerequisite for clinical decision-making in stroke, head trauma, and intracranial bleeding, yet it remains confined to centralised radiology departments in virtually all healthcare systems. As a result, reperfusion therapy reaches fewer than 10% of stroke patients globally, with delayed or unavailable imaging identified as a primary contributor. [2]
The economic footprint of this bottleneck is measurable and material. The cost of managing a CT-indicated patient rises from around €230 when imaging is available on-site to €908 when an external transfer is required. [3] Inter-hospital transfers of critically ill neurological patients add an estimated $9,600 per ICU admission in additional costs. [4] ICU daily costs in European settings range from €1,225 to €1,911 per patient per day, [5] and delays in imaging-based decision-making directly extend length of stay and worsen clinical outcomes across tens of thousands of acute neurological admissions every year.
Beyond direct transfer costs, the need to reserve imaging capacity for acute neurological emergencies structurally reduces the availability of CT and MRI slots for scheduled use, a well-documented operational constraint that compounds inefficiencies across the broader hospital imaging pathway. [6]
Evidence from analogous technologies suggests that earlier bedside imaging-derived information can generate per-patient savings of several thousand EUR through avoided imaging costs, reduced transfers, and 0.4–1.5 day reductions in ICU and hospital length of stay. These savings materialise when bedside imaging reduces unnecessary transfers, avoids non-contributory CT/MRI scans, and supports faster escalation decisions. [7] [8]
To validate its clinical and commercial assumptions, Rilemo conducted 317 structured interviews with physicians, radiologists, emergency medicine specialists, and clinical staff across Europe and the United States between 2023 and 2025, using a Customer Scientific Interview methodology designed to minimize interviewer bias. Interviews were conducted at major clinical events, including the European Congress of Radiology (ECR 2024 and ECR 2025) and through direct outreach to hospital departments across multiple geographies.
The results consistently identified point-of-care imaging for acute neurological conditions as the most validated clinical and commercial opportunity across all seven business models tested, by a significant margin.
Three signals emerged with particular clarity from the dataset:
These findings are reinforced by feedback from Rilemo's clinical advisors.
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Dr. Jody Filippo Capitanio, Neurosurgeon at IRCCS San Raffaele Hospital, has highlighted the need for portable imaging in intensive care and ward settings, where repeated patient transport to radiology represents both an operational burden and a patient safety risk.
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Dr. Luca Sconfienza, Head of Diagnostic and Interventional Radiology at IRCCS Galeazzi–Sant'Ambrogio and Full Professor at the University of Milan, has noted that current imaging technologies present significant limitations in detecting fluids in small quantities and cannot be deployed in ambulatory or decentralized settings.
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