Reader Response: Association of Time of Day When Endovascular Therapy for Stroke Starts and Functional Outcome

We read with great interest the recent article by Hajdu et al.1 in which the authors investigated the association between the onset time of mechanical thrombectomy in stroke patients and evaluated medium-term functional outcomes. The research finds that those patients who were operated on between the 8:00 and 12:00 am hours had better results, compared with those who were operated on in the afternoon or night hours. This finding is very curious considering the hypothesis proposed by Kario et al.2 based on the neurobiology of blood pressure, which describes that cerebrovascular events tend to occur in the day because of adrenergic shock, while they are reduced at night by cholinergic regulation.2

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