transient ischemic attack
Introduction
Introduction to transient ischemic attack Transient ischemic attack refers to a transient disorder in the brain tissue of a certain area due to insufficient blood supply, referred to as TIA. basic knowledge Sickness ratio: 0.1%-0.2% Susceptible people: no specific population Mode of infection: non-infectious Complications: high blood pressure
Cause
Cause of transient ischemic attack
The disease is mostly associated with hypertensive arteriosclerosis, and its onset may be caused by a variety of factors.
1. Microthrombus: a wall thrombus in the internal carotid artery and the vertebral-basal artery system, where the arteriosclerotic stenosis is located, the hardened plaque and the blood decomposing substance, platelet aggregates, etc., detached, and the brain artery is blocked. The ischemic symptoms disappear when fragmented or moved distally.
2. Cerebral vasospasm: The internal carotid artery or the vertebral arterial system atherosclerotic plaque narrows the vascular lumen, where blood flow vortex is generated. When the eddy current accelerates, the blood vessel wall is stimulated to cause vasospasm and transient cerebral ischemia occurs. When the vortex is decelerated, the symptoms disappear.
3. Cerebral hemodynamic changes: When the carotid artery and the vertebral-basal artery system are occluded or stenotic, if the patient suddenly has a transient hypotension, the cerebral blood flow is reduced, which leads to the onset of the disease; after the blood pressure rises, the symptoms disappear. This disease is more common in blood pressure fluctuations when the disease is prone to occur, in addition, arrhythmia, atrioventricular block, myocardial damage can also cause a sudden reduction in local blood flow to the brain.
4. The neck artery is distorted, too long, and the knot or vertebral artery is compressed by the cervical vertebrae. When the head turns, it can cause the attack.
Prevention
Transient ischemic attack prevention
prevention
1, primary prevention (refers to the occurrence of atherosclerosis and small arteriosclerosis before the occurrence of stroke).
2. Carefully manage blood pressure. People who quit smoking, abstain from alcohol, have a family history of stroke, and other vascular risk factors regularly check for platelet aggregation.
3, secondary prevention (refers to prevention of recurrence after stroke). Mainly taking anti-platelet aggregation drugs, while carefully looking for risk factors for stroke in patients.
4, appropriate control of fat intake, diet avoid salty, too sweet.
Complication
Transient ischemic attack Complications
Concurrent lateral chorea.
Symptom
Symptoms of transient ischemic attack Common symptoms Paralysis of the iliac artery is multi-extension, twisted, reversed, diplopia, cerebral ischemic hemianopia
1. History and symptoms: TIA of the internal carotid artery system can be characterized by sudden confusion, epileptic seizures or localized seizures, limb numbness, sputum, hemiplegia, homonymous hemianopia, aphasia, misuse, cross-heeled blackhead Et al; vertebral-basal artery system TIA manifested as dizziness, syncope, tripping, black sputum, diplopia, visual distortion, visual field defect, balance disorder, ball paralysis, forgetting, loss of recognition, etc., often have incentives, each episode The duration is no more than 24h. There is no residual symptoms in the interictal period. The medical history should be asked about the onset of symptoms, the characteristics of the symptoms, the incentives, the duration of the symptoms, the duration of the symptoms and the symptoms of the interictal period.
2. Physical examination revealed that the signs of the attack period are as described above. Some patients in the interictal period may have mild hemiplegia, nystagmus, corneal, pharyngeal wall and ankle asymmetry, gaze, and radiation and other slight signs.
Examine
Examination of transient ischemic attack
1, hematuria, erythrocyte sedimentation rate, blood sugar, blood lipids and electrocardiogram should be listed as routine inspection items.
2, cerebrospinal fluid.
3, cerebral angiography.
4, skull CT scan.
5. Magnetic resonance imaging (MRI).
6, positron emission computed tomography (PET).
Diagnosis
Diagnosis and diagnosis of transient ischemic attack
The diagnosis is mainly based on medical history, which is characterized by transient localized symptoms and focal signs. The duration is very short. Symptoms and signs disappear within 24 hours, but need to be identified with the following diseases:
1. Focal epilepsy: manifested as paroxysmal limb twitching or paresthesia, lasting only a few seconds to a few minutes, EEG has many typical changes.
2. Meniere's disease: manifested as paroxysmal vertigo, vomiting, but lasts longer, more than 24 hours, and often occurs in young people, often with tinnitus and hearing loss.
