Aim of the research: Acute and chronic stroke complications in patients burden the patients with expensive treatment costs. Using stroke protocol including DWI / ADC / FLAIR / GRE MRI sequences, stroke patients with an unknown onset time of symptoms can be effectively identified for intravenous thrombolytics. Methods:This historical cohort study investigated stroke patients with unknown onset of symptoms undergoing MRI studies in GolestanHospital, Ahwaz, Iran. The first study group was composed of patients with a positive DWI sequence and negative FLAIR sequences and received alteplase treatment. The second group included patients with a positive FLAIR and DWI and did not receive any thrombolytic treatment. Comparisons were made between these two groups using NIHSS score at baseline and 24 hours post-treatment and using MRS score at 3 months postdischarge. Bleeding complications were also assessed across the groups. Results:The patients of two groups did not significantly differ in demographic features, which provided unbiased and more reliable findings. The majority of the risk factor variables had aneven distribution in the patients of two groups. Smoking was slightly higher in the group receiving thrombolytic therapy than inthe non-thrombolytic group, which was also significant. The mean NIHSS score in the group receiving thrombolytic therapy at the time of discharge was lower than their baseline means score at admission time.Furthermore, the results in relation to the MRS index showed that at the time of discharge and 3 months after discharge, the average of this index in the group receiving thrombolytic therapy was significantly lower as compared to the non-receiving thrombolytic therapy group. Conclusion:According to the results of the present study, no significant difference was present between the occurrence of death between receiving and non-receiving the thrombolytic therapy groups. However, lower values of NIHSS and MRS indicators in the survivors showed the effectiveness of this method. Therefore, it is recommended that this method has to be followed as a comprehensive disease management protocol in the early hours of the disease in patients with unknown onset of the symptoms and considered as a serious intervention that has to be done without any delay.

NIHSS, MRS, wake up stroke, FLAIR