Wake-up stroke: imaging-based diagnosis and recanalization therapy

Area of Science:

• Neurology
• Radiology
• Emergency Medicine

Background:

• Wake-up stroke (WUS) presents with neurological deficits upon waking, complicating diagnosis and treatment.
• Delayed reperfusion therapy in WUS patients is linked to poorer clinical outcomes.
• Current treatment guidelines often exclude WUS due to uncertain symptom onset.

Purpose of the Study:

• To review the pathogenesis, risk factors, and diagnostic imaging of WUS.
• To explore recanalization therapies and their benefits for WUS patients.
• To identify strategies for improving treatment options and prognosis in WUS.

Main Methods:

• Narrative review of existing research on WUS.
• Analysis of CT and MRI imaging techniques for WUS diagnosis.
• Evaluation of thrombolysis and endovascular therapy outcomes in WUS.

Main Results:

• Multimodal MRI and CT scans show promise in extending the therapeutic window for WUS.
• Advanced imaging facilitates better patient selection for reperfusion therapies.
• Timely and appropriate treatment can lead to favorable prognoses for many WUS patients.

Conclusions:

• Optimizing diagnostic imaging is crucial for managing WUS.
• Expanding treatment eligibility based on advanced imaging can improve outcomes.
• Further research into WUS pathogenesis and treatment is warranted.