Gomez C R, Tulyapronchote R
Souers Stroke Institute, Saint Louis University Medical Center, Missouri 63110.
Echocardiography. 1993 Jul;10(4):367-72. doi: 10.1111/j.1540-8175.1993.tb00049.x.
The evaluation of victims of ischemic stroke has evolved over the last few years, primarily as a result of the introduction of innovative, sensitive, and informative diagnostic procedures. The role of the neurologist appears to have been redefined as one in which the identification of the presumptive cause and mechanism of the stroke is one of the primary responsibilities. The trend towards classification of patients into stroke subtypes, based upon etiology and pathogenesis, has led to a shift in care to a more etiology-specific approach. The inclusion of results of ancillary tests in the criteria utilized for stroke subtype classification has expanded the neurologists' ability to ascertain the presumptive etiology of many strokes that in the past were considered of unknown etiology. This has also resulted in an apparent increase in the proportion of ischemic strokes presumably due to cardiogenic embolism. The impact of transesophageal echocardiography upon changes in the presumptive etiology of ischemic stroke is illustrated, underscoring the future collaboration of neurologists and cardiologists in the evaluation of victims of presumed cardiogenic ischemic stroke.
在过去几年中，缺血性中风患者的评估方法不断演变，这主要是由于引入了创新、灵敏且信息丰富的诊断程序。神经科医生的角色似乎已被重新定义，其中确定中风的推测病因和机制是主要职责之一。基于病因和发病机制将患者分类为中风亚型的趋势，已导致护理方式转向更具病因特异性的方法。将辅助检查结果纳入中风亚型分类标准中，扩大了神经科医生确定许多过去被认为病因不明的中风推测病因的能力。这也导致推测由心源性栓塞引起的缺血性中风比例明显增加。文中说明了经食管超声心动图对缺血性中风推测病因变化的影响，强调了神经科医生和心脏病专家未来在评估疑似心源性缺血性中风患者方面的合作。
