Wake-up stroke

Authors

  • ศรวิทย์ เจียรนัยศิลป์ คณะแพทยศาสตร์โรงพยาบาลรามาธิบดี มหาวิทยาลัยมหิดล

Keywords:

Wake-up stroke, neuroimaging, acute reperfusion therapy

Abstract

About 1 in 5 of all strokes occur during sleep. Wake-up stroke, without exact time of symptom onset, awakens with stroke symptoms, remains a therapeutic dilemma. This large group of patients was excluded from the treatment trials and often ineligible for acute reperfusion therapy in current clinical practice. Studies of neuroimaging suggest that many wake-up stroke patients may occur shortly before awakening and thus, patients might be within the therapeutic time-window. Several imaging approaches are suggested to identify wake-up stroke patients likely to benefit from reperfusion therapy, including penumbral imaging, and the diffusion weighted imagingfluid attenuated inversion recovery (DWI-FLAIR) mismatch. Small case series, observational studies and some pilot studies report no safety concerns in treatment of these wake-up stroke. However, true efficacy and safety cannot be conclude from these studies, ongoing randomized control trials using neuroimaging-based patient selection may identify a group patients with wake-up stroke that likely to benefit from acute reperfusion therapies. The results of these trials will provide guiding clinical evidence and thus, expand treatment options for this large group of ischemic stroke patients in the near future.

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Published

2019-02-14

How to Cite

1.
เจียรนัยศิลป์ ศ. Wake-up stroke. J Thai Stroke Soc [Internet]. 2019 Feb. 14 [cited 2024 Jun. 23];15(3):153-62. Available from: https://he01.tci-thaijo.org/index.php/jtss/article/view/172146

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