真性短暂性脑缺血发作与短暂性脑缺血发作模拟症的鉴别。
Differentiation of true transient ischemic attack versus transient ischemic attack mimics.
作者信息
Noureddine Ali, Ghandehari Kavian, Taghi Shakeri Mohammad
机构信息
Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Neurology, Neuro cognitive Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
出版信息
Iran J Neurol. 2014 Jul 4;13(3):127-30.
BACKGROUND
Previous literatures have shown a transient ischemic attack (TIA) mimic rate of 9-31%. We aimed to ascertain the proportion of stroke mimics amongst suspected TIA patients.
METHODS
A prospective observational study was performed in Ghaem Hospital, Mashhad, Iran during 2012-2013. Consecutive TIA patients were identified in a stroke center. The initial diagnosis of TIA was made by the resident of neurology and final diagnosis of true TIA versus TIA mimics was made after 3 months follow-up by stroke subspecialist.
RESULTS
A total of 310 patients were assessed during a 3-month period of which 182 (58.7%) subjects were male and 128 (41.3%) were female. Ten percent of the patients was categorized as a TIA mimic. The presence of hypertension, aphasia, duration of symptoms, and increased age was the strongest predictor of a true TIA. Migraine was the most common etiology of stroke mimic in our study.
CONCLUSION
It seems that many signs and symptoms have low diagnostic usefulness for discrimination of true TIA from non-cerebrovascular events and predictive usefulness of any sign or symptom should be interpreted by a stroke neurologist.
背景
既往文献显示短暂性脑缺血发作（TIA）的误诊率为9% - 31%。我们旨在确定疑似TIA患者中卒中误诊的比例。
方法
2012 - 2013年期间在伊朗马什哈德的加姆医院进行了一项前瞻性观察研究。在卒中中心识别连续的TIA患者。TIA的初步诊断由神经科住院医师做出，真正的TIA与TIA误诊的最终诊断在卒中专科医生进行3个月随访后做出。
结果
在3个月期间共评估了310例患者，其中182例（58.7%）为男性，128例（41.3%）为女性。10%的患者被归类为TIA误诊。高血压、失语、症状持续时间和年龄增加是真正TIA的最强预测因素。偏头痛是我们研究中卒中误诊最常见的病因。
结论
似乎许多体征和症状对于区分真正的TIA与非脑血管事件的诊断价值较低，任何体征或症状的预测价值都应由卒中神经科医生进行解读。
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