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这份声明主要是针对医师和护理短暂性脑缺血发作(transient ischemic attacks,TIA)患者的健康工作者。基于文献回顾及资料分析,声明支持以下基于组织的TIA定义:由局部脑组织、脊髓或视网膜缺血而造成的短时间的神经功能缺损,除外急性脑梗死。TIA的患者有早期卒中的较大风险,可以根据临床量表、血管影像及磁共振(magnetic resonance,MR)弥散成像对其风险进行分层。关于诊断的推荐包括:TIA患者应该在症状出现24h内进行神经影像学的评估,最好行包含弥散序列的MR检查;应进行无创性颈部血管及颅内血管检查;心电图应该在TIA发生后尽早进行,对于血管病因尚未明确的患者,应考虑进行随后的心电监测及心脏超声检查;可行常规血液检查;如患者是发病72h内且ABCD2评分≥3分,提示早期再发的风险较高,应该收入院治疗,另外,在门诊难以快速完成评估的患者,也应该入院治疗。
This statement is mainly aimed at physicians and health workers in the care of patients with transient ischemic attacks (TIA). Based on literature review and data analysis, the statement supports the following organization-based TIA definitions: Short-term neurological deficits caused by ischemia of the local brain, spinal cord or retina, excluding acute cerebral infarction. Patients with TIA have a greater risk of early stroke and can stratify their risk based on clinical scales, vascular imaging, and magnetic resonance (MR) diffusion imaging. Recommendations for diagnosis include: TIA patients should be evaluated for neuroimaging within 24 hours of symptom onset, preferably with disseminated MR examinations; noninvasive neck and intracranial vascular examination should be performed; ECG should occur after TIA As soon as possible, for patients whose blood vessel etiology is not yet clear, follow-up ECG and echocardiography should be considered; routine blood tests are available; if the patient is within 72 hours of onset and ABCD2 score is ≥3 points, the risk of early recurrence is high , Should be admitted to the hospital treatment, in addition, difficult to quickly evaluate the patient in the clinic, should also be admitted to hospital.