ReviewFrontiers in neurology2014
Wake-up stroke and stroke of unknown onset: a critical review.
Review in Frontiers in neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Mechanical thrombectomy in low Alberta Stroke Program Early Computed Tomographic Score: A systematic review and meta-analysis of randomized controlled trials.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Pooled it
- Efficacy and Safety of Intravenous Thrombolysis in Patients with Unknown Onset Stroke: A Meta-Analysis.Behavioural neurology · 2019Pooled it
- Trial
- Association between the perfusion/diffusion and diffusion/FLAIR mismatch: data from the AXIS2 trial.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2015Trial
- Value of CT perfusion imaging in wake-up strokes - a comparative study of patients qualifying for thrombolysis vs those not suitable for thrombolysis.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Relationship between stroke onset timing and clinical outcomes in ischemic and hemorrhagic strokes: a systematic review.International journal of cardiology. Cardiovascular risk and prevention · 2026Review
- Endovascular treatment of stroke in the late time window with large vessel occlusion using the ASPECTS as an imaging screening criterion.Scientific reports · 2024Article
- An Automatic DWI/FLAIR Mismatch Assessment of Stroke Patients.Diagnostics (Basel, Switzerland) · 2023Article
- Multicentre registration of wake-up stroke in China (MCRWUSC): a protocol for a prospective, multicentre, registry-based cohort study.BMJ open · 2022Article
- Utilization of CT angiography of the head and neck in the era of endovascular therapy for acute ischemic stroke: a retrospective study.Emergency radiology · 2022Article
- Use of DWI-FLAIR Mismatch to Estimate the Onset Time in Wake-Up Strokes.Neuropsychiatric disease and treatment · 2022Article
- Effectiveness and Predictors of Poor Prognosis Following Intravenous Thrombolysis in Patients with Wake-Up Ischemic Stroke Guided by Rapid MRI.Neuropsychiatric disease and treatment · 2022Article
- Four Decades of Ischemic Penumbra and Its Implication for Ischemic Stroke.Translational stroke research · 2021Review
- Wake-up stroke: imaging-based diagnosis and recanalization therapy.Journal of neurology · 2021Review
- Article
- Implications of Circadian Rhythm in Stroke Occurrence: Certainties and Possibilities.Brain sciences · 2021Review
- Acute Ischemic Stroke With Mild Symptoms-To Thrombolyse or Not to Thrombolyse?Frontiers in neurology · 2021Review
- Impact of onset-to-door time on outcomes and factors associated with late hospital arrival in patients with acute ischemic stroke.PloS one · 2021Article
- Clinical and radiological characteristics and outcome of wake-up intracerebral hemorrhage.Scientific reports · 2020Article
- A Comparison of TJournal of central nervous system disease · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patients, who wake up with an ischemic stroke, account for a large number of the total stroke population, due to circadian morning predominance of stroke. Currently, this subset of patients is excluded from revascularization-therapy since no exact time of onset is known. A large group of these patients might be eligible for therapy. In this review, we assessed the current literature about the hypothesis that wake-up-strokes occur just prior on awakening and if this subgroup differs in characteristics compared to the overall stroke population. We looked at the safety and efficacy of thrombolysis and interventional techniques in the group of patients with unknown stroke-onset. We performed a meta-analysis of the diagnostic accuracy of the diffusion-FLAIR mismatch in identifying stroke within 3 and 4.5 h. The different imaging-selection criteria that can be used to treat these patients are discussed. Additional research on imaging findings associated with recent stroke and penumbral imaging will eventually lead to a shift from a rigid time-frame based therapy to a tissue-based individualized treatment approach.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.