International Survey on the Management of Wake-Up Stroke.
BACKGROUND
Patients who wake up having experienced a stroke while asleep represent around 20% of acute stroke admissions. According to international guidelines for the management of acute stroke, patients presenting with wake-up stroke are not currently eligible to receive revascularization treatments. In this study, we aimed to assess the opinions of stroke experts about the management of patients with wake-up stroke by using an international multicenter electronic survey.


METHODS
This study consisted of 8 questions on wake-up stroke treatment.


RESULTS
Two hundred invitations to participate in the survey were sent by e-mail. Fifty-nine participants started the survey, 4 dropped out before completing it, and 55 completed the full questionnaire. We had 55 participants from 22 countries.


CONCLUSIONS
In this study, most stroke experts recommended a recanalization treatment for wake-up stroke. However, there was considerable disagreement among experts regarding the best brain imaging method and the best recanalization treatment. The results of ongoing randomized trials on wake-up stroke are urgently needed.
Division of Interventional Neuroradiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Luís Henrique
LH
de Castro-Afonso
Division of Interventional Neuroradiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Guilherme Seizem
GS
Nakiri
Department of Neurology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Octávio Marques
OM
Pontes-Neto
Division of Diagnostic Neuroradiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Antônio Carlos
AC
dos Santos
Division of Interventional Neuroradiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Daniel Giansante
DG
Abud
D002545:Brain Ischemia / Q000188:drug therapy; D019468:Disease Management; D057510:Endovascular Procedures / Q000379:methods; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D061185:Mechanical Thrombolysis / Q000379:methods; D059906:Neuroimaging / Q000379:methods; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D017131:Thrombectomy; D015912:Thrombolytic Therapy / Q000379:methods; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
Brain imaging; Endovascular treatment; Intra-arterial thrombolysis; Intravenous thrombolysis; Mechanical thrombectomy; Wake-up stroke