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An estimated 58000 wake up with stroke each year that goes untreated

Kathleen Blanchard's picture
wake up stroke happens in 14 percent of patients

’Wake-up’ stroke prevents clot busting treatment

Stroke that happens during sleep sends 58,000 to the emergency room annually, according to research estimates, but most patients don’t receive treatment because no one knows when the stroke happened.

Researchers are addressing the 14 percent of people in the US who experience “ wake up stroke” to see what type of intervention would be most beneficial.

In a new study, investigators found many patients would be eligible to receive drugs to break up clots and restore blood flow to the brain if the time of symptom onset had been known.

Clot busting drugs, known as tPA (tissue plasminogen activator) are approved for use in the first 3 hours of stroke symptoms, leaving out one in 7 patients who have stroke during sleep but might be eligible for treatment with the drugs.

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According to study author Jason Mackey, MD, of the University of Cincinnati and a member of the American Academy of Neurology, “Imaging studies are being conducted now to help us develop better methods to identify which people are most likely to benefit from the treatment, even if symptoms started during the night.”

Researchers studied patients with stroke in the Greater Cincinnati/Northern Kentucky region over one year period and found most causes are from blocked arteries, known as ischemic stroke that they say should be a focus for future studies.

Of the 1,854 ischemic strokes in the study, 273, or 24 percent were “wake up” strokes”. The scientists found no difference in risk factors whether stroke happens during sleep or while awake.

Typical risk factors include high blood pressure, high cholesterol, smoking and diabetes.

Minor differences were found in age - stroke during sleep occurred more often around age 72 versus age 70 and tended to be slightly more severe.

Ninety eight of the 273 patients would have been eligible for clot busting drugs but the time of stroke was unknown. Mackey said. “It’s likely that some of these strokes occurred immediately prior to awakening, and people would benefit from treatment.”

American Academy of Neurology



Can anyone tell me what problems can arise from non-treatment. Also, could the failure to treat someone result in left arm and leg numbness occurring in the months following. Example: Possible WakeUp Stroke occurs (Monday), symptoms disappeared by mid-day, GP consulted later that day, sent to hospital the following day(Tuesday), MRI carried out late on the Tuesday afternoon, hospital say no stroke occurred.
Hi Sarann: Without treatment the risk is higher for a recurrence of stroke or even a larger one. Many strokes can be seen on scans, but certainly not all. The bottom line is if there is any suspicion of stroke and there are risk factors (family history, age, high cholesterol, high blood pressure, abnormalities of the blood that would lead to clotting), that should all be addressed. So, the answer is non-treatment could mean higher chance of stroke again and also brain tissue death that could be spared with tPA drugs. Arm and leg numbness alone - without weakness or other symptoms could be so many things also. As far as symptoms go from lack of stroke treatment, I think the best source of that information would be from a healthcare provider who knows the person's history in depth.