Jamieson Dara G
Department of Neurology, Weill Medical College of Cornell University, New York, New York 10021, USA.
Am J Med. 2009 Apr;122(4 Suppl 2):S14-20. doi: 10.1016/j.amjmed.2009.02.006.
Early stroke management, and early initiation of secondary stroke prevention, may improve outcomes in patients with acute ischemic stroke. However, <10% of patients with acute ischemic stroke arrive at the receiving hospital within 3 hours of symptom onset. Factors such as poor public awareness of symptoms, lack of rapid detection by emergency medical services (EMS), poor coordination between EMS and the hospital emergency department, or delay of diagnosis on arrival at the emergency department are all contributing factors in the failure to provide prompt diagnosis and treatment of acute ischemic stroke. This article focuses on the critical steps in diagnosing ischemic stroke, starting at the initial patient evaluation by emergency personnel. Stroke mimics and different imaging techniques that may be used in the differential diagnosis and evaluation of acute ischemic stroke are also discussed.
早期卒中管理以及二级卒中预防的早期启动，可能会改善急性缺血性卒中患者的预后。然而，不到10%的急性缺血性卒中患者在症状发作后3小时内抵达接收医院。公众对症状的认知不足、紧急医疗服务（EMS）缺乏快速检测、EMS与医院急诊科之间协调不佳，或到达急诊科后诊断延迟等因素，都是未能及时诊断和治疗急性缺血性卒中的促成因素。本文重点关注急诊人员对患者进行初始评估时诊断缺血性卒中的关键步骤。还讨论了可能用于急性缺血性卒中和鉴别诊断的卒中模仿症及不同成像技术。
