Thanvi B, Treadwell S, Robinson T
Southwarwickshire Hospital, Warwick, UK.
Postgrad Med J. 2008 Aug;84(994):412-7. doi: 10.1136/pgmj.2007.066118.
Early neurological deterioration (END) in acute ischaemic stroke is a common event. The underlying mechanisms are heterogeneous. The clinical predictors of END include severity of the initial stroke, large vessel occlusion, diabetes mellitus, hypotension, and atrial fibrillation. Serial observations and detailed assessment by the trained staff in specialised stroke units are key to the successful management of these patients. Advances in brain and vascular imaging have provided insight into the underlying mechanisms, enabling clinicians to use preventative and therapeutic interventions specifically targeted at them, though several questions still remain unanswered. END has potentially serious consequences on the short term (morbidity and death) and long term (recovery from stroke) outcomes for the patient. Therefore, attempts to prevent and treat END should be made promptly and aggressively.
急性缺血性卒中的早期神经功能恶化（END）是一种常见事件。其潜在机制具有异质性。END的临床预测因素包括初始卒中的严重程度、大血管闭塞、糖尿病、低血压和心房颤动。由专业卒中单元的训练有素的工作人员进行连续观察和详细评估是成功管理这些患者的关键。脑和血管成像技术的进步为潜在机制提供了深入了解，使临床医生能够使用专门针对这些机制的预防和治疗干预措施，尽管仍有几个问题未得到解答。END对患者的短期（发病率和死亡率）和长期（卒中恢复）结局可能产生严重后果。因此，应迅速且积极地尝试预防和治疗END。
