Transient ischemic attack and ischemic stroke: definition, commonality and inspiration
10.3760/cma.j.issn.1673-4165.2021.01.013
- VernacularTitle:短暂性脑缺血发作与缺血性卒中：定义、共性和启示
- Author:
Zhanqing SU
- From:
International Journal of Cerebrovascular Diseases
2021;29(1):69-74
- CountryChina
- Language:Chinese
-
Abstract:
This article discusses the definition, commonality and clinical implications of transient ischemic attack (TIA) and ischemic stroke. In the definition of the two, the problems in the definition of TIA and ischemic stroke published by the American Heart Association/American Stroke Association are pointed out, such as how to define " transient" ? In the commonality part of the two, based on the analysis of reversible ischemic tissue (i.e. ischemic penumbra), It is pointed out that there is a situation that the symptoms last for 24 h or even several days without infarction in clinical practice, and the concept of persistent ischemic attack (PIA or " persistent state of ischemic attack" ) is introduced. In the clinical implications part, the PIA is further elaborated, and the judgment, inference and significance of transience/persistence are discussed. It is suggested that the significantly increased risk of ischemic stroke over a certain time threshold should be taken as the criterion of " transient" threshold. This time threshold may be between 5 and 20 min. If the threshold is exceeded, it can be diagnosed as PIA. Patients with PIA may benefit from intravenous thrombolytic therapy, and this also becomes another basis to determine whether the time threshold exists and is reasonable.
