Wake Up and Non-Wake up stroke: A comparative Hospital Based Study

Background: Almost 25% of all acute ischemic strokes occur during sleep with the patients or relatives become aware of the neurological deficits as they wake up. The present study was conducted with an aim to find out the prevalence of wakeup stroke along with clinical profile and outcome of wake up stroke as compared to non-wake up stroke. Methods: All patients of age group 18 years or more presenting with stroke during the 12-month study period were included. Data was compared with non-wakeup stroke by applying Chi square test, Fischer exact test and Yates corrections was used to evaluate the association between the variables defining the clinical profile and outcome. Results: Patients of non wake-up stroke were higher (63%) as compared to wake-up stroke (37%). Out of 37 wake-up stroke patients, ischemic stroke was found in 23(62.16%) and hemorrhagic stroke in 14(37.83%) patients. Out of 14(37.83%) wakeup strokes; in 8(57.14%) patients lesion was parenchymal and in 5(35.71%) multiple lesions were present. Higher incidence of diabetes mellitus in wake up strokes was found. Atherothrombotic and cardioembolic strokes contribute to majority of the cases of ischemic stroke. Conclusions: The incidence of stroke increases dramatically with advancing age irrespective of gender. .Diabetes mellitus emerged as the main risk factor in wake-up stroke. In wake up hemorrhagic stroke, the higher percentage of thalamic bleed was found. Improvement was appreciated more in non wake-up stroke as compared to wake-up stroke.