Department of Neurology, John Hunter Hospital, Newcastle, NSW.
Med J Aust. 2012 May 21;196(9):572-7. doi: 10.5694/mja12.10441.
Stroke is a common neurological emergency and may occur in patients of all ages. Rapid assessment is crucial for patients with acute neurological symptoms suggestive of stroke because the opportunity for a positive outcome from thrombolytic treatment diminishes rapidly within the first few hours. Although plain non-contrast computed tomography of the brain is adequate to exclude haemorrhage and conditions such as malignancy, advanced multimodal imaging can be used to assist with decision making regarding the use of recombinant tissue plasminogen activator and mechanical clot-retrieval approaches without adding significant delay. Excellent outcomes are possible with the early use of reperfusion therapies, even when large areas of brain ischaemia are present, provided that there is evidence of potentially salvageable brain and that treatment can commence without unnecessary delay and hazard.
中风是一种常见的神经急症,可发生在各个年龄段的患者中。对于有急性神经症状提示中风的患者,快速评估至关重要,因为在最初的几个小时内,溶栓治疗的积极效果迅速降低。虽然脑平扫非增强 CT 足以排除出血和恶性肿瘤等情况,但先进的多模态成像可用于辅助决定是否使用重组组织型纤溶酶原激活剂和机械取栓方法,而不会显著延迟。即使存在大面积脑缺血,如果有潜在可挽救的脑组织的证据,并且治疗可以在没有不必要的延迟和风险的情况下开始,早期使用再灌注治疗可以获得良好的效果。