Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Switzerland.
Stroke. 2010 Apr;41(4):661-6. doi: 10.1161/STROKEAHA.109.572883. Epub 2010 Feb 25.
The term "minor stroke" is often used; however a consensus definition is lacking. We explored the relationship of 6 "minor stroke" definitions and outcome and tested their validity in subgroups of patients.
A total of 760 consecutive patients with acute ischemic strokes were classified according to the following definitions: A, score < or = 1 on every National Institutes of Health Stroke Scale (NIHSS) item and normal consciousness; B, lacunar-like syndrome; C, motor deficits with or without sensory deficits; D, NIHSS < or = 9 excluding those with aphasia, neglect, or decreased consciousness; E, NIHSS < or = 9; and F, NIHSS < or = 3. Short-term outcome was considered favorable when patients were discharged home, and favorable medium-term outcome was defined as a modified Rankin Scale score of < or = 2 at 3 months. The following subgroup analyses were performed by definition: sex, age, anterior versus posterior and right versus left hemispheric stroke, and early (0 to 6 hours) versus late admission (6 to 24 hours) to the hospital.
Short-term and medium-term outcomes were most favorable in patients with definition A (74% and 90%, respectively) and F (71% and 90%, respectively). Patients with definition C and anterior circulation strokes were more likely to be discharged home than patients with posterior circulation strokes (P=0.021). The medium-term outcome of older patients with definition E was less favorable compared with the outcome of younger ones (P=0.001), whereas patients with definition A, D, and F did not show different outcomes in any subgroup.
Patients fulfilling definition A and F had best short-term and medium-term outcomes. They would be best suited to the definition of "minor stroke."
“小中风”这一术语经常被使用；然而，目前尚无共识的定义。我们探讨了 6 种“小中风”定义与结局之间的关系，并在患者亚组中对其有效性进行了检验。
共纳入 760 例连续急性缺血性脑卒中患者，根据以下定义进行分类：A 项，国立卫生研究院卒中量表（NIHSS）每一项评分均<或=1 分，意识正常；B 项，腔隙样综合征；C 项，运动障碍伴或不伴感觉障碍；D 项，NIHSS<或=9 分，除外失语、忽视或意识下降者；E 项，NIHSS<或=9 分；F 项，NIHSS<或=3 分。出院时患者可回家被认为短期结局良好，3 个月时改良 Rankin 量表评分<或=2 分被定义为中期结局良好。通过定义进行了以下亚组分析：性别、年龄、前循环与后循环卒中以及发病后 0 至 6 小时与 6 至 24 小时内就诊。
A 项（分别为 74%和 90%）和 F 项（分别为 71%和 90%）患者的短期和中期结局最佳。C 项和前循环卒中患者比后循环卒中患者更有可能出院（P=0.021）。E 项定义中年龄较大的患者中期结局不如年龄较小者（P=0.001），而 A、D 和 F 项定义中患者在任何亚组中均未表现出不同的结局。
符合 A 项和 F 项定义的患者具有最佳的短期和中期结局。他们最适合作为“小中风”的定义。
