Sylaja Padmavathy N, Hill Michael D
Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Am J Cardiovasc Drugs. 2007;7(1):67-74. doi: 10.2165/00129784-200707010-00006.
Transient ischemic attack (TIA) is a precursor to ischemic stroke. At least half of patients with TIA have a new, small ischemic lesion demonstrable on magnetic resonance imaging using a diffusion weighted sequence. The risk of subsequent major stroke is 10-20% in the next 3 months with much of that risk front-loaded in the first week. Strategies to identify and treat high-risk patients need to be defined. The optimal treatment approach and the timing of interventions, both medical and surgical, remains unknown. In general, aspirin is the first line of treatment to prevent further stroke. Other antiplatelet agents such as clopidogrel alone or in combination with aspirin and the combination aspirin/extended-release dipyridamole may be administered. Endarterectomy or carotid stenting is of great benefit to patients with TIA secondary to stenosis in the extracranial carotid artery.
短暂性脑缺血发作（TIA）是缺血性卒中的先兆。至少一半的TIA患者在使用扩散加权序列的磁共振成像上可显示出新的小缺血性病变。在接下来的3个月内，随后发生重大卒中的风险为10%-20%，其中大部分风险集中在第一周。需要确定识别和治疗高危患者的策略。最佳治疗方法以及药物和手术干预的时机仍然未知。一般来说，阿司匹林是预防进一步卒中的一线治疗药物。也可使用其他抗血小板药物，如单独使用氯吡格雷或与阿司匹林联合使用，以及阿司匹林/缓释双嘧达莫联合制剂。对于因颅外颈动脉狭窄继发TIA的患者，动脉内膜切除术或颈动脉支架置入术非常有益。
