POSSIBLE THROMBOLYTIC THERAPY FOR TREATMENT OF WAKE-UP STROKE

Background and Aim : Wake-upstroke(WUS) or ischemic stroke occurring during sleep accountsfor 14%–29. 6% of all ischemic strokes. Management of WUS is complicated by its narrowtherapeutic time window and attributable risk factors, which can affect the safety and efficacy ofadministering intravenous(IV) tissue plasminogen activator (t-PA). This manuscript will reviewrisk factors of WUS, with a focus on obstructive sleep apnea, potential mechanisms of WUS, andevaluate studies assessing safety and efficacy of IV t-PA treatment in WUS patients guided byneuroimaging to estimate time of symptom onset.Methods : The authors used PubMed (1966 to March 2018) to search for the term Wake-UpStroke cross-referenced with pathophysiology, ‘‘pathogenesis, pathology, magneticresonanceimaging, obstructive sleepapnea, or treatment. English language Papers were reviewed. Also reviewed were pertinentpapers from the reference list of the above-matched manuscripts. Studies that focused only onacute Strokes with known-onset of symptoms were not reviewed.Results : ...Conclusion : Literature showed several potential risk factors associated with increased risk ofWUS. Although the onset of WUS is unknown, a few studies investigated the potential benefit ofmagnetic resonance imaging (MRI) in estimating the age of onset which encouraged conductingclinical trials assessing the efficacy of MRI-guided thrombolytic therapy in WUS.

کلیدواژه ها:

Wake-up Stroke ، thrombolytic therapy ، MRI