Wake-up stroke
Keywords:
Wake-up stroke, neuroimaging, acute reperfusion therapyAbstract
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.
References
Powers WJ, Derdeyn CP, Biller J, Coffey CS, Hoh BL, Jauch EC, et al. 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015;46(10):3020-35.
Jauch EC, Saver JL, Adams HP, Bruno A, Connors JJ, Demaerschalk BM, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44(3):870-947.
Emberson J, Lees KR, Lyden P, Blackwell L, Albers G, Bluhmki E, et al. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet. 2014;384 (9958):1929-35.
Saver JL, Goyal M, van der Lugt A, Menon BK, Majoie CB, Dippel DW, et al. Time to Treatment With Endovascular Thrombectomy and Outcomes From Ischemic Stroke: A Meta-analysis. JAMA. 2016;316(12):1279-88.
Barreto AD. Intravenous thrombolytics for ischemic stroke. Neurotherapeutics. 2011;8(3):388-99.
Barreto AD, Martin-Schild S, Hallevi H, Morales MM, Abraham AT, Gonzales NR, et al. Thrombolytic therapy for patients who wake-up with stroke. Stroke. 2009;40(3):827-32.
Rimmele DL, Thomalla G. Wake-up stroke: clinical characteristics, imaging findings, and treatment option - an update. Front Neurol. 2014;5:35.
Irokawa M, Nishinaga M, Funayama H, Ikeda U, Shimada K. Effect of a Change in the Sleep/Wake Cycle on the Diurnal Variation of Fibrinolytic Parameters. J Thromb Thrombolysis. 1998;5(2):165-8.
Smolensky MH, Hermida RC, Castriotta RJ, Portaluppi F. Role of sleep-wake cycle on blood pressure circadian rhythms and hypertension. Sleep Med. 2007;8(6):668-80.
Elliott WJ. Circadian variation in the timing of stroke onset: a meta-analysis. Stroke. 1998;29(5):992-6.
Bassetti CL, Milanova M, Gugger M. Sleepdisordered breathing and acute ischemic stroke: diagnosis, risk factors, treatment, evolution, and long-term clinical outcome. Stroke. 2006;37(4): 967-72.
Hsieh SW, Lai CL, Liu CK, Hsieh CF, Hsu CY. Obstructive sleep apnea linked to wake-up strokes. J Neurol. 2012;259(7):1433-9.
Riccio PM, Klein FR, Pagani Cassará F, Muñoz Giacomelli F, González Toledo ME, Racosta JM, et al. Newly diagnosed atrial fibrillation linked to
wake-up stroke and TIA: hypothetical implications. Neurology. 2013;80(20):1834-40.
Mackey J, Kleindorfer D, Sucharew H, Moomaw CJ, Kissela BM, Alwell K, et al. Population-based study of wake-up strokes. Neurology. 2011;76(19):1662-7.
Denny MC, Boehme AK, Dorsey AM, George AJ, Yeh AD, Albright KC, et al. Wake-up Strokes Are Similar to Known-Onset Morning Strokes in Severity and Outcome. J Neurol Neurol Disord. 2014;1(1).
Roveri L, La Gioia S, Ghidinelli C, Anzalone N, De Filippis C, Comi G. Wake-up stroke within 3 hours of symptom awareness: imaging and clinical features compared to standard recombinant tissue plasminogen activator treated stroke. J Stroke Cerebrovasc Dis. 2013;22(6):703-8.
Fink JN, Kumar S, Horkan C, Linfante I, Selim MH, Caplan LR, et al. The stroke patient who woke up: clinical and radiological features, including diffusion
and perfusion MRI. Stroke. 2002;33(4):988-93.
Silva GS, Lima FO, Camargo EC, Smith WS, Singhal AB, Greer DM, et al. Wake-up stroke: clinical and neuroimaging characteristics. Cerebrovasc Dis.
2010;29(4):336-42.
Wintermark M, Sanelli PC, Albers GW, Bello J, Derdeyn C, Hetts SW, et al. Imaging recommendations for acute stroke and transient ischemic attack patients:
A joint statement by the American Society of Neuroradiology, the American College of Radiology, and the Society of NeuroInterventional Surgery. AJNR Am J Neuroradiol. 2013;34(11):E117-27.
Barreto AD, Fanale CV, Alexandrov AV, Gaffney KC, Vahidy FS, Nguyen CB, et al. Prospective, open-label safety study of intravenous rtPA in wake-up stroke. Ann Neurol. 2016.
