POSSIBLE THROMBOLYTIC THERAPY FOR TREATMENT OF WAKE-UP STROKE
Publish place: 14th iranian annual congress of emergency medicine
Publish Year: 1398
نوع سند: مقاله کنفرانسی
زبان: English
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شناسه ملی سند علمی:
EMERGENCYMED14_040
تاریخ نمایه سازی: 26 بهمن 1398
Abstract:
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.
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Authors
Alireza Baratloo
Department of Emergency Medicine, Sina Hospital,TehranUniversityofMedicalSciences,Tehran,Iran
Mohamed Elfil
Department of Neurology, Yale University, New Haven, Connecticut, USA