Humphrey P R
Walton Centre for Neurology & Neurosurgery, Liverpool, UK.
Postgrad Med J. 1995 Oct;71(840):577-84. doi: 10.1136/pgmj.71.840.577.
The management of stroke and transient ischaemic attacks (TIAs) has changed greatly in the last two decades. The importance of good blood pressure control is the hallmark of stroke prevention. Large multicentre trials have proven beyond doubt the value of aspirin in TIAs, warfarin in patients with atrial fibrillation and embolic cerebrovascular symptoms, and carotid endarterectomy in patients with carotid TIAs. There seems little doubt that patients managed in acute stroke units are more likely to be independent at six months than those managed in a general medical ward. This article emphasizes the importance of basing clinical management on simple history taking and examination and appropriate investigation. This, combined with knowledge of the natural history risk of TIA and stroke and the results of randomised trials, allows individuals to be managed in the most appropriate manner. This review is designed to be a practical guide, useful in the day to day management of patients with cerebrovascular disease.
在过去二十年中，中风和短暂性脑缺血发作（TIA）的治疗发生了很大变化。良好的血压控制是预防中风的关键。大型多中心试验已毫无疑问地证明了阿司匹林在TIA中的价值、华法林在房颤和栓塞性脑血管症状患者中的价值，以及颈动脉内膜切除术在颈动脉TIA患者中的价值。毫无疑问，在急性中风单元接受治疗的患者在六个月时比在普通内科病房接受治疗的患者更有可能实现自理。本文强调了基于简单的病史采集、检查和适当的调查进行临床管理的重要性。这一点，再加上对TIA和中风的自然病史风险以及随机试验结果的了解，使得能够以最合适的方式对个体进行管理。本综述旨在成为一份实用指南，对脑血管疾病患者的日常管理有用。
