Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/16752
Title: Stroke with unknown time of symptom onset: baseline clinical and magnetic resonance imaging data of the first thousand patients in WAKE-UP (efficacy and safety of MRI-Based thrombolysis in WAKE-UP stroke: a randomized, doubleblind, placebo-controlled trial)
Authors: Thomalla, Gotz;Boutitie, Florent;Fiebach, Jochen B;Simonsen, Claus Z;Nighoghossian, Norbert;Pedraza, Salvador;Lemmens, Robin;Roy, Pascal;Muir, Keith W;Ebinger, Martin;Ford, Ian;Cheng, Bastian;Galinovic, Ivana;Cho, Tae-Hee;Puig, Josep;Thijs, Vincent;Endres, Matthias;Fiehler, Jens;Gerloff, Christian;WAKE-UP Investigators
Issue Date: Mar-2017
EDate: 2017-02-17
Citation: Stroke 2017; 48(3): 770-773
Abstract: BACKGROUND AND PURPOSE: We describe clinical and magnetic resonance imaging (MRI) characteristics of stroke patients with unknown time of symptom onset potentially eligible for thrombolysis from a large prospective cohort. METHODS: We analyzed baseline data from WAKE-UP (Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke: A Randomized, Doubleblind, Placebo-Controlled Trial), an investigator-initiated, randomized, placebo-controlled trial of MRI-based thrombolysis in stroke patients with unknown time of symptom onset. MRI judgment included assessment of the mismatch between visibility of the acute ischemic lesion on diffusion-weighted imaging and fluid-attenuated inversion recovery. RESULTS: Of 1005 patients included, diffusion-weighted imaging and fluid-attenuated inversion recovery mismatch was present in 479 patients (48.0%). Patients with daytime-unwitnessed stroke (n=138, 13.7%) had a shorter delay between symptom recognition and hospital arrival (1.5 versus 1.8 hours; P=0.002), a higher National Institutes of Stroke Scale score on admission (8 versus 6; P<0.001), and more often aphasia (72.5% versus 34.0%; P<0.001) when compared with stroke patients waking up from nighttime sleep. Frequency of diffusion-weighted imaging and fluid-attenuated inversion recovery mismatch was comparable between both groups (43.7% versus 48.7%; P=0.30). CONCLUSIONS: Almost half of the patients with unknown time of symptom onset stroke otherwise eligible for thrombolysis had MRI findings making them likely to be within a time window for safe and effective thrombolysis. Patients with daytime onset unwitnessed stroke differ from wake-up stroke patients with regards to clinical characteristics but are comparable in terms of MRI characteristics of lesion age. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01525290. URL: https://www.clinicaltrialsregister.eu. Unique identifier: 2011-005906-32.
URI: http://ahro.austin.org.au/austinjspui/handle/1/16752
DOI: 10.1161/STROKEAHA.116.015233
ORCID: 0000-0002-6614-8417
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/28174327
Type: Journal Article
Subjects: Aphasia
Informed consent
Magnetic resonance imaging
Risk factors
Stroke
Type of Clinical Study or Trial: Randomized Controlled Clinical Trial/Controlled Clinical Trial
Appears in Collections:Journal articles

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