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出血性和缺血性中风患者神经临床表现的比较。

Comparison of neurological clinical manifestation in patients with hemorrhagic and ischemic stroke.

作者信息

Ojaghihaghighi Seyedhossein, Vahdati Samad Shams, Mikaeilpour Akram, Ramouz Ali

机构信息

Emergency Medicine Deparmtent, Tabriz University of Medical Science, Tabriz, Iran.

Road Traffic Injury Research Center, Tabriz University of Medical Science, Tabriz, Iran.

出版信息

World J Emerg Med. 2017;8(1):34-38. doi: 10.5847/wjem.j.1920-8642.2017.01.006.

Abstract

BACKGROUND

Cerebrovascular accident (CVA) is the third leading cause of death and disability in developed countries. Anyone suspected of having a stroke should be taken immediately to a medical facility for diagnosis and treatment. The symptoms that follow a stroke aren't significant and depend on the area of the brain that has been affected and the amount of tissue damaged. Parameters for predicting long-term outcome in such patients have not been clearly delineated, therefore the aim of this study was to investigate this possibility and to test a system that might practicably be used routinely to aid management and predict outcomes of individual stroke patients.

METHODS

A descriptive hospital-based study of the neurological symptoms and signs of 503 patients with ischemic stroke, including severe headache, seizure, eye movement disorder, pupil size, Glasgow Coma Scale (GCS), agitation were analyzed in this study.

RESULTS

In the current study, dilated pupils, agitation, acute onset headache, lower GCS score, seizure, and eye gaze impairment had significantly higher prevalence in hemorrhagic stroke patients (<0.001). However, the rate of gradual progressive headache is significantly higher in ischemic stroke patients (<0.001).

CONCLUSION

Although this result provides reliable indicators for discrimination of stroke types, imaging studies are still the gold standard modality for diagnosis.

摘要

背景

在发达国家,脑血管意外(CVA)是导致死亡和残疾的第三大主要原因。任何疑似中风的患者都应立即送往医疗机构进行诊断和治疗。中风后的症状并不显著,这取决于受影响的脑区以及受损组织的数量。预测此类患者长期预后的参数尚未明确界定,因此本研究的目的是调查这种可能性,并测试一种可能切实可行地常规用于辅助管理和预测个体中风患者预后的系统。

方法

本研究对503例缺血性中风患者的神经症状和体征进行了基于医院的描述性研究,分析内容包括严重头痛、癫痫发作、眼球运动障碍、瞳孔大小、格拉斯哥昏迷量表(GCS)、烦躁不安等。

结果

在本研究中,瞳孔散大、烦躁不安、急性起病头痛、较低的GCS评分、癫痫发作和眼球凝视障碍在出血性中风患者中的患病率显著更高(<0.001)。然而,缺血性中风患者中逐渐进展性头痛的发生率显著更高(<0.001)。

结论

尽管该结果为区分中风类型提供了可靠指标,但影像学检查仍是诊断的金标准方式。

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