一次中风
Nina A Hilkens1, Barbara Casolla2, Thomas W Leung3
1Department of Neurology, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands.
Lancet (London, England)
|May 17, 2024
概括
脑卒中是全球首要的死亡原因, 最近的进展包括对缺血性中风的新疗法和对出血性中风的改善护理,
科学领域:
- 神经学
- 血管医学
- 公共卫生
背景情况:
- 脑卒中是全球主要的健康问题,
- 它临床上呈现出突发的神经缺陷,通常源于血管原因.
- 在高收入国家和低收入国家中,患病率有很大差异.
研究的目的:
- 审查目前对中风的理解和管理,包括诊断,急性治疗和二次预防.
- 为了突出最近的治疗进步在缺血和出血中风.
- 强调以机制为指导的二次预防策略的重要性.
主要方法:
- 对诊断神经成像技术 (CT,MRI) 进行评估.
- 对急性缺血性中风的当前和新兴治疗方法的分析,包括血栓溶解和血管内血栓切除术.
- 检查脑内出血的治疗方案,重点是捆绑治疗和血压管理.
- 基于潜在的中风机制的二次预防策略概述.
主要成果:
- 多模式CT/MRI有效地识别了中风病理,并有助于治疗决策.
- 在急性缺血性中风中,丁氏是一种安全有效的静脉血栓溶解替代品.
- 血管内血栓切除的指示已经扩展到大血管封闭性中风,时间窗口延长.
- 综合治疗方案可以改善脑内出血的结果.
- 二次预防策略是针对中风机制的,包括药物,血管和生活方式干预.
结论:
- 在急性治疗缺血性中风和出血性中风方面取得了重大进展.
- 扩大治疗窗口和新的治疗选择改善了患者的结果.
- 基于机制的二次预防对于减少中风复发和长期残疾至关重要.
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