| Wake-up stroke: clinical and neuroimaging characteristics. | |
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MedLine Citation:
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PMID: 20130399 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Approximately 25% of ischemic stroke patients awaken with neurological deficits. In these patients, in whom the time from symptom onset is uncertain, brain imaging is a potential strategy to characterize the ischemia duration and the presence of salvageable brain tissue. METHODS: We prospectively evaluated consecutive patients with acute ischemic stroke. CT angiography and CT perfusion (CTP) were performed in patients within 24 h of symptom onset. The patients were classified into 'known onset', 'indefinite onset but not on awakening' and 'wake-up stroke' groups. RESULTS: Of 676 patients evaluated, 420 had known-onset strokes, 131 wake-up strokes and 125 strokes with an indefinite time of symptom onset. Ischemic lesion volumes were higher in patients with indefinite-onset strokes (p = 0.04). The frequencies of CTP mismatch and of large-vessel intracranial occlusions were similar among the groups (p = 0.9 and p = 0.2, respectively). CONCLUSION: The considerable prevalence of CTP mismatch and of intracranial artery occlusions in our patients with wake-up strokes suggests that arterial and perfusion imaging might be particularly important in this population. Revised indications for thrombolysis by using imaging-based protocols might offer these patients the prospect of receiving acute stroke treatment even without a clear time of symptom onset. |
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Authors:
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Gisele S Silva; Fabricio O Lima; Erica C S Camargo; Wade S Smith; Aneesh B Singhal; David M Greer; Hakan Ay; Michael H Lev; Gordon J Harris; Elkan F Halpern; Shruti Sonni; Walter Koroshetz; Karen L Furie |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural Date: 2010-01-30 |
Journal Detail:
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Title: Cerebrovascular diseases (Basel, Switzerland) Volume: 29 ISSN: 1421-9786 ISO Abbreviation: Cerebrovasc. Dis. Publication Date: 2010 |
Date Detail:
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Created Date: 2010-03-12 Completed Date: 2010-06-01 Revised Date: 2011-07-25 |
Medline Journal Info:
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Nlm Unique ID: 9100851 Medline TA: Cerebrovasc Dis Country: Switzerland |
Other Details:
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Languages: eng Pagination: 336-42 Citation Subset: IM |
Copyright Information:
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(c) 2010 S. Karger AG, Basel. |
Affiliation:
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Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. giselesampaio @ hotmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Brain Damage, Chronic / epidemiology, etiology Brain Ischemia / pathology, radiography* Cerebral Angiography Cohort Studies Female Fibrinolytic Agents / administration & dosage Hospitals, University / statistics & numerical data Humans Image Processing, Computer-Assisted* Male Middle Aged Perfusion Imaging Prognosis Prospective Studies Reperfusion Severity of Illness Index Single-Blind Method Thrombolytic Therapy* / contraindications Time Factors Tomography, X-Ray Computed / methods* Wakefulness* |
| Grant Support | |
ID/Acronym/Agency:
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R01 HS11392/HS/AHRQ HHS |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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