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One in seven stroke occurs during sleep

May 12, 2011

One in seven stroke occurs during sleep

NEW YORK (Reuters Health) – About 15 percent of people who suffer a stroke (CVA) does not receive thrombolytic therapy because they all happened while they slept.

Thrombolytics help prevent permanent disability after a stroke, but must be administered within 4.5 hours of symptom onset.

Since people who have a stroke during sleep can not know exactly when it happened, can not receive treatment if they slept for more than 4.5 hours, said Dr. Jason Mackey, University of Cincinnati.

When Mackey’s team compared those with the ACV ACV day night, no major differences observed between the two, indicating that you can apply the same advice for prevention and treatment used for ACV day, explained the author.

Strokes that occur while the patient is asleep or awake “no different”, so said the people concerned should prevent the general health care, taking the pressure, eat right, exercise and control cholesterol.

Stroke can be treated if you act quickly, said Mackey. So that any person who wakes up with typical symptoms (difficulty speaking or walking, or weakness in an arm, leg or one side of the face) should act immediately.

“If you suspect that someone is having a stroke, call Fast 911,” he said. Stroke is the third leading cause of death in the United States, after heart disease and cancer.

The team reviewed the medical records of patients treated at emergency units in Ohio and Kentucky in 2005. Identified 1,854 people with the most common type of stroke, which obstructs blood flow to the brain. Nearly 15 percent of that group (273) said he had woken up with symptoms.

If 15 percent of strokes occur during sleep, the team estimated 58,000 Americans consult in emergency units after waking with symptoms of a stroke, according to the journal Neurology.

By comparing the ACV day with night, the team found no major differences. In general, patients with stroke were slightly higher arousal and heart attacks were more severe, but no other distinguishing characteristics.

No patient awoke with symptoms received the clot-busting drug called tPA (the acronym of tissue plasminogen activator).

But what if some had had the stroke immediately before waking, rather than several hours earlier? That would have enabled them to receive treatment.

In fact, one third of people with awakening stroke drug could have received if the weather was not a requirement. None had other features that would prevent him from receiving tPA, such as hypertension or recent surgery.

“A lot of these patients have no reason to not receiving the therapy,” said Mackey. The reason why physicians hesitate to administer tPA after that key window of time, he explained, is the risk of bleeding in the brain.

In addition, no previous study showed that there are benefits if these drugs are used long after the onset of stroke symptoms.

The next step, Mackey said, is to investigate how to estimate the ACV when arousal occurs so that doctors can determine which patients with symptoms on awakening may receive tPA “and thus give them a chance.”

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