Stroke Center EOC, Neurology Department, Neurocentre of Southern Switzerland (NSI), Ospedale Civico, Via Tesserete 46, CH-6900, Lugano, Switzerland.
Stroke Center, Department of Neurology, Hôpital Pierre-Paul Riquet, Toulouse, France.
Curr Atheroscler Rep. 2018 Sep 25;20(11):56. doi: 10.1007/s11883-018-0755-5.
Patients with transient ischemic attacks (TIAs) have a higher risk for stroke and vascular events. Specialized and organized management, if rapidly initiated in the emergency department (ED), reduces the vascular burden of TIA. This review summarizes the rationale for optimal triage of patients suspected with TIA in the ED, focusing on early diagnosis confirmation, individual risk stratification, and management.
New evidence is emerging on the yield of integrating clinical scales with advanced neuroimaging of the vessels and brain for improved diagnosis and risk stratification in patients with TIA. The "TIA clinic" model of management is associated with the lowest long-term cardio-cerebrovascular recurrence rate ever reported. TIA are vascular emergencies that require a specialized, systematic evaluation to confirm the diagnosis of an ischemic mechanism, identify high-risk source of brain ischemia and initiate a tailored therapeutic strategy. TIA triage in the ED should organized as part of a "TIA clinic program" that unifies the expedited specialized management of the patient, in collaboration with stroke neurologists.
短暂性脑缺血发作（TIA）患者发生卒中及血管事件的风险较高。如果在急诊科（ED）迅速启动专门且规范的管理，可降低 TIA 的血管负担。本文重点介绍了 TIA 患者 ED 分诊的最佳策略，包括早期诊断确认、个体化风险分层和管理，以总结相关内容。
目前新的证据表明，将临床量表与血管和脑部的高级神经影像学相结合，可提高 TIA 患者的诊断和风险分层效果。TIA 管理的“TIA 诊所”模式与报告的最低长期心脑血管复发率相关。TIA 是血管急症，需要专门、系统的评估来确认缺血机制的诊断，识别脑缺血的高危源头，并启动针对性的治疗策略。ED 中的 TIA 分诊应作为“TIA 诊所计划”的一部分进行组织，该计划与卒中神经科医生合作，统一对患者进行快速的专门管理。
