ArticleJournal of neurology and neurological disorders2014
Wake-up Strokes Are Similar to Known-Onset Morning Strokes in Severity and Outcome.
Article in Journal of neurology and neurological disorders, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Efficacy and safety of rt-PA intravenous thrombolysis in patients with wake-up stroke: A meta-analysis.Medicine · 2022Pooled it
- Efficacy and Safety of Intravenous Thrombolysis in Patients with Unknown Onset Stroke: A Meta-Analysis.Behavioural neurology · 2019Pooled it
- Improving physiological monitoring and reporting standards in preclinical stroke research.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026Review
- Quantification Beyond Binary of MR FLAIR Hyperintensity Lesions in Acute Ischemic Stroke of Unknown Time Since Onset.Diagnostics (Basel, Switzerland) · 2026Article
- A minimally invasive thrombotic model to study stroke in awake mice.Nature communications · 2025Article
- Towards improving the prognosis of stroke through targeting the circadian clock system.International journal of biological sciences · 2024Review
- Elevated Hypoperfusion Intensity Ratio (HIR) observed in patients with a large vessel occlusion (LVO) presenting in the evening.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2023Observational
- Ischemic stroke with unknown onset of symptoms: current scenario and perspectives for the future.Arquivos de neuro-psiquiatria · 2022Article
- Surrogate biomarkers of outcome for wake-up ischemic stroke.BMC neurology · 2022Article
- Wake-up stroke: imaging-based diagnosis and recanalization therapy.Journal of neurology · 2021Review
- Safety and efficacy of intravenous thrombolytic treatment in wake-up stroke: Experiences from a single center.Brain and behavior · 2021Article
- Multimodal CT Imaging Characteristics in Predicting Prognosis of Wake-Up Stroke.Frontiers in neurology · 2021Article
- Disruptions of Circadian Rhythms and Thrombolytic Therapy During Ischemic Stroke Intervention.Frontiers in neuroscience · 2021Review
- Thrombolysis beyond 4.5 h in Acute Ischemic Stroke.Current neurology and neuroscience reports · 2020Review
- Wake-up stroke: thrombolysis reduces ischemic lesion volume and neurological deficit.Journal of neurology · 2020Article
- Neuroimaging Paradigms to Identify Patients for Reperfusion Therapy in Stroke of Unknown Onset.Frontiers in neurology · 2018Review
- Wake-Up Stroke versus Stroke with Known Onset Time: Clinical and Multimodality CT Imaging Characteristics.Cerebrovascular diseases (Basel, Switzerland) · 2018Observational
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundStroke symptoms noticed upon waking, wake-up stroke, account for up to a quarter of all acute ischemic strokes. Patients with wake-up stroke, however, are often excluded from thrombolytic therapy.
methodsUsing our prospectively collected stroke registry, wake-up stroke and known-onset morning strokes were identified. Wakeup stroke was defined as a patient who was asleep >3 hours and first noted stroke symptoms upon awakening between 0100 and 1100. Known-onset morning stroke was defined as a patient who had symptom onset while awake during the same time interval. We compared wake-up stoke to known-onset morning stroke with respect to patient demographics, stroke severity, etiology and outcomes.
resultsOne-quarter of patients with acute ischemic strokes (391/1415) had documented time between 0100 and 1100 of symptom onset: 141 (36%) wake-up strokes and 250 (64%) known-onset morning strokes. No difference in baseline characteristics, stroke severity, stroke etiology, neurologic deterioration, discharge disposition or functional outcome was detected. Known-onset morning stroke patients were significantly more likely to get thrombolytic therapy and have higher risk of in-hospital mortality. Wake-up stroke patients tended to be older, have higher diastolic blood pressure and have longer length of hospital stay. DISCUSSION: While patients with wake-up stroke were similar to patients with known-onset morning stroke in many respects, patients with known onset morning stroke were significantly more likely to get treated with thrombolytic therapy and have higher in-hospital mortality.
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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.