Just curious how many of you guys do stroke alerts on wake up strokes at your hospital? Is this standard of care where you are? Are you giving lytics to wake up strokes? Doing CT angios then endovascular?
This is exactly what MR-Witness is doing, assessing the safety of using MRI diffusion/FLAIR ratio to assess the radiographic age of the infarct as a surrogate for a LSW time for wake-up strokes.No, currently its not recommended to treat (with tpa) wake up strokes( after therapeutic window), even if u get radiological evidence of mismatch. Some people might still be candidates for IR/IA so u still want to do the acute Imaging and may call 'Stroke Alert'(whatever that means!). Although this is going to change soon, many places are doing it on a 'research' basis. I mean, I see patients who normally wake up at say 7 and today they woke up at 3 am w symptoms, big mismatch on perfusion- U know it has to be acute- but u cant treat .
U know it has to be acute- but u cant treat .