Hoyer Carolin, Szabo Kristina
Department of Neurology and Mannheim Center for Translational Neuroscience, University Medical Center Mannheim, Mannheim, Germany.
Front Neurol. 2021 Jul 14;12:682827. doi: 10.3389/fneur.2021.682827. eCollection 2021.
Posterior circulation stroke (PCS), caused by infarction within the vertebrobasilar arterial system, is a potentially life-threatening condition and accounts for about 20-25% of all ischemic strokes. Diagnosing PCS can be challenging due to the vast area of brain tissue supplied by the posterior circulation and, as a consequence, the wide range of-frequently non-specific-symptoms. Commonly used prehospital stroke scales and triage systems do not adequately represent signs and symptoms of PCS, which may also escape detection by cerebral imaging. All these factors may contribute to causing delay in recognition and diagnosis of PCS in the emergency context. This narrative review approaches the issue of diagnostic error in PCS from different perspectives, including anatomical and demographic considerations as well as pitfalls and problems associated with various stages of prehospital and emergency department assessment. Strategies and approaches to improve speed and accuracy of recognition and early management of PCS are outlined.
后循环卒中（PCS）由椎基底动脉系统梗死引起，是一种潜在的危及生命的疾病，约占所有缺血性卒中的20%-25%。由于后循环供应的脑组织面积广阔，因此会出现各种各样通常不具有特异性的症状，这使得PCS的诊断具有挑战性。常用的院前卒中量表和分诊系统不能充分体现PCS的体征和症状，脑部成像也可能无法检测到这些症状。所有这些因素都可能导致在紧急情况下对PCS的识别和诊断出现延迟。这篇叙述性综述从不同角度探讨了PCS诊断错误的问题，包括解剖学和人口统计学方面的考虑，以及与院前和急诊科评估各阶段相关的陷阱和问题。文中概述了提高PCS识别速度和准确性以及早期管理的策略和方法。
