title: Wake-up stroke-Amendable for thrombolysis-like stroke with known onset time?
abstract: Patients suffering an acute ischemic stroke can be treated with intravenous thrombolysis in the absence of contraindications. A known onset time is a prerequisite as treatment, according to guidelines, has to be started within 4.5 hours. In patients awakening with a stroke, the last time they were seen without a neurological deficit is assumed to be the time of onset. Thus, despite of lack of contraindications on initial brain imaging, these patients are largely excluded from therapy. This review discusses the underlying pathophysiological, clinical, and radiological evidence surrounding wake-up stroke and its consequences for making treatment decisions.
authors.affiliation: Department of Neurology, Stavanger University Hospital, Stavanger, Norway.|Neuroscience Research Group, Stavanger University Hospital, Stavanger, Norway.
authors.forename: M W
authors.initials: MW
authors.lastname: Kurz
authors.affiliation: Department of Neurology, Stavanger University Hospital, Stavanger, Norway.|Neuroscience Research Group, Stavanger University Hospital, Stavanger, Norway.
authors.forename: R
authors.initials: R
authors.lastname: Advani
authors.affiliation: Department of Radiology, Stavanger University Hospital, Stavanger, Norway.|Radiological Research Group, Stavanger University Hospital, Stavanger, Norway.
authors.forename: G N
authors.initials: GN
authors.lastname: Behzadi
authors.affiliation: Department of Neurology, Molde County Hospital, Molde, Norway.
authors.forename: G
authors.initials: G
authors.lastname: Eldøen
authors.affiliation: Department of Neurology, Stavanger University Hospital, Stavanger, Norway.|Neuroscience Research Group, Stavanger University Hospital, Stavanger, Norway.|Department of Clinical Medicine, Haukeland University Hospital, Bergen, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Farbu
authors.affiliation: Department of Radiology, Stavanger University Hospital, Stavanger, Norway.|Radiological Research Group, Stavanger University Hospital, Stavanger, Norway.
authors.forename: K D
authors.initials: KD
authors.lastname: Kurz
mesh_terms: D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D012890:Sleep; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods*
keywords: acute ischemic stroke; computed tomography; diffusion; imaging; magnetic resonance imaging; penumbra; perfusion; unknown onset; wake up