Strokes frequently occur during sleep, undermining the ability of clot-busting drugs to minimize damage, suggests a large study being published tomorrow in the journal Neurology. And that makes stroke prevention more important than ever.
Researchers examined the records from 1,854 ischemic strokes—caused by blocked blood flow to the brain—treated in hospital emergency rooms in the greater Cincinnati area (which also includes parts of Northern Kentucky) in 2005. Of them, 273, or 14 percent, were “wake-up strokes,” meaning the person went to bed healthy and woke up with stroke symptoms, such as slurred speech, facial drooping, and weakness on one side of the body.
"Wake-up" stroke patients currently aren't candidates for potentially life-saving clot-dissolving drugs known as thrombolytics,
because they're effective only if given within three hours of the onset of symptoms, and because they can be used only if doctors know exactly when the stroke occurred. In addition, many people aren’t good candidates for thrombolytics because of high blood pressure or other risk factors. But the researchers determined that 98 of the wake-up stroke patients in the study, or about 36 percent, would have been good candidates for the therapy if doctors had known when the stroke occurred.
The finding underlines the importance of preventing strokes in the first place. See our recent report on how to avoid a stroke, plus advances in rehabilitation.
Population-based study of wake-up strokes [Neurology]