Department of Neurology, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, 600 North Wolfe St, Baltimore, MD 21287, USA.
Neurotherapeutics. 2023 Apr;20(3):732-743. doi: 10.1007/s13311-023-01349-5. Epub 2023 Feb 8.
In the era of mechanical thrombectomy and better preventative strategies, a higher number of patients are being discharged home from the hospital with the so-called minor strokes. This has significantly changed the landscape of stroke recovery. Unfortunately, while symptoms may be categorized as mild compared to individuals with higher NIH Stroke Scale scores, the physical, cognitive, and emotional sequelae can be disabling and result in failure to return to work and poor quality of life in a population with significant potential to recover fully. In this review, we discuss the current state of minor stroke, the most common pattern of resulting deficits, what is known about the underlying pathophysiology that leads to a relatively global pattern of impaired cognition following an infarct in any location, and special considerations for treatment based on this population's unique needs. Raising awareness of the current morbidity associated with minor stroke, the need for a uniform definition that allows for comparisons of individuals across studies, and further research focused on this population to optimize outcomes, has the potential to significantly improve recovery.
在机械取栓和更好的预防策略时代，越来越多的所谓小中风患者从医院出院回家。这极大地改变了中风康复的格局。不幸的是，虽然与 NIH 中风量表评分较高的个体相比，症状可能被归类为轻度，但身体、认知和情感后遗症可能会导致残疾，使患者无法重返工作岗位，生活质量较差，而这群人有很大的完全康复的潜力。在这篇综述中，我们讨论了小中风的现状、最常见的缺陷模式、导致任何部位梗死导致认知相对广泛受损的潜在病理生理学的已知情况，以及基于该人群独特需求的治疗的特殊考虑。提高对小中风相关当前发病率的认识、对允许个体在研究间进行比较的统一定义的需求，以及针对该人群的进一步研究以优化结果，有可能显著改善康复效果。
