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Haptic/Graphic Rehabilitation: Integrating a Robot into a Virtual Environment Library and Applying it to Stroke Therapy

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Published on: August 8, 2011

Recanalisation therapies for wake-up stroke.

Melinda B Roaldsen¹, Haakon Lindekleiv, Ellisiv B Mathiesen

¹Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.

The Cochrane Database of Systematic Reviews

|August 22, 2018

Summary

Wake-up strokes, occurring during sleep, lack sufficient evidence for thrombolytic treatment recommendations. Ongoing trials aim to establish the efficacy and safety of recanalisation therapies for these stroke patients.

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Area of Science:

Neurology
Cardiovascular Diseases
Clinical Trials

Background:

Approximately 20% of strokes occur during sleep (wake-up stroke).
Wake-up stroke patients are often excluded from thrombolytic treatment due to unknown onset time.
Emerging evidence suggests potential benefits of recanalisation therapies for wake-up strokes.

Purpose of the Study:

To evaluate the effectiveness of intravenous thrombolysis and other recanalisation therapies compared to control in acute ischemic stroke patients presenting upon awakening.
To synthesize current evidence on recanalisation therapies for wake-up strokes.

Main Methods:

Comprehensive search of multiple electronic databases and trial registries up to January 2018.
Inclusion of randomized controlled trials investigating thrombolytic drugs or intra-arterial therapies for wake-up strokes.
Data extraction and quality assessment using the GRADE approach by two independent reviewers.

Main Results:

Only one small pilot feasibility trial with nine participants was included.
The pilot trial randomized participants with unknown stroke onset to alteplase or placebo.
One trial was terminated early, and data for wake-up stroke patients could not be obtained.

Conclusions:

Current randomized controlled trial evidence is insufficient to recommend recanalisation therapies for wake-up stroke.
Results from ongoing trials are anticipated to clarify the efficacy and safety of these treatments.
Further research is needed to guide treatment decisions for patients with stroke onset during sleep.