Ross Michael, Nahab Fadi
Department of Emergency Medicine, Emory University, Atlanta, Georgia 30322, USA.
Emerg Med Clin North Am. 2009 Feb;27(1):51-69, viii. doi: 10.1016/j.emc.2008.08.008.
Patients who have a transient ischemic attack (TIA) represent a group that may appear well but are at high risk for stroke within 90 days. Management of patients who have a TIA requires an understanding of the short-term risk for stroke to guide acute management and the long-term benefits to medical and surgical therapies. The initial emergency department (ED) evaluation may be supplemented with simple TIA stroke risk scores to estimate short-term stroke risk. The addition of MRI provides yet more information regarding stroke risks, while identifying some specific causes of TIA. Extended testing may not be feasible in the ED, and to address this limitation, new outpatient strategies for patients who have a TIA have been developed, such as the use of an ED observation unit or an outpatient TIA clinic. Although controversy remains in some areas of acute TIA management because of the lack of evidence from controlled trials, evidence from large randomized trials have led to a better understanding of effective measures for the long-term prevention of stroke.
短暂性脑缺血发作（TIA）患者是一类看似状况良好但在90天内发生中风风险很高的群体。对TIA患者的管理需要了解中风的短期风险以指导急性治疗，以及了解药物和手术治疗的长期益处。最初的急诊科（ED）评估可以辅以简单的TIA中风风险评分来估计短期中风风险。MRI的加入提供了更多关于中风风险的信息，同时还能识别一些TIA的特定病因。在急诊科进行扩展检查可能不可行，为了解决这一限制，已经开发了针对TIA患者的新门诊策略，例如使用ED观察单元或门诊TIA诊所。尽管由于缺乏对照试验的证据，急性TIA管理的某些领域仍存在争议，但大型随机试验的证据已使人们对长期预防中风的有效措施有了更好的理解。
