Loh Victor Weng Keong, Soon Derek Tuck Loong, Yeo Leonard Leong Litt
Division of Family Medicine, University Medicine Cluster, National University Health System, Singapore.
Division of Neurology, University Medicine Cluster, National University Health System, Singapore.
Singapore Med J. 2016 Dec;57(12):658-663. doi: 10.11622/smedj.2016180.
Stroke is a significant cause of death and disability in Singapore; in 2014, it was the fourth most common cause of death. Transient ischaemic attack (TIA) is defined as a transient episode of neurological dysfunction caused by focal brain, spinal cord or retinal ischaemia without evidence of acute infarction. The diagnosis of TIA/acute stroke needs to be considered in all patients who present with sudden focal neurological dysfunction. Prompt referral for assessment, neuroimaging and intervention provides the best chance for neurological recovery and/or minimising further neurological damage. Primary care physicians have a crucial role in TIA/stroke prevention and management. This includes referring patients with suspected acute TIA/stroke to hospitals with stroke treatment facilities immediately; managing the modifiable risk factors of cerebral ischaemia; continuing prescription of antiplatelet agents and/or anticoagulation where indicated; and teaching patients to recognise and respond to suspected cerebral ischaemia using the FAST (face, arm, speech, time) acronym.
中风是新加坡死亡和残疾的一个重要原因；2014年，它是第四大常见死因。短暂性脑缺血发作（TIA）被定义为由局灶性脑、脊髓或视网膜缺血引起的短暂性神经功能障碍发作，且无急性梗死证据。所有出现突发局灶性神经功能障碍的患者都需要考虑TIA/急性中风的诊断。及时转诊进行评估、神经影像学检查和干预，为神经功能恢复和/或最大限度减少进一步神经损伤提供了最佳机会。初级保健医生在TIA/中风的预防和管理中起着关键作用。这包括立即将疑似急性TIA/中风的患者转诊至具备中风治疗设施的医院；管理可改变的脑缺血危险因素；在有指征时继续开具抗血小板药物和/或抗凝药物处方；以及使用FAST（面部、手臂、言语、时间）首字母缩写词教导患者识别并应对疑似脑缺血情况。
