Stroke warning syndrome

Clin Neurol Neurosurg. 2022 Feb:213:107120. doi: 10.1016/j.clineuro.2022.107120. Epub 2022 Jan 10.


Stroke Warning Syndrome (SWS) is a form of early recurrent transient ischemic attack (TIA) which carries a high risk of infarction. It is characterized by repeated stereotypical sensorimotor symptoms affecting the face, arm, and leg without associated cortical involvement occurring within a seven-day period after an index TIA. In this systematic review, we identified that 1.5-4.5% of TIAs present as SWS and despite this occurrence, little is known about management strategies and treatment outcomes. Various mechanisms including small vessel disease, artery to artery embolism, hemodynamic instability and periinfarct depolarization may account for its nature. There are no specific guidelines on treatment, but thrombolysis appears safe but does not necessarily provide an advantage over antiplatelet and/or anticoagulation in preventing recurrences. Regardless of treatment, SWS is associated with excellent clinical outcomes.

Keywords: Capsular warning syndrome; Early recurrent TIA; Pontine warning syndrome; Recurrent TIA; Stroke warning syndrome.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Ischemic Attack, Transient* / epidemiology
  • Stroke* / epidemiology
  • Syndrome
  • Treatment Outcome