Etiologia do Acidente Vascular Cerebral Isquêmico em paciente com Wake Up Stroke

Abstract

Introduction: Stroke is one of the most common diseases in our emergency services and it corresponds to the third largest cause of mortality in the US, while in Brazil it was the main cause in 2002. Wake up stroke (WUS), in which the affected individual awakens with neurological signs and symptoms, it is a distinct and underprivileged subgroup that holds the attention of the studies regarding the treatment of the acute phase. However, there is a literature description about an etiological characterization and presentation of WUS, which corresponds to 25% of all stroke. Objective: To verify the association of WUS with types of ischemic stroke according to the TOAST classification and to describe as clinical characteristics of the patients affected by WUS post-occurrence of stroke. Methodology: Cross-sectional study with reference to the study of unaccompanied patients in the outpatient clinic of Cerebrovascular Diseases of the University Hospital Complex Professor Edgard Santos, over 18 years who suffered stroke. The instrument of collection for a standardized questionnaire, filled through data obtained without medical records of the patients. The data were analyzed with the aid of Statistical Package for Social Sciences (version 17.0 for Windows, SPSS, Chicago, IL, USA). Results: In a sample of 241 subjects, mean age was 58.6 years (standard deviation 15.5). In this population 53.5% were female, and the brown color was predominant (42.7%). Regarding the vascular event characteristic, 29.5% were classified as WUS. 78.7% had systemic arterial hypertension (SAH), 26.7% had diabetes mellitus (DM) and 65.2% had dyslipidemic. Most WUS events were of ischemic etiology, although there was no statistical significance. In the WUS group, an "indeterminate" etiology prevailed and then cardioembolism (21.6%). Conclusion: The study did not show an association between wake up stroke and ischemic stroke subtypes according to the TOAST classification. Likewise, there is no difference between groups as to clinical characteristics and frequency of thrombolysis.