Ferrari Julia, Reynolds Audrey, Knoflach Michael, Sykora Marek
Department of Neurology, St John's Hospital, Vienna, Austria.
Department of Neurology, St Vincent's University Hospital, Dublin, Ireland.
Front Neurol. 2021 Nov 18;12:760813. doi: 10.3389/fneur.2021.760813. eCollection 2021.
Management of stroke with minor symptoms may represent a therapeutical dilemma as the hemorrhage risk of acute thrombolytic therapy may eventually outweigh the stroke severity. However, around 30% of patients presenting with minor stroke symptoms are ultimately left with disability. The objective of this review is to evaluate the current literature and evidence regarding the management of minor stroke, with a particular emphasis on the role of IV thrombolysis. Definition of minor stroke, pre-hospital recognition of minor stroke and stroke of unknown onset are discussed together with neuroimaging aspects and existing evidence for IV thrombolysis in minor strokes. Though current guidelines advise against the use of thrombolysis in those without clearly disabling symptoms due to a paucity of evidence, advanced imaging techniques may be able to identify those likely to benefit. Further research on this topic is ongoing.
轻度症状性卒中的管理可能是一个治疗难题，因为急性溶栓治疗的出血风险最终可能超过卒中的严重程度。然而，约30%出现轻度卒中症状的患者最终会遗留残疾。本综述的目的是评估有关轻度卒中管理的当前文献和证据，特别强调静脉溶栓的作用。讨论了轻度卒中的定义、院前对轻度卒中和起病不明的卒中的识别，以及神经影像学方面和轻度卒中静脉溶栓的现有证据。尽管目前的指南因证据不足而建议不应对那些没有明显致残症状的患者使用溶栓治疗，但先进的成像技术可能能够识别那些可能受益的患者。关于这一主题的进一步研究正在进行中。
