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The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
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Electroencephalography Network Indices as Biomarkers of Upper Limb Impairment in Chronic Stroke
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Published on: July 14, 2023

Population-based study of wake-up strokes.

J Mackey1, D Kleindorfer, H Sucharew

  • 1University of Cincinnati, Department of Neurology, Cincinnati, OH 45219, USA. jason.mackey@uc.edu

Neurology
|May 11, 2011
PubMed
Summary

Approximately 14% of ischemic strokes are wake-up strokes, presenting similar clinical features and outcomes to other strokes. These findings highlight the significant proportion of wake-up strokes in the population.

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Area of Science:

  • Neurology
  • Epidemiology
  • Public Health

Background:

  • Wake-up strokes are ischemic strokes where symptom onset is unknown.
  • Previous estimates of wake-up stroke prevalence (8-28%) were based on small or non-population-based studies.

Purpose of the Study:

  • To determine the proportion and event rate of wake-up strokes in a large, population-based cohort.
  • To compare clinical features and outcomes of wake-up stroke patients with those of awake-onset stroke patients.

Main Methods:

  • A population-based study identified ischemic strokes in the Greater Cincinnati/Northern Kentucky region (1.3 million population) in 2005.
  • International Classification of Diseases-9 codes (430-436) were used for initial identification, followed by physician review for verification.
  • Included patients aged 18+ presenting to emergency departments, collecting baseline characteristics, modified Rankin Scale scores, and 90-day mortality.

Main Results:

  • 1,854 ischemic strokes were identified, with 273 (14.3%) classified as wake-up strokes.
  • No significant differences in clinical features or outcomes were observed between wake-up and awake-onset strokes.
  • The adjusted wake-up stroke event rate was 26.0 per 100,000 population; 35.9% of wake-up strokes were potentially eligible for thrombolysis.

Conclusions:

  • Wake-up strokes constitute approximately 14% of emergency department ischemic strokes in this population.
  • Clinical presentation and outcomes do not differentiate wake-up strokes from other ischemic strokes.
  • An estimated 58,000 wake-up stroke patients presented to US emergency departments in 2005.