Sun Bin, Wang Zhigang
Department of Neurosurgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, Shandong 266035, China.
Galen Med J. 2023 Aug 21;12:e2993. doi: 10.31661/gmj.v12i0.2993. eCollection 2023.
Ischemic stroke is a leading cause of morbidity and mortality worldwide, necessitating advancements in early diagnosis and treatment modalities. This review aims to provide an overview of recent advances in the early diagnosis and treatment of ischemic stroke, highlighting the importance of the potential impact on patient outcomes. Recent advancements have focused on various aspects of stroke care, including imaging techniques, laboratory testing, telemedicine and mobile technology, intravenous thrombolysis, mechanical thrombectomy, and collaborative systems. Advances in imaging techniques have played a pivotal role in the early diagnosis of ischemic stroke. Computed tomography perfusion imaging, advanced magnetic resonance imaging (MRI) techniques, multimodal imaging, and automated image processing tools have greatly improved the ability to assess the extent of ischemic injury. Laboratory testing has seen significant progress in identifying biomarkers associated with ischemic stroke. High-sensitivity cardiac troponin assays have improved our understanding of the cardiac component of stroke. Additionally, biomarkers such as S100B, glial fibrillary acidic protein, and neuron-specific enolase have shown promise in assessing stroke severity and prognosis. Mobile applications and wearable devices facilitate stroke symptom recognition, risk assessment, and prompt medical attention. The development of tenecteplase, a modified form of tissue plasminogen activator, has enhanced clot-dissolving efficacy. Collaborative systems, including regional stroke systems of care and telestroke networks, have optimized communication and coordination among healthcare providers. Interoperable electronic health records streamline information exchange and facilitate prompt decision-making. Mobile communication technologies enhance real-time collaboration, involving all stakeholders in stroke care. Future directions focus on artificial intelligence and machine learning algorithms for stroke diagnosis and risk assessment. Wearable devices and remote monitoring may enable continuous monitoring of stroke-related indicators. Overall, advances in early diagnosis and treatment of ischemic stroke can enhance stroke care, reduce treatment delays, and improve patient outcomes.
缺血性中风是全球发病和死亡的主要原因，因此需要在早期诊断和治疗方式上取得进展。本综述旨在概述缺血性中风早期诊断和治疗的最新进展，强调其对患者预后潜在影响的重要性。最近的进展集中在中风护理的各个方面，包括成像技术、实验室检测、远程医疗和移动技术、静脉溶栓、机械取栓以及协作系统。成像技术的进步在缺血性中风的早期诊断中发挥了关键作用。计算机断层扫描灌注成像、先进的磁共振成像（MRI）技术、多模态成像和自动图像处理工具极大地提高了评估缺血性损伤程度的能力。实验室检测在识别与缺血性中风相关的生物标志物方面取得了显著进展。高敏心肌肌钙蛋白检测提高了我们对中风心脏成分的认识。此外，诸如S100B、胶质纤维酸性蛋白和神经元特异性烯醇化酶等生物标志物在评估中风严重程度和预后方面显示出前景。移动应用程序和可穿戴设备有助于中风症状识别、风险评估和及时就医。改良型组织纤溶酶原激活剂替奈普酶的开发提高了溶栓效果。协作系统，包括区域中风护理系统和远程中风网络，优化了医疗保健提供者之间的沟通与协调。可互操作的电子健康记录简化了信息交换，便于及时决策。移动通信技术加强了实时协作，使中风护理的所有利益相关者都能参与其中。未来的方向集中在用于中风诊断和风险评估的人工智能和机器学习算法。可穿戴设备和远程监测可能实现对中风相关指标的持续监测。总体而言，缺血性中风早期诊断和治疗的进展可以加强中风护理、减少治疗延误并改善患者预后。
