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Updated: Feb 11, 2026

Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Safety and cost-effectiveness thrombolysis by diffusion-weighted imaging and fluid attenuated inversion recovery
Tong Sun1, Zhuan Xu1, Shan-Shan Diao1
1Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Abstract:
Wake-up stroke, defined as patients who wake up with stroke symptoms which were not present prior to falling asleep, accounted for 14%-25% of acute ischemic stroke. Due to the unknown time of symptom onset, wake-up stoke was not in including criteria of intravenous thrombolysis. Several large randomized stroke trials using diffusion-weighted imaging(DWI)and fluid attenuated inversion recovery(FLAIR)mismatch patient selection may identify a subset of patients with wake-up stroke that can safely and effectively benefit from intravenous thrombolysis. In addition, economic factor was another important limitation to generalize thrombolysis treatment. Fortunately, MRI-based thrombolysis was a cost-effective treatment for wake-up stroke compared to these patients with no thrombolysis.
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