JNNP:疑似短暂性脑缺血发作(TIA)和轻度脑卒中患者偶发颅内动脉瘤的患病率、预测因素和预后:一项基于人群的研究和系统回溯

2020-11-22 MedSci原创 MedSci原创

未破裂颅内动脉瘤(UIAs)是常见的偶发影像学表现,但对于短暂性脑缺血发作(TIA)/脑卒中的患者,相关资料很少。由于共同的危险因素,UIA的发生频率可能更高,但通过强化的二级预防可以降低破裂风险。本

未破裂颅内动脉瘤(UIAs)是常见的偶发影像学表现,但对于短暂性脑缺血发作(TIA)/脑卒中的患者,相关资料很少。由于共同的危险因素,UIA的发生频率可能更高,但通过强化的二级预防可以降低破裂风险。本文通过研究了疑似短暂性脑缺血发作/轻微中风患者中UIA的患病率和预后。

方法:纳入牛津血管研究(2011-2020)的所有疑似短暂性脑缺血发作(TIA)和无创血管造影的患者。作者通过对强化治疗的随访和基于指南的监测/管理,确定了偶发无症状UIA的患病率和随后发生蛛网膜下腔出血(SAH)的风险。作者还对TIA/中风队列中UIA患病率/预后进行了系统回顾。

在2013名符合条件的患者中,95名(4.7%)有103名先前未知的无症状UIA。女性(OR 2.3,95%CI 1.5-3.7),吸烟(2.1,1.2-3.6)和高血压(1.6,1.0-2.5)是UIA的独立预测因素,在所有三个危险因素中患病率为11.1%。在平均4.5年的随访中,仅发生一例蛛网膜下腔出血:2.3例(95%可信区间0.3~16.6)。作者在TIA/中风队列中确定了19项UIA研究(n=12 781),所有研究都有症状性颈动脉狭窄或严重急性中风。TIA/卒中患者的合并平均UIA患病率为5.1%(95%CI为4.8-5.5),SAH的发病率为4.6(95%CI为1.9-11.0)。

在确诊的TIA/轻度中风患者中,5%的UIA患病率可能高于普通人群。然而,在强化医疗和基于指南的管理/监测中,SAH的风险较低。

Hurford RTaveira IKuker W, et al Prevalence, predictors and prognosis of incidental intracranial aneurysms in patients with suspected TIA and minor stroke: a population-based study and systematic review

 

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  5. 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    2020-11-24 咻凡

    未破裂颅内动脉瘤(UIAs)是常见的偶发影像学表现,但对于短暂性脑缺血发作(TIA)/脑卒中的患者,相关资料很少。

    0

  6. 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  7. 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  8. [GetPortalCommentsPageByObjectIdResponse(id=1679152, encodeId=e4a516e915242, content=<a href='/topic/show?id=7a2684e600b' target=_blank style='color:#2F92EE;'>#脑卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84760, encryptionId=7a2684e600b, topicName=脑卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=091e27733095, createdName=weihongyv, createdTime=Tue Jul 20 06:01:06 CST 2021, time=2021-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720357, encodeId=70321e2035760, content=<a href='/topic/show?id=915c3604e6b' target=_blank style='color:#2F92EE;'>#卒中患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36047, encryptionId=915c3604e6b, topicName=卒中患者)], attachment=null, authenticateStatus=null, createdAvatar=null, 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  9. 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    2020-11-23 ms3000000383186090

    学习学习

    0

  10. 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    2020-11-23 weigq

    SAH的风险较低可能与TIA/轻度中风无关,而主要是强化医疗和基于指南的管理/监测的结果。

    0

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当血管堵塞或者破裂时,脑血供中断,导致脑细胞损伤或死亡,进而引发各种功能障碍。这就是我们常说的脑卒中,也称为脑血管意外。

梅斯心血管|病例解读:PCI术后发生卒中,运动功能严重丧失!

缺血性脑卒中是心导管术后的一种严重并发症。经皮冠状动脉介入术(PCI)后血栓栓塞事件的危险因素包括升主动脉或主动脉弓存在粥样硬化斑块、房颤、老年、动脉疾病和心源性休克,可能导致终身神经功能受损和死亡。

Circ Res:赖仞组揭示缺铁性贫血和口服避孕药诱导脑卒中分子机制

缺血性脑卒中通常是由血管阻塞引起的,约占中风的87%。简而言之,缺血性脑卒中是在血管阻塞引起的脑血流严重减少或中断后发生的。当前,缺血性脑卒中是全球第二大死因,也是永久性残疾的最重要原因。

Stroke:脑卒中再灌注治疗后癫痫发作的发生率和相关因素

每15名接受IVT和/或机械血栓切除术治疗的缺血性卒中患者,无论是否接受特定的再灌注治疗,均会出现癫痫发作。

JAMA Neurol:选择性5-羟色胺再摄取抑制剂对卒中幸存患者卒中复发及抑郁症状的影响

原发性脑出血后接受选择性5-羟色胺再摄取抑制剂治疗可缓解患者抑郁症状,但增加出血性卒中复发风险