Observational studyCerebrovascular diseases (Basel, Switzerland)2018
Wake-Up Stroke versus Stroke with Known Onset Time: Clinical and Multimodality CT Imaging Characteristics.
Observational study in Cerebrovascular diseases (Basel, Switzerland), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Meta-Analysis of the Association Between Atrial Fibrillation, Hypertension, Sleep-Disordered Breathing, and Wake-Up Stroke.Texas Heart Institute journal · 2023Pooled it
- Diffusion-/perfusion-weighted imaging fusion to automatically identify stroke within 4.5 h.European radiology · 2024Article
- Circ_0008146 Exacerbates Ferroptosis via Regulating the miR-342-5p/ACSL4 Axis After Cerebral Ischemic/Reperfusion.Journal of inflammation research · 2024Article
- 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
- Clinical and radiological factors predicting stroke outcome after successful mechanical intervention in anterior circulation.European heart journal supplements : journal of the European Society of Cardiology · 2022Article
- Multimodal CT Imaging Characteristics in Predicting Prognosis of Wake-Up Stroke.Frontiers in neurology · 2021Article
- CT Imaging Characteristics and Influence Factors of Renal Dialysis-Associated Peritoneal Injury.Journal of healthcare engineering · 2021Article
- Stroke Treatment With PAR-1 Agents to Decrease Hemorrhagic Transformation.Frontiers in neurology · 2021Review
- Effect of the Number of Neurointerventionalists on Off-Hour Endovascular Therapy for Acute Ischemic Stroke Within 12 Hours of Symptom Onset.Journal of the American Heart Association · 2019Article
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Authors and funding
10 authors.
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Abstract
backgroundCurrent guidelines for the treatment of acute ischemic stroke are mainly based on the time between symptom onset and initiation of treatment. This time is unknown in patients with wake-up stroke (WUS). We investigated clinical and multimodality CT imaging characteristics on admission in patients with WUS and in patients with a stroke with a known onset time.
methodsAll patients were selected from a large prospective cohort study (Dutch acute stroke study). WUS patients last seen well > 4.5 and ≤4.5 h were separately compared to patients with a known onset time ≤4.5 h. In addition, WUS patients with a proximal occlusion of the anterior circulation last seen well > 6 and ≤6 h were separately compared to patients with a known onset time ≤6 h and a proximal occlusion. National Institute of Health Stroke Score, age, gender, history of atrial fibrillation, non-contrast CT (NCCT) Alberta Stroke Program Early CT Score (ASPECTS), CT-perfusion abnormalities, proximal occlusions, and collateral filling on CT angiography were compared between groups using the Mann-Whitney U test and Fisher's exact test.
resultsWUS occurred in 149/1,393 (10.7%) patients. Admission clinical and imaging characteristics of WUS patients last seen well > 4.5 h (n = 81) were not different from WUS patients last seen well ≤4.5 h (n = 68). Although WUS patients last seen well > 4.5 h had a significantly lower NCCT ASPECTS than patients with a known time of stroke symptom onset of ≤4.5 h (n = 1,026), 85.2% had an NCCT ASPECTS > 7 and 75% had a combination of favorable ASPECTS > 7 and good collateral filling. There were no statistically significant differences between the admission clinical and imaging characteristics of WUS patients with proximal occlusions last seen well > 6 h (n = 23), last seen well ≤6 h (n = 40), and patients with a known time to stroke symptom onset ≤6 h (n = 399). Of all WUS patients with proximal occlusions last seen well > 6 h, only 4.3% had severe ischemia (ASPECTS < 5), 13 (56.5%) had ASPECTS > 7 and good collateral filling.
conclusionsThere are only minor differences between clinical and imaging characteristics of WUS patients and patients who arrive in the hospital within the time criteria for intravenous or endovascular treatment. Therefore, CT imaging may help to identify WUS patients who would benefit from treatment and rule out those patients with severe ischemia and poor collaterals.
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