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Article Dans Une Revue Stroke Année : 2017

Stroke With Unknown Time of Symptom Onset

Götz Thomalla
  • Fonction : Auteur
Florent Boutitie
  • Fonction : Auteur
Jochen Fiebach
  • Fonction : Auteur
Claus Simonsen
  • Fonction : Auteur
Norbert Nighoghossian
Salvador Pedraza
  • Fonction : Auteur
Robin Lemmens
  • Fonction : Auteur
Keith Muir
  • Fonction : Auteur
Martin Ebinger
  • Fonction : Auteur
Ian Ford
  • Fonction : Auteur
Bastian Cheng
  • Fonction : Auteur
Ivana Galinovic
  • Fonction : Auteur
Tae-Hee Cho
  • Fonction : Auteur
  • PersonId : 918240
Josep Puig
  • Fonction : Auteur
Vincent Thijs
  • Fonction : Auteur
Matthias Endres
  • Fonction : Auteur
Jens Fiehler
  • Fonction : Auteur
Christian Gerloff
  • Fonction : Auteur

Résumé

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.

Dates et versions

hal-04152578 , version 1 (05-07-2023)

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Citer

Götz Thomalla, Florent Boutitie, Jochen Fiebach, Claus Simonsen, Norbert Nighoghossian, et al.. Stroke With Unknown Time of Symptom Onset. Stroke, 2017, 48 (3), pp.770-773. ⟨10.1161/STROKEAHA.116.015233⟩. ⟨hal-04152578⟩

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