Mas J L
Service de neurologie, Centre Raymond-Garcin Hôpital Sainte-Anne, Paris.
Rev Prat. 1998 Jan 15;48(2):175-81.
Emergency management of cerebral infarct aims to confirm the diagnosis, determine the mechanism and the cause (on which depend the prognosis and treatment), prevent and treat immediate, general and neurologic complications and to begin as early as possible the appropriate treatment. A first progressive step was made with the creation of hospital units devoted to management of cerebrovascular accidents. Various studies showed that patients hospitalised in such units have not only better survival and functional prognosis, but also that the length of hospitalisation and the number of patients requiring subsequent hospitalisation in rehabilitation centres are significantly reduced. More recently, clinical trials suggested that thrombolytic treatment, although comprising a risk of severe cerebral haemorrhage, can clearly improve patient prognosis if it is given in the first hours. Cerebral infarct should henceforth be considered as a medical emergency, and our health care system should be adapted to give patients the best chance of cure.
脑梗死的急诊处理旨在确诊、确定发病机制及病因（预后和治疗均取决于此）、预防和治疗即刻出现的、全身性及神经系统并发症，并尽早开始适当治疗。随着致力于脑血管意外管理的医院科室的设立，向前迈出了重要的一步。各项研究表明，在这类科室住院的患者不仅生存及功能预后更好，而且住院时间以及随后需要在康复中心住院的患者数量也显著减少。最近，临床试验表明，溶栓治疗尽管存在严重脑出血的风险，但如果在发病后的最初几个小时内进行，可明显改善患者预后。因此，应将脑梗死视为医疗急症，我们的医疗保健系统应进行调整，以使患者获得最佳治愈机会。
