Kessler Chad, Thomas Kurian E
Department of Emergency Medicine, University of Illinois-Chicago, 820 S Damen Ave, M-C 111, Chicago, IL 60612, USA.
Am J Manag Care. 2009 Jun;15(6 Suppl):S170-6.
Transient ischemic attack (TIA) is a common cerebrovascular event that is associated with a high risk for secondary stroke, possibly higher than stroke itself. Nevertheless, a TIA is often described as a "mini-stroke," implying a less serious event requiring less urgent treatment. In reality, TIA and subsequent secondary stroke are associated with a very high economic burden. Cerebrovascular disease is the most financially costly of all major disease states, while morbidity and mortality risk is highly elevated in TIA patients. TIA is also associated with a very severe quality-of-life burden, which manifests both in terms of diminished functional independence and high rates of depression. Furthermore, TIA is commonly misdiagnosed and underdiagnosed, often leading to inappropriate treatment. More than half of patients who experience TIA are undiagnosed, while those who do receive a diagnosis are often offered neither diagnostic imaging nor hospital admission. Much of the morbidity and mortality associated with TIA and secondary stroke might be avoided by the application of timely and appropriate treatment. Clinical data have shown that accelerated treatment of TIA during its acute phase is associated with an 80% reduction of secondary stroke risk for the following 3 months, the period of greatest risk.
短暂性脑缺血发作（TIA）是一种常见的脑血管事件，与继发性中风的高风险相关，其风险可能高于中风本身。然而，TIA常被描述为“小中风”，这意味着它是一种不太严重的事件，所需的紧急治疗较少。实际上，TIA及随后的继发性中风会带来非常高的经济负担。脑血管疾病是所有主要疾病中经济成本最高的，而TIA患者的发病和死亡风险会大幅升高。TIA还会带来非常严重的生活质量负担，这在功能独立性下降和高抑郁症发病率方面都有体现。此外，TIA常被误诊和漏诊，往往导致治疗不当。超过一半经历TIA的患者未被诊断出来，而那些得到诊断的患者通常既没有接受诊断性成像检查，也没有住院。通过及时和适当的治疗，TIA和继发性中风相关的许多发病和死亡情况可能会避免。临床数据表明，在TIA急性期加快治疗与在接下来3个月（风险最高的时期）内继发性中风风险降低80%相关。
