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J Neurol Sci. 2011 Jan 15;300(1-2):148-50. doi: 10.1016/j.jns.2010.10.019.

Acute endovascular recanalization therapy in wake-up stroke.

Author information

  • 1WSU/DMC Comprehensive Stroke Program, Department of Neurology, Wayne State University School of Medicine, 4201 St. Antoine, Detroit, MI 48201, USA. akuruvilla@doctor4u.com

Abstract

BACKGROUND AND PURPOSE:

Up to 15-25% of patients with ischemic stroke wake up with their deficits. Because of the uncertainty about the time of onset, these patients are generally not offered thrombolytic therapy. Some of these wake-up stroke patients may be eligible for acute endovascular stroke therapy based on hyperacute CT or MR imaging independent of the time window.

REPORT:

We report two patients with acute ischemic stroke whose symptoms were present upon awakening and who were successfully treated with endovascular interventions.

RESULTS:

The first patient was discharged with complete neurological recovery on second day after endovascular intervention. The second patient went home on fifth day with a mild left facial paresis and left arm drift. Both these patients did not have any neurological deficit on 18-month follow up.

CONCLUSIONS:

Some patients who present with stroke on awakening may be candidates for thrombolytic therapy or recanalization techniques irrespective of mode of therapy (intravenous, intravenous+intra-arterial or intra-arterial tPA alone). Further randomized, controlled studies are warranted to safely identify those candidates who would benefit from thrombolysis and endovascular interventions in ischemic wake-up strokes.

PMID:
21078516
DOI:
10.1016/j.jns.2010.10.019
[PubMed - indexed for MEDLINE]
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