中国急性缺血性卒中及短暂性脑缺血发作二级预防药物依从性的现状

目的 评估中国急性缺血性卒中和短暂性脑缺血发作（transient ischemic attack,TIA）患者二级预防药物依从性的现状。      

短暂性脑缺血发作新进展

短暂性脑缺血发作（transient ischemic attack,TIA）是常见的缺血性脑血管病之一,但其诊 断、治疗中仍存在许多争议。磁共振成像（magnetic resonance imaging,MRI）/弥散加权成像（diffusion weighted imaging,DWI）检查在TIA诊断中是否必要;TIA患者是否应住院治疗;TIA后的抗血小板治疗应 单用阿司匹林还是阿司匹林联合氯吡格雷;心源性TIA后何时开始抗凝治疗最合适;TIA的二级预防 对减少卒中的发生至关重要,如何做好二级预防,避免误诊、误治的发生;几种较为特殊的TIA发病 率较低,如何尽快明确诊断,这些问题值得临床医师重视。本文对上述有关临床研究进行总结,结 合国内外指南,对这些问题的最新进展作一综述,以期帮助大家更科学地了解TIA的诊断及治疗。     

短暂性脑缺血发作生物学标志物研究进展

短暂性脑缺血发作（transient ischemic attack,TIA）是卒中的危险预警信号。至今尚无公认的对卒中风险预测价值高的TIA的生物学标志物。寻找快速而准确的TIA后卒中风险的生物学标志物是目前研究的热点。本文从应激激素、炎症因子、血栓形成因子等方面对TIA后卒中风险的生物学标志物研究进行综述,并简要介绍基因测序及代谢组学等方法在TIA后卒中风险预测中的应用。     

关于短暂性脑缺血发作的最新认识

短暂性脑缺血发作(transient ischemicattack,TIA)是缺血性脑血管病的一种常见类型,其神经功能损害是短暂的,但TIA后卒中的发生率将明显增加。研究报道,TIA后2天内卒中发生率为3.5%,30天内为8.0%,90天内为9.2%。也有研究显示TIA后2天、7天内卒中发生率分别为3.1%和5.2%。作为一种预警,它受     

Orthostatic-Mediated Hypoperfusion in Limb-Shaking Transient Ischemic Attack

In patients with severe carotid stenosis or total occlusion, episodic contralateral motor dysfunction is more likely related to cerebral hypoperfusion than epileptogenic activity. A man with orthostatic-mediated right-sided limb shaking was found to have total left internal carotid artery occlusion. There was prominent reduction of cerebrovascular reserve seen on single photon emission computed tomography (SPECT) performed with and without acetazolamide. During assumption of an upright position transcranial Doppler (TCD) revealed a marked attenuation of the left middle cerebral artery flow pattern not associated with changes during electroencephalographic monitoring, even after administration of acetazolamide. In this man, limb shaking episodes were attributed to hypoperfusion of the contralateral cerebral hemisphere, and not to epileptogenic activity.     

肢体抖动型短暂性脑缺血发作的研究进展

肢体抖动短暂性脑缺血发作（limb-shaking transient ischemic attack,LS-TIA）是一种少见的TIA类型,极易被误诊为局灶性运动性癫痫发作或锥体外系疾病,在此对其发病机制、诊断、责任血管及影像学改变、治疗方法等方面进行阐述,期望对其临床诊治提供一定的指导作用。     

短暂性脑缺血发作的重新定义和病理生理学的探讨

短暂性脑缺血发作（transient ischemic attack,TIA）的传统定义是指短暂的、可逆的、局部的脑血液循环障碍,症状和体征在24h内完全消失。这个定义是以TIA的持续时间为基础的,其中所指定的24h是在应用神经影像学方法前随意达成的共识。     

短暂性脑缺血发作对脑缺血耐受的影响

目的 探讨短暂性脑缺血发作（TIA）在脑缺血耐受方面的临床意义。方法 选择30例TIA后72h内发生脑梗死的患者为试验组（TIA组）,并随机选择30例无TIA史的脑梗死患者作对照组。结果 TIA组和脑梗死组在脑梗死体积、治疗前与治疗后15d,30d,90d的欧洲卒中量表（ESS）评分方面存在统计学差异（8.2 ml vs 10.6 ml;62±22 vs 58±24;70±28 vs 66±32;80±20 vs 76±24;82±18 vs 77±23; P均<0.05）。结论 TIA后发生脑梗死对减轻脑细胞损伤有一定临床意义。     

Isolated Petrous Carotid Stenosis and Transient Ischemic Attack

Although anterior circulation transient ischemic attacks (TIAs) tend to be more common in patients with extra- cranial carotid arterial disease than in those with intracranial carotid or middle cerebral arterial disease, the authors recently encountered 4 patients with both recurrent, stereotypical TIAs as well as isolated stenosis of their petrous internal carotid artery (ICA). While the gold standard for establishing the diagnosis of intracranial large-artery disease has always been conventional angiography, magnetic resonance angiography changes, confirmed with intra-arterial digital subtraction angiography in 2 of these patients, were quite sufficient to define the occlusive disease in each of the cases. Petrous ICA stenosis is not uncommon, but it has often been overshadowed by the search for extracranial ICA disease that might be amenable to surgical reconstruction.     

短暂性脑缺血发作研究的历史与现状

在提出短暂性脑缺血发作(transient ischemic attack,TIA)的概念之后的半个多世纪中,随着对TIA的研究不断深入,到目前为止整个研究过程可以大致分为3个阶段:TIA定义的提出——时间与临床概念;TIA是否有组织学损伤——脑梗死与TIA的界限区分;更关注TIA的预后——预后评估与管理。3个阶段     

短暂性脑缺血发作：风险评估及思考

2009年,美国心脏协会(American Heart Association,AHA)/美国卒中协会(American Stroke Association,ASA)颁布"短暂性脑缺血发作"(transient ischemic attack,TIA)新定义:由于脑、脊髓及视网膜缺血导致的短暂神经功能缺损,未引起梗死。将诊断标准从传统定义的"时间"标准转化到"组织学"证据。新定义不再强调24 h的时间概