Department of Neurology, The Canberra Hospital, Canberra, ACT, Australia.
Department of Neurology, The Canberra Hospital, Canberra, ACT, Australia.
Clin Neurol Neurosurg. 2022 Feb;213:107120. doi: 10.1016/j.clineuro.2022.107120. Epub 2022 Jan 10.
Stroke Warning Syndrome (SWS) is a form of early recurrent transient ischemic attack (TIA) which carries a high risk of infarction. It is characterized by repeated stereotypical sensorimotor symptoms affecting the face, arm, and leg without associated cortical involvement occurring within a seven-day period after an index TIA. In this systematic review, we identified that 1.5-4.5% of TIAs present as SWS and despite this occurrence, little is known about management strategies and treatment outcomes. Various mechanisms including small vessel disease, artery to artery embolism, hemodynamic instability and periinfarct depolarization may account for its nature. There are no specific guidelines on treatment, but thrombolysis appears safe but does not necessarily provide an advantage over antiplatelet and/or anticoagulation in preventing recurrences. Regardless of treatment, SWS is associated with excellent clinical outcomes.
中风预警综合征(SWS)是一种早期复发性短暂性脑缺血发作(TIA),具有很高的梗死风险。它的特征是在指数 TIA 后七天内,反复出现典型的影响面部、手臂和腿部的感觉运动症状,而无相关皮质受累。在这项系统评价中,我们发现 1.5-4.5%的 TIA 表现为 SWS,尽管如此,人们对其管理策略和治疗结果知之甚少。包括小血管疾病、动脉到动脉栓塞、血流动力学不稳定和梗死周围去极化等各种机制可能解释了其本质。目前尚无关于治疗的具体指南,但溶栓似乎是安全的,但在预防复发方面并不一定优于抗血小板和/或抗凝治疗。无论治疗与否,SWS 都与极好的临床结果相关。