短暂性脑缺血发作

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最后审阅: 1 Nov 2024
最后更新: 13 Jul 2020

小结

定义

病史和体格检查

关键诊断因素

  • 症状突然发作且持续时间短(数分钟)
  • 患者/目击者报告局灶性神经功能缺损
完整详情

其他诊断因素

  • 单侧无力或麻痹
  • 言语障碍
  • 共济失调、眩晕或失去平衡
  • 单眼突发一过性视力丧失(一过性黑矇)
  • 同侧偏盲
  • 复视
  • 危险因素
完整详情

危险因素

  • 心房颤动
  • 心瓣膜病
  • 颈动脉狭窄
  • 充血性心力衰竭
  • 高血压
  • 高脂血症
  • 糖尿病
  • 吸烟
  • 酒精使用障碍
  • 高龄
  • 卵圆孔未闭(PFO)
  • 缺乏运动
  • 肥胖
  • 高凝状态
完整详情

诊断性检查

首要检查

  • 血糖
  • 全血细胞计数和血小板计数
  • 凝血酶原时间、INR、部分凝血活酶时间
  • 空腹血脂检查
  • 血清电解质
  • 心电图(ECG)
完整详情

需考虑的检查

  • CT 扫描
完整详情

治疗流程

初步治疗

疑似短暂性脑缺血发作

急症处理

确诊短暂性脑缺血发作

撰稿人

专家顾问

Matthew Jones, MD, FRCP

Consultant Neurologist

Greater Manchester Neurosciences Centre

Salford Royal Foundation Trust

Manchester

UK

简介

MJ is an honorary senior lecturer at the University of Manchester.

利益声明

MJ is the chair of the Association of British Neurologists Education Committee (unpaid position). MJ is a faculty member of an MRCP revision course.

Rachael Power, MBChB, MRCP

Neurology Registrar

Manchester Centre for Clinical Neurosciences

Manchester

UK

利益声明

RP has been sponsored by Novartis to attend the International Headache Conference.

鸣谢

BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work is retained in parts of the content:

Jennifer Simpson, MD

Associate Assistant Professor

Department of Neurology

University of Colorado School of Medicine

Denver

CO

Disclosures: JS is a site investigator for the POINT trial.

Ethan Cumbler, MD

Associate Professor

Section of Hospital Medicine

Department of Internal Medicine

Division of Medicine

University of Colorado School of Medicine

Denver

CO

Disclosures: EC declares that he has no competing interests.

同行评议者

Kayvan Khadjooi, MD, FRCP, PGCertMedEd

Consultant in Stroke Medicine

Addenbrooke’s Hospital

Associate Lecturer

School of Clinical Medicine

University of Cambridge

Cambridge

UK

利益声明

KK has received travel grants for conferences/speaker honoraria from Bayer, Boehringer, Daiichi-Sankyo, Pfizer, and Shire.

编辑

Helena Delgado-Cohen

Section Editor, BMJ Best Practice

利益声明

HDC declares that she has no competing interests.

Tannaz Aliabadi-Oglesby

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Susan Mayor

Lead Section Editor, BMJ Best Practice

利益声明

SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

Julie Costello

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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