BACKGROUND: An estimated 20-25% of all strokes occur during sleep and these patients wake up with their deficits. This study evaluated outcomes among patients who woke up with stroke compared to those who were awake at stroke onset. METHODS: Using data from the Registry of the Canadian Stroke Network Phases 1 and 2, we compared demographics, clinical data and six-month outcomes between patients with stroke-on-awakening versus stroke-while-awake. Strokes of all types (ischemic stroke, transient ischemic attack, intracerebral hemorrhage and subarachnoid hemorrhage) were included. Standard descriptive statistics, multivariable logistic regression and general linear modeling were applied to the data to compare variables. RESULTS: Among 2585 stroke patients, 349 (13.5%) woke up with stroke and 2236 (86.5%) did not. Patients with stroke-on-awakening were more likely to have higher blood pressure and to suffer ischemic stroke, but stroke severity, measured by level of consciousness, did not differ. Mortality both at discharge and at six-month follow-up did not differ between the two cohorts. However, patients with stroke-on-awakening were less likely to return home, and their median Stroke Impact Scale-16 scores were 7.0 points lower compared to those with stroke-while-awake. CONCLUSIONS: There are minor demographic and clinical differences between patients with stroke-on-awakening and stroke-while-awake. Functional outcomes are slightly worse among patients with stroke-on-awakening, an effect which was driven by poor outcomes among patients with subarachnoid hemorrhage.
BACKGROUND: An estimated 20-25% of all strokes occur during sleep and these patients wake up with their deficits. This study evaluated outcomes among patients who woke up with stroke compared to those who were awake at stroke onset. METHODS: Using data from the Registry of the Canadian Stroke Network Phases 1 and 2, we compared demographics, clinical data and six-month outcomes between patients with stroke-on-awakening versus stroke-while-awake. Strokes of all types (ischemic stroke, transient ischemic attack, intracerebral hemorrhage and subarachnoid hemorrhage) were included. Standard descriptive statistics, multivariable logistic regression and general linear modeling were applied to the data to compare variables. RESULTS: Among 2585 strokepatients, 349 (13.5%) woke up with stroke and 2236 (86.5%) did not. Patients with stroke-on-awakening were more likely to have higher blood pressure and to suffer ischemic stroke, but stroke severity, measured by level of consciousness, did not differ. Mortality both at discharge and at six-month follow-up did not differ between the two cohorts. However, patients with stroke-on-awakening were less likely to return home, and their median Stroke Impact Scale-16 scores were 7.0 points lower compared to those with stroke-while-awake. CONCLUSIONS: There are minor demographic and clinical differences between patients with stroke-on-awakening and stroke-while-awake. Functional outcomes are slightly worse among patients with stroke-on-awakening, an effect which was driven by poor outcomes among patients with subarachnoid hemorrhage.
Authors: Geoffrey A Donnan; Stephen M Davis; Mark W Parsons; Henry Ma; Helen M Dewey; David W Howells Journal: Nat Rev Neurol Date: 2011-06-14 Impact factor: 42.937
Authors: Lee H Schwamm; Ona Wu; Shlee S Song; Lawrence L Latour; Andria L Ford; Amie W Hsia; Alona Muzikansky; Rebecca A Betensky; Albert J Yoo; Michael H Lev; Gregoire Boulouis; Arne Lauer; Pedro Cougo; William A Copen; Gordon J Harris; Steven Warach Journal: Ann Neurol Date: 2018-04-27 Impact factor: 10.422
Authors: J Mackey; D Kleindorfer; H Sucharew; C J Moomaw; B M Kissela; K Alwell; M L Flaherty; D Woo; P Khatri; O Adeoye; S Ferioli; J C Khoury; R Hornung; J P Broderick Journal: Neurology Date: 2011-05-10 Impact factor: 9.910
Authors: Andrew D Barreto; Sheryl Martin-Schild; Hen Hallevi; Miriam M Morales; Anitha T Abraham; Nicole R Gonzales; Kachi Illoh; James C Grotta; Sean I Savitz Journal: Stroke Date: 2009-01-08 Impact factor: 7.914
Authors: J W Evans; B R Graham; P Pordeli; F S Al-Ajlan; R Willinsky; W J Montanera; J L Rempel; A Shuaib; P Brennan; D Williams; D Roy; A Y Poppe; T G Jovin; T Devlin; B W Baxter; T Krings; F L Silver; D F Frei; C Fanale; D Tampieri; J Teitelbaum; D Iancu; J Shankar; P A Barber; A M Demchuk; M Goyal; M D Hill; B K Menon Journal: AJNR Am J Neuroradiol Date: 2017-11-30 Impact factor: 3.825