Understanding Wake-Up Strokes: Symptoms, Diagnosis, and Patient Awareness

Teacher Krista Figari is opening up about how she experienced a “wake-up” stroke at the age of 39. This includes sharing video clips of the event that were captured as it happened. Figari is sharing her story to help others recognize the symptoms of stroke and raise awareness, as early intervention of stroke can help save lives.

What is a Wake-Up Stroke?

A wake-up stroke is a type of ischemic stroke that occurs when symptoms are discovered as a person wakes up from sleep. While strokes are unpredictable and can happen at any time, about 20% of strokes are wake-up strokes.

Recognizing the Symptoms

During her experience, Krista Figari described the sudden onset of symptoms: “I remember waking up and doing my normal routine. I made my bed, and all the sudden, I kind of stumbled over to the left and was on the ground.” She further explained the severity of the condition:

• “I couldn’t stand up.”
• “I literally couldn’t move, lift, feel my leg, my arm, my hand.”
• “That whole left side was just not working.”

As Figari tried to understand what was happening, she used Siri to call 911. When Figari arrived at New York-Presbyterian/Weill Cornell Medical Center, doctors quickly diagnosed her with a stroke.

Diagnosis and Treatment Options

Nicholas Janocko, MD, a neurologist at NewYork Presbyterian Hospital, explained the medical protocols for such events. If a patient comes in with witnessed stroke onset within 4.5 hours of having their first symptoms, they can be treated with a clot-busting medication or thrombolysis; TPA or TNK are the medication names.

The 2018 WAKE-UP trial demonstrated that in selected patients who experienced a stroke with unknown onset or a wake-up stroke, a hyperacute MRI can be used to determine if the stroke happened within a few hours, and if so, whether they are eligible for thrombolysis treatment.

Comparison of Stroke Onset and Medical Response

According to Nicholas Janocko, MD, the use of hyperacute MRI is crucial for those who experience a stroke with unknown onset to determine if they are eligible for specialized treatment.