Lev MH. Perfusion imaging of acute stroke: its role in current and future clinical practice. Radiology. 2013;266(1):22-7.
Goyal M, Menon BK, Derdeyn CP. Perfusion imaging in acute ischemic stroke: let us improve the science before changing clinical practice. Radiology. 2013;266(1):16-21.
Albers GW, Thijs VN, Wechsler L, Kemp S, Schlaug G, Skalabrin E, et al. Magnetic resonance imaging profiles predict clinical response to early reperfusion:
the diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study. Ann Neurol. 2006;60(5):508-17.
Thomalla G, Schwark C, Sobesky J, Bluhmki E, Fiebach JB, Fiehler J, et al. Outcome and symptomatic bleeding complications of intravenous thrombolysis within 6 hours in MRI-selected stroke patients: comparison of a German multicenter study with the pooled data of ATLANTIS, ECASS, and NINDS tPA trials. Stroke. 2006;37(3):852-8.
Olivot JM, Mlynash M, Thijs VN, Kemp S, Lansberg MG, Wechsler L, et al. Optimal Tmax threshold for predicting penumbral tissue in acute stroke. Stroke.
2009;40(2):469-75.
Davis S, Donnan GA. Time is Penumbra: imaging, selection and outcome. The Johann jacob wepfer award 2014. Cerebrovasc Dis. 2014;38(1):59-72.
Thomalla G, Gerloff C. Treatment Concepts for Wake-Up Stroke and Stroke With Unknown Time of Symptom Onset. Stroke. 2015;46(9):2707-13.
Thomalla G, Rossbach P, Rosenkranz M, Siemonsen S, Krützelmann A, Fiehler J, et al. Negative fluidattenuated inversion recovery imaging identifies acute
ischemic stroke at 3 hours or less. Ann Neurol. 2009;65(6):724-32.
Thomalla G, Cheng B, Ebinger M, Hao Q, Tourdias T, Wu O, et al. DWI-FLAIR mismatch for the identification of patients with acute ischaemic stroke within 4·5 h of symptom onset (PRE-FLAIR): a multicentre observational study. Lancet Neurol. 2011;10(11):978-86.
Demaerschalk BM, Kleindorfer DO, Adeoye OM, Demchuk AM, Fugate JE, Grotta JC, et al. Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2016;47(2): 581-641.
Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score. Lancet. 2000;355(9216):1670-4.
Saur D, Kucinski T, Grzyska U, Eckert B, Eggers C, Niesen W, et al. Sensitivity and interrater agreement of CT and diffusion-weighted MR imaging in hyperacute stroke. AJNR Am J Neuroradiol. 2003;24(5):878-85.
Pexman JH, Barber PA, Hill MD, Sevick RJ, Demchuk AM, Hudon ME, et al. Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol. 2001;22(8):1534-42.
Srinivasan A, Goyal M, Al Azri F, Lum C. Stateof-the-art imaging of acute stroke. Radiographics. 2006;26 Suppl 1:S75-95.
Kang DW, Sohn SI, Hong KS, Yu KH, Hwang YH, Han MK, et al. Reperfusion therapy in unclearonset stroke based on MRI evaluation (RESTORE): a prospective multicenter study. Stroke. 2012;43(12): 3278-83.
Barreto AD, Fanale CV, Alexandrov AV, Gaffney KC, Vahidy FS, Nguyen CB, et al. Prospective, open-label safety study of intravenous recombinant tissue plasminogen activator in wake-up stroke. Ann Neurol. 2016.
Goyal M, Menon BK, van Zwam WH, Dippel DW, Mitchell PJ, Demchuk AM, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387(10029):1723-31.
Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornton J, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke.
N Engl J Med. 2015;372(11):1019-30.
Buck D, Shaw LC, Price CI, Ford GA. Reperfusion therapies for wake-up stroke: systematic review. Stroke. 2014;45(6):1869-75.
Mokin M, Kan P, Sivakanthan S, Veznedaroglu E, Binning MJ, Liebman KM, et al. Endovascular therapy of wake-up strokes in the modern era of stent retriever thrombectomy. J Neurointerv Surg. 2016;8(3):240-3.
Amiri H, Bluhmki E, Bendszus M, Eschenfelder CC, Donnan GA, Leys D, et al. European Cooperative Acute Stroke Study-4: Extending the time for thrombolysis in emergency neurological deficits ECASS-4: ExTEND. Int J Stroke. 2016;11(2):260-7.
