Lioutas Vasileios-Arsenios, Sonni Shruti, Caplan Louis R
Department of Neurology, Division of Cerebrovascular Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Curr Treat Options Cardiovasc Med. 2013 Jun;15(3):276-87. doi: 10.1007/s11936-013-0233-x.
Stroke is the leading cause of disability and the third leading cause of death in the USA. Ischemic and hemorrhagic strokes must be distinguished since treatment is quite different. Ischemic strokes account for 80 % of the total and recent advances in management of brain ischemia have added valuable options to the physicians' armamentarium. Wise selection and targeted treatment of patients is of paramount importance. Properly treated patients benefit significantly, while those erroneously diagnosed as ischemic stroke are exposed to potentially harmful side effects of therapy. Stroke can present in the form of several different clinical syndromes some of which are difficult to identify. Conversely, there are numerous conditions whose clinical presentation closely resembles stroke, also known as stroke mimics. Ancillary testing, especially imaging, is a crucial part of diagnostic evaluation, while clinical judgment, thorough knowledge of cerebrovascular anatomy and familiarity with characteristic stroke syndromes remain indispensable even in this era of technological advance.
中风是美国导致残疾的首要原因，也是第三大死因。必须区分缺血性中风和出血性中风，因为治疗方法截然不同。缺血性中风占总数的80%，并且脑缺血管理方面的最新进展为医生的治疗手段增添了宝贵的选择。明智地选择患者并进行针对性治疗至关重要。得到妥善治疗的患者会显著受益，而那些被错误诊断为缺血性中风的患者则会面临治疗带来的潜在有害副作用。中风可以表现为几种不同的临床综合征，其中一些难以识别。相反，有许多病症的临床表现与中风非常相似，也被称为类中风。辅助检查，尤其是影像学检查，是诊断评估的关键部分，而即使在这个技术进步的时代，临床判断、对脑血管解剖结构的透彻了解以及对典型中风综合征的熟悉程度仍然不可或缺。
