病例报告:短暂性脑缺血发作伴房颤后脑卒中预测模型

Mason Rubianto, S. Yusuf, S. Giovani
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引用次数: 0

摘要

背景:房颤(AF)是卒中的独立危险因素。房颤在短暂性脑缺血发作(TIA)中的作用较少见。因此,这种情况不能低估,因为TIA和AF都增加了患者中风的风险。病例:一名80岁妇女,表现为言语障碍和定向障碍,持续2小时。患者格拉斯哥昏迷评分总分13分(E4V3M6),血压150/80,心率147次/分不规则。神经学检查显示:面神经中枢和舌下神经麻痹,但在24小时内完全消退。她的心电图显示AF。对该患者的诊断是TIA合并AF和高血压1期。讨论:ABCD2评分似乎是预测中风早期风险的最佳指标,该评分是通过对5个独立因素(1)年龄、(2)血压、(3)TIA的临床特征、(4)TIA持续时间和(5)糖尿病的积分相加来计算的。该患者ABCD2评分为5分,属于中度危险。结论:这些患者需要综合的方法和额外的影像学考虑,因为有中等到较高的卒中复发机会。关键词:心房颤动,ABCD2评分,脑卒中,短暂性脑缺血发作
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CASE REPORT: STROKE PREDICTION MODELS AFTER TRANSIENT ISCHEMIC ATTACK WITH ATRIAL FIBRILLATION
Background : Atrial fibrillation (AF) is an independent risk factor for stroke. The role of AF in transient ischemic attack (TIA) is less common. Thus, this situation cannot be underestimated because both TIA and AF are increasing the risk of a patient to get stroke. Case : An 80 years old woman presented with speech disturbance and disorientation which lasted for 2 hours. Patients look confused with glasgow coma scale total 13 (E4V3M6), blood pressure was 150/80 and heart rate 147 beats/min irregular. From neurological examination, there was paresis nervus facialis central and nervus hypoglossus but completely resolved under 24 hours. Her electrocardiogram showed an AF. Working diagnosis for this patient were TIA with AF and hypertension stage 1. Discussion : The early risk of stroke seems