Wake-Up Strokes Are Similar to All Other Ischemic Strokes

In a large population-based study, demographic characteristics, stroke risk factors, and outcomes were similar between patients with wake-up ischemic strokes and those with all other strokes.


Patients who wake up with symptoms of stroke typically are not eligible for treatment with intravenous tissue plasminogen activator unless they are known to have been well within 3 hours before presentation (4.5 hours for certain patients). In a retrospective review of all adult patients who presented in 2005 with ischemic stroke to emergency departments in the greater Cincinnati/northern Kentucky region (population 1.3 million), researchers compared characteristics between patients with wake-up ischemic strokes and those with other ischemic strokes.

Of 1854 first-time or recurrent ischemic strokes (1778 patients), 273 (14.7%) were categorized as wake-up strokes. The wake-up stroke event rate (adjusted for age, sex, and race, and extrapolated to the U.S. adult population) was 26 per 100,000 persons. No clinically significant differences were noted between patients with wake-up strokes and those with other strokes. The authors estimated that 36% of patients with wake-up strokes would have been eligible for thrombolytic therapy if time were not an exclusion criterion.


Citation(s):

Mackey J et al. Population-based study of wake-up strokes. Neurology 2011 May 10; 76:1662.