Journal of Thai Stroke Society

Public Relations

Sureerat Suwatcharangkoon — Sat, 30 Aug 2025 00:00:00 +0700

Case Report: Navigating the Complexities of Postoperative Paraparesis: A Case of Transient Ischemic Attack due to ACA stenosis following OPLL decompression

Adisak Tanpun, Preedee Kanjanapongkul, Varodom Sukcharoenchit — Sat, 30 Aug 2025 00:00:00 +0700

Ossification of the posterior longitudinal ligament (OPLL) is a condition where abnormal bone growth occurs within the spinal ligament. While often asymptomatic, OPLL can lead to spinal cord compression, resulting in neurological symptoms. A 66-year-old Thai man with progressive upper extremity weakness was diagnosed with OPLL and underwent cervical decompression surgery. Despite the surgery, the patient developed postoperative lower extremity weakness (paraparesis). Further investigation revealed reduced blood flow during surgery, and a subsequent CT brain scan demonstrated pre-existing bilateral anterior cerebral artery infarction. This case highlights the complexity of managing OPLL and the importance of a comprehensive approach involving multiple medical specialties.

Outcomes of Wake-Up Stroke in the Mechanical Thrombectomy Era

Patis Chunhachatrachai, Pornpatr Dharmasaroja — Sat, 30 Aug 2025 00:00:00 +0700

A substantial portion of stroke patients wake up with stroke, and they are likely excluded from intravenous alteplase treatment due to unknown time of onset. Currently, mechanical thrombectomy (MT) is approved to treat selected patients with large vessel occlusion (LVO) within 24 hours. This may change outcomes in these patients.

Objective: The aim of the study was to evaluate the causes and outcomes in patients with non-wake-up stroke compared to wake-up stroke.

Methods: Patients with acute ischemic stroke during September, 2022 to March, 2023 were studied. All patients were investigated and treated according to the standard stroke protocol in the certified stroke unit. Causes and outcomes were compared in patients between non-wake-up and wake-up stroke.

Results: A total of 693 patients were included, with 138 patients (19.9%) presenting as wake-up stroke. The etiologies of stroke were nonsignificantly different between non-wake-up and wake-up stroke. MT was performed in 18% of patients in each group. Intravenous alteplase alone was given to 14.2% of patients with non-wake-up stroke, but none in the wake-up group. Favorable outcome at 3 months revealed a nonsignificant difference (non-wake-up: 54% vs wake-up:55%, p=0.83). A slightly higher death rate (6.8% vs 2.2%, p=0.037) and symptomatic intracerebral hemorrhage (5.4% vs 1.4%, p=0.188) were found in patients with non-wake-up compared to wake-up stroke.

Conclusion: In the MT era, the rate of favorable outcome in wake-up stroke patients did not significantly differ from that observed in non-wake-up stroke cases, despite none of the wake-up stroke patients being treated with intravenous alteplase alone.

Message from President of Thai Stroke Society

chesda Udommongkol — Sat, 30 Aug 2025 00:00:00 +0700

Editorial

Napasri Chaisinanunkul — Sat, 30 Aug 2025 00:00:00 +0700

Stroke News

Napasri Chaisinanunkul — Sat, 30 Aug 2025 00:00:00 +0700