最后审阅: 11 四月 2021
最后更新: 06 十月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 面部、上肢或下肢单侧无力或瘫痪
  • 感觉缺失(麻木
  • 构音障碍
  • 构音障碍
  • 视觉障碍
  • 畏光
  • 头痛
  • 共济失调
  • 危险因素

其他诊断因素

  • 眩晕
  • 恶心/呕吐
  • 意识水平下降/昏迷
  • 意识模糊
  • 凝视麻痹

危险因素

  • 高血压
  • 老年
  • 男性
  • 亚裔、黑人和/或西班牙裔
  • 酗酒
  • 滥用拟交感神经药物
  • 脑出血家族史
  • 血友病
  • 脑血管淀粉样变性
  • COL4A1 基因常染色体显性突变
  • 遗传性出血性毛细血管扩张症
  • KRIT1 基因、CCM2 基因或 PDCD10 基因发生常染色体显性突变
  • 抗凝治疗
  • 血管畸形
  • 烟雾病
  • 吸烟
  • 非甾体抗炎药 (non-steroidal anti-inflammatories, NSAIDs)
  • 糖尿病
  • 拟交感神经药物
  • 脑血管炎
  • 血小板减少
  • 白血病

诊断性检查

首要检查

  • 头颅 CT 平扫
  • 血清葡萄糖
  • 血清电解质
  • 血清尿素和肌酐
  • 肝功能检测
  • 全血细胞计数 (FBC
  • 凝血筛查
  • 心电图(ECG

需考虑的检查

  • 血清毒理学筛查

治疗流程

初步治疗
急症处理

撰稿人

Consultant Neurologist

Greater Manchester Neurosciences Centre

Salford Royal Foundation Trust

Honorary Senior Lecturer

University of Manchester

Manchester

UK

利益声明

MJ declares that he has no competing interests.

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

Fernando D. Goldenberg, MD

Clinical Associate of Neurology

Medical Director, Neuroscience ICU

Director, Neurocritical Care Education

Co-Director, Stroke Center

University of Chicago

Chicago

IL

Raisa C. Martinez, MD

Neurocritical Care Fellow

Department of Neurology

University of Chicago

Chicago

IL

利益声明

FDG and RCM declare that they have no competing interests.

同行评议者展开全部内容

Professor of Clinical Neurology

Head of Research Department, Brain Repair and Rehabilitation

UCL Institute of Neurology

Honorary Consultant Neurologist

National Hospital for Neurology and Neurosurgery

University College Hospitals NHS Foundation Trust

North Thames Clinical Research Specialty Lead for Stroke

NIHR Clinical Research Network

London

UK

利益声明

DW has received honoraria (speaking) from Bayer 2016, 2017, 2018 (talks or debates on intracerebral haemorrhage, atrial fibrillation, dementia) and honoraria (chairing) from Portola and Bayer 2019. DW has received consultancy fees from Bayer (2017; embolic stroke of undetermined source), JFB consulting (2018; PCSK9 inhibitors in stroke), Alnylam (2019; cerebral amyloid angiopathy), Portola (2019, 2020; andexanet alpha). JW was UCL Principle Investigator for NIHR clinical trials NAVIGATE-ESUS (Bayer, 2016-19), B2341002 (Pfizer 2014-2016), Action-2 (Biogen, 2016-19); Chief Investigator for OPTIMAS; steering committee and co-investigator for RESTART, TICH-2.

Section Editor, BMJ Best Practice

利益声明

HDC declares that she has no competing interests.

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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