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AJNR - American Journal of Neuroradiology

Published ahead of print on April 3, 2008
doi: 10.3174/ajnr.A1069

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American Journal of Neuroradiology 29:1314-1316, August 2008
© 2008 American Society of Neuroradiology

Case Report
BRAIN

MR Imaging–Based Decision in Thrombolytic Therapy for Stroke on Awakening: Report of 2 Cases

C. Iosif^a, C. Oppenheim^a, D. Trystram^a, V. Domigo^b and J.-F. Méder^a

^a Departments of Neuroradiology, Université Paris Descartes, Centre Hospitalier Sainte-Anne, Paris, France
^b Departments of Neurology, Université Paris Descartes, Centre Hospitalier Sainte-Anne, Paris, France

Please address correspondence to Catherine Oppenheim, MD, Department of Neuroradiology, Université Paris Descartes, Centre Hospitalier Sainte-Anne, 1 rue Cabanis, 75674 Paris Cedex 14, France; e-mail: c.oppenheim{at}ch-sainte-anne.fr

SUMMARY: Patients with stroke on awakening are denied the potential benefit of thrombolysis on the grounds that the onset time is unknown. Relying on clinical and MR imaging to indicate the most appropriate treatment could be more rational. We report 2 cases of stroke with unknown onset time. In both cases, anamnesis and MR imaging indicated that we might still be within 6 hours from stroke onset, with salvageable tissue. Arterial recanalization was successfully performed in both cases.