Recent advances in the management of transient ischaemic attack: a clinical review

被引:6
|
作者
Phan, T. G.
Sanders, L.
Srikanth, V.
机构
[1] Monash Univ, Stroke Unit, Dept Neurosci, Monash Med Ctr, Melbourne, Vic 3168, Australia
[2] Monash Univ, Stroke & Aging Res Grp, Dept Med, Melbourne, Vic 3168, Australia
基金
澳大利亚国家健康与医学研究理事会; 英国医学研究理事会;
关键词
TIA; carotid; atrial fibrillation; organisation; SYMPTOMATIC CAROTID STENOSIS; RANDOMIZED CONTROLLED-TRIAL; EMERGENCY-DEPARTMENT; ATRIAL-FIBRILLATION; STROKE PREVENTION; RECURRENT STROKE; PREDICTIVE-VALUE; VASCULAR EVENTS; MEDICAL THERAPY; ABCD2; SCORE;
D O I
10.1111/imj.12059
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Transient ischaemic attack (TIA) if untreated carries a high risk of early stroke and is associated with poorer long-term survival. There have been recent advances in the understanding of TIA, its investigations, management and organisation of services for patient care. Clinically, patients are diagnosed TIA if they have transient sudden-onset focal neurological symptoms which usually completely and rapidly resolve by presentation. Patients with residual symptoms should be evaluated as potentially having stroke, if they present within 4.5h of onset, should be urgently evaluated for their potential eligibility for thrombolysis. TIA patients should receive rapid attention with essential investigations, including brain imaging, electrocardiograph and carotid ultrasound. Immediate administration of an antiplatelet agent is recommended after brain imaging, with subsequent attention to preventing or treating other mechanistic factors. There is emerging evidence that TIA patients can be managed safely in the outpatient setting after initial rapid management in emergency departments as part of a structured clinical pathway supervised by stroke specialists. Clinical systems of management may require approaches individualised to the healthcare setting, while adopting the central aspects of rapid management.
引用
收藏
页码:353 / 360
页数:8
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