Jauch EC, Saver JL, Adams HP, Bruno A, Connors JJ, Demaerschalk BM, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44(3):870-947.
Emberson J, Lees KR, Lyden P, Blackwell L, Albers G, Bluhmki E, et al. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet. 2014;384 (9958):1929-35.
Saver JL, Goyal M, van der Lugt A, Menon BK, Majoie CB, Dippel DW, et al. Time to Treatment With Endovascular Thrombectomy and Outcomes From Ischemic Stroke: A Meta-analysis. JAMA. 2016;316(12):1279-88.
Barreto AD. Intravenous thrombolytics for ischemic stroke. Neurotherapeutics. 2011;8(3):388-99.
Barreto AD, Martin-Schild S, Hallevi H, Morales MM, Abraham AT, Gonzales NR, et al. Thrombolytic therapy for patients who wake-up with stroke. Stroke. 2009;40(3):827-32.
Rimmele DL, Thomalla G. Wake-up stroke: clinical characteristics, imaging findings, and treatment option - an update. Front Neurol. 2014;5:35.
Irokawa M, Nishinaga M, Funayama H, Ikeda U, Shimada K. Effect of a Change in the Sleep/Wake Cycle on the Diurnal Variation of Fibrinolytic Parameters. J Thromb Thrombolysis. 1998;5(2):165-8.
Smolensky MH, Hermida RC, Castriotta RJ, Portaluppi F. Role of sleep-wake cycle on blood pressure circadian rhythms and hypertension. Sleep Med. 2007;8(6):668-80.
Elliott WJ. Circadian variation in the timing of stroke onset: a meta-analysis. Stroke. 1998;29(5):992-6.
Bassetti CL, Milanova M, Gugger M. Sleepdisordered breathing and acute ischemic stroke: diagnosis, risk factors, treatment, evolution, and long-term clinical outcome. Stroke. 2006;37(4): 967-72.
Hsieh SW, Lai CL, Liu CK, Hsieh CF, Hsu CY. Obstructive sleep apnea linked to wake-up strokes. J Neurol. 2012;259(7):1433-9.
Riccio PM, Klein FR, Pagani Cassará F, Muñoz Giacomelli F, González Toledo ME, Racosta JM, et al. Newly diagnosed atrial fibrillation linked to
wake-up stroke and TIA: hypothetical implications. Neurology. 2013;80(20):1834-40.
Mackey J, Kleindorfer D, Sucharew H, Moomaw CJ, Kissela BM, Alwell K, et al. Population-based study of wake-up strokes. Neurology. 2011;76(19):1662-7.
Denny MC, Boehme AK, Dorsey AM, George AJ, Yeh AD, Albright KC, et al. Wake-up Strokes Are Similar to Known-Onset Morning Strokes in Severity and Outcome. J Neurol Neurol Disord. 2014;1(1).
Roveri L, La Gioia S, Ghidinelli C, Anzalone N, De Filippis C, Comi G. Wake-up stroke within 3 hours of symptom awareness: imaging and clinical features compared to standard recombinant tissue plasminogen activator treated stroke. J Stroke Cerebrovasc Dis. 2013;22(6):703-8.
Fink JN, Kumar S, Horkan C, Linfante I, Selim MH, Caplan LR, et al. The stroke patient who woke up: clinical and radiological features, including diffusion
and perfusion MRI. Stroke. 2002;33(4):988-93.
Silva GS, Lima FO, Camargo EC, Smith WS, Singhal AB, Greer DM, et al. Wake-up stroke: clinical and neuroimaging characteristics. Cerebrovasc Dis.
2010;29(4):336-42.
Wintermark M, Sanelli PC, Albers GW, Bello J, Derdeyn C, Hetts SW, et al. Imaging recommendations for acute stroke and transient ischemic attack patients:
A joint statement by the American Society of Neuroradiology, the American College of Radiology, and the Society of NeuroInterventional Surgery. AJNR Am J Neuroradiol. 2013;34(11):E117-27.
Barreto AD, Fanale CV, Alexandrov AV, Gaffney KC, Vahidy FS, Nguyen CB, et al. Prospective, open-label safety study of intravenous rtPA in wake-up stroke. Ann Neurol. 2016.
Lev MH. Perfusion imaging of acute stroke: its role in current and future clinical practice. Radiology. 2013;266(1):22-7.
Goyal M, Menon BK, Derdeyn CP. Perfusion imaging in acute ischemic stroke: let us improve the science before changing clinical practice. Radiology. 2013;266(1):16-21.
