title: Stroke warning syndrome: 18 new cases.
abstract: BACKGROUND
  Stroke warning syndrome (SWS) is a rare cause of stroke characterized by recurrent and short-lasting episodes of transient focal neurological deficits leading up to infarction. On the basis of clinical findings and neuroimaging, it can be capsular, pontine, or callosal. The aim of this study is to evaluate the prevalence of SWS in patients admitted to our Stroke Unit for an ischemic stroke and to look for the difference in outcome between patients treated or not with systemic thrombolysis by intravenous recombinant tissue plasminogen activator (IV-rtPA).
  
  
  METHODS
  Among the 967 patients admitted to our Stroke Unit between April 2008 and January 2013 for ischemic stroke, we identified 18 patients with SWS. Nine patients underwent IV-rtPA (IV Group) and the other 9 (No IV Group) other therapies.
  
  
  RESULTS
  The prevalence of SWS in our population was 1.8%. The most common risk factors were hypertension and dyslipidemia in both groups. A good outcome at 3-month follow-up (modified Rankin Scale 0-2) was found in 3 patients (33%) in IV Group and in 5 patients (55%) in No IV Group.
  
  
  CONCLUSIONS
  SWS is an under-recognized syndrome. Intravenous rt-PA treatment seems to have lower efficacy than in other subtypes of strokes, but none of the patients with SWS undergoing treatment presented haemorrhagic transformation or other complications.
authors.affiliation: Stroke Unit, Department of Neurological and Sensorineural Sciences, Azienda Ospedaliera Universitaria Senese, Policlinico Santa Maria alle Scotte, Siena, Italy. r.tassi@ao-siena.toscana.it
authors.forename: Rossana
authors.initials: R
authors.lastname: Tassi
authors.forename: Alfonso
authors.initials: A
authors.lastname: Cerase
authors.forename: Maurizio
authors.initials: M
authors.lastname: Acampa
authors.forename: Paolo
authors.initials: P
authors.lastname: D'Andrea
authors.forename: Francesca
authors.initials: F
authors.lastname: Guideri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lo Giudice
authors.forename: Giovanna
authors.initials: G
authors.lastname: Marotta
authors.forename: Sandra
authors.initials: S
authors.lastname: Bracco
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Martini
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D050171:Dyslipidemias / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000188:drug therapy / Q000209:etiology*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
chemical_list: D010959:Tissue Plasminogen Activator
keywords: Capsular warning syndrome; Intravenous thrombolysis; Pontine warning syndrome; Small vessel diseases; Stroke warning syndrome; Transient ischemic attack