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短暂性脑缺血发作:急诊科诊断与管理的进展

Transient Ischemic Attacks: Advances in Diagnosis and Management in the Emergency Department.

作者信息

Duca Andrea, Jagoda Andy

机构信息

Department of Emergency Medicine, Ospedale San Raffaele, via Olgettina 60, 20132 Milan, Italy.

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1620, New York, NY 10029, USA.

出版信息

Emerg Med Clin North Am. 2016 Nov;34(4):811-835. doi: 10.1016/j.emc.2016.06.007. Epub 2016 Sep 7.

Abstract

The definition of a transient ischemic attack (TIA) has evolved over the past decade from a clinical diagnosis to a tissue-based definition based on neuroimaging results. TIA shares the same pathophysiology as stroke, which occurs in up to 5% of patients within 48 hours of the TIA and 10% within 90 days. This rate is decreasing, likely due to improved diagnostic and management strategies. Decision support scores have been developed to risk stratify patients, which include clinical and radiological elements. Antiplatelet and anticoagulant therapy, as well as carotid endarterectomy/stenting have been shown to reduce the stroke occurrence after TIA.

摘要

短暂性脑缺血发作(TIA)的定义在过去十年中已从临床诊断演变为基于神经影像学结果的组织学定义。TIA与中风具有相同的病理生理学,在TIA发作后48小时内,高达5%的患者会发生中风,90天内这一比例为10%。这一比例正在下降,可能是由于诊断和管理策略的改进。已开发出决策支持评分系统对患者进行风险分层,其中包括临床和放射学因素。抗血小板和抗凝治疗以及颈动脉内膜切除术/支架置入术已被证明可降低TIA后中风的发生率。

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