Related Experiment Video
Updated: Mar 14, 2026
09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
12.7K
Wake-up stroke-Amendable for thrombolysis-like stroke with known onset time?
M W Kurz1,2, R Advani1,2, G N Behzadi3,4
1Department of Neurology, Stavanger University Hospital, Stavanger, Norway.
Acta Neurologica Scandinavica
|September 20, 2016
Summary
Acute ischemic stroke patients awakening with stroke symptoms are often excluded from thrombolysis. This review examines evidence to improve treatment decisions for these wake-up stroke cases.
Area of Science:
- Neurology
- Emergency Medicine
- Radiology
Background:
- Intravenous thrombolysis is a key treatment for acute ischemic stroke.
- Treatment requires a known onset time within 4.5 hours.
- Wake-up stroke patients have an unknown onset time, often excluding them from therapy.
Purpose of the Study:
- To review evidence for treating wake-up stroke patients.
- To inform clinical decision-making for thrombolysis in these cases.
Main Methods:
- Literature review of pathophysiological, clinical, and radiological evidence.
- Analysis of treatment guidelines and patient exclusion criteria.
Main Results:
- Wake-up strokes present unique challenges due to unknown onset times.
- Current guidelines largely exclude these patients despite potential eligibility.
- Pathophysiological and imaging evidence may support expanded treatment windows.
Conclusions:
- Further research and guideline adaptation are needed for wake-up stroke treatment.
- Improved diagnostic criteria could enable more patients to receive timely thrombolysis.
