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Patients who wake up with symptoms of stroke typically are not eligible for treatment with intravenous tissue plasminogen activator unless they are known to have been well within 3 hours before presentation (4.5 hours for certain patients). In a retrospective review of all adult patients who presented in 2005 with ischemic stroke to emergency departments in the greater Cincinnati/northern Kentucky region (population 1.3 million), researchers compared characteristics between patients with wake-up ischemic strokes and those with other ischemic strokes.
Of 1854 first-time or recurrent ischemic strokes (1778 patients), 273 (14.7%) were categorized as wake-up strokes. The wake-up stroke event rate (adjusted for age, sex, and race, and extrapolate…