Advances in safety and efficacy of intravenous thrombolytic therapy for post-stroke stroke patients based on multi-modal MRI

Abstract

Wake up ischemic stroke (WUIS), also known as awakening stroke, refers to patients with no new stroke symptoms during sleep, but after waking up, the patients or witness who found the acute cerebral infarction with stroke performance.The key to the treatment of acute ischemic stroke is to effectively restore reperfusion within the time window.The original intravenous recombinant tissue-type plasminogen activator (rt-PA) thrombolytic therapy, is widely recognized as an effective treatment method of choice for 4.5h onset of acute ischemic stroke reperfusion.Because the exact onset time of WUIS is unclear and limited by current scientific and technical levels, intravenous thrombolysis may lead to an increased risk of intracranial hemorrhage.Therefore, the American Heart Association and the American Stroke Association (AHA/ASA) were included in the Thrombolysis . Intravenous thrombolysis is not recommended in the Standard Scientific Statement.Patients who may be suitable for thrombolytic therapy are not able to obtain thrombolytic therapy, resulting in poor clinical prognosis.In recent years, with the further development of relevant clinical research and the rapid development of imaging technology, the latest research found that multi-mode imaging examination is safe and effective for intravenous thrombolytic therapy in patients with post-stroke stroke.Multi-mode imaging studies help screening patients with acute reperfusion therapy, so that part of WUIS patients will benefit from the acute reperfusion therapy.This article reviews and summarizes the literature findings of WUIS in recent years.The pathophysiological changes, clinical features and imaging changes of patients with WUIS and non-WUIS are almost unanimously.Early CT and MRI examinations can help to extend acute stroke treatment to patients with WUIS.At present, for this type of patients, there are great research progress in the formulation and implementation of clinical treatment strategies.This article will briefly summarize the research progress and treatment status of WUIS. Key words: Stroke; Thrombolytic therapy; Magnetic resonance imaging; Review