Albers GW, Thijs VN, Wechsler L, Kemp S, Schlaug G, Skalabrin E, et al. Magnetic resonance imaging profiles predict clinical response to early reperfusion:
the diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study. Ann Neurol. 2006;60(5):508-17.
Thomalla G, Schwark C, Sobesky J, Bluhmki E, Fiebach JB, Fiehler J, et al. Outcome and symptomatic bleeding complications of intravenous thrombolysis within 6 hours in MRI-selected stroke patients: comparison of a German multicenter study with the pooled data of ATLANTIS, ECASS, and NINDS tPA trials. Stroke. 2006;37(3):852-8.
Olivot JM, Mlynash M, Thijs VN, Kemp S, Lansberg MG, Wechsler L, et al. Optimal Tmax threshold for predicting penumbral tissue in acute stroke. Stroke.
2009;40(2):469-75.
Davis S, Donnan GA. Time is Penumbra: imaging, selection and outcome. The Johann jacob wepfer award 2014. Cerebrovasc Dis. 2014;38(1):59-72.
Thomalla G, Gerloff C. Treatment Concepts for Wake-Up Stroke and Stroke With Unknown Time of Symptom Onset. Stroke. 2015;46(9):2707-13.
Thomalla G, Rossbach P, Rosenkranz M, Siemonsen S, Krützelmann A, Fiehler J, et al. Negative fluidattenuated inversion recovery imaging identifies acute
ischemic stroke at 3 hours or less. Ann Neurol. 2009;65(6):724-32.
Thomalla G, Cheng B, Ebinger M, Hao Q, Tourdias T, Wu O, et al. DWI-FLAIR mismatch for the identification of patients with acute ischaemic stroke within 4·5 h of symptom onset (PRE-FLAIR): a multicentre observational study. Lancet Neurol. 2011;10(11):978-86.
Demaerschalk BM, Kleindorfer DO, Adeoye OM, Demchuk AM, Fugate JE, Grotta JC, et al. Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2016;47(2): 581-641.
Barber PA, Demchuk AM, Zhang J, Buchan AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score. Lancet. 2000;355(9216):1670-4.
Saur D, Kucinski T, Grzyska U, Eckert B, Eggers C, Niesen W, et al. Sensitivity and interrater agreement of CT and diffusion-weighted MR imaging in hyperacute stroke. AJNR Am J Neuroradiol. 2003;24(5):878-85.
Pexman JH, Barber PA, Hill MD, Sevick RJ, Demchuk AM, Hudon ME, et al. Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol. 2001;22(8):1534-42.
Srinivasan A, Goyal M, Al Azri F, Lum C. Stateof-the-art imaging of acute stroke. Radiographics. 2006;26 Suppl 1:S75-95.
Kang DW, Sohn SI, Hong KS, Yu KH, Hwang YH, Han MK, et al. Reperfusion therapy in unclearonset stroke based on MRI evaluation (RESTORE): a prospective multicenter study. Stroke. 2012;43(12): 3278-83.
Barreto AD, Fanale CV, Alexandrov AV, Gaffney KC, Vahidy FS, Nguyen CB, et al. Prospective, open-label safety study of intravenous recombinant tissue plasminogen activator in wake-up stroke. Ann Neurol. 2016.
Goyal M, Menon BK, van Zwam WH, Dippel DW, Mitchell PJ, Demchuk AM, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387(10029):1723-31.
Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornton J, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke.
N Engl J Med. 2015;372(11):1019-30.
Buck D, Shaw LC, Price CI, Ford GA. Reperfusion therapies for wake-up stroke: systematic review. Stroke. 2014;45(6):1869-75.
Mokin M, Kan P, Sivakanthan S, Veznedaroglu E, Binning MJ, Liebman KM, et al. Endovascular therapy of wake-up strokes in the modern era of stent retriever thrombectomy. J Neurointerv Surg. 2016;8(3):240-3.
Amiri H, Bluhmki E, Bendszus M, Eschenfelder CC, Donnan GA, Leys D, et al. European Cooperative Acute Stroke Study-4: Extending the time for thrombolysis in emergency neurological deficits ECASS-4: ExTEND. Int J Stroke. 2016;11(2):260-7.
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2019-02-14
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เจียรนัยศิลป์ ศ. Wake-up stroke. J Thai Stroke Soc [Internet]. 2019 Feb. 14 [cited 2024 Jul. 1];15(3):153-62. Available from: https://he01.tci-thaijo.org/index.php/jtss/article/view/172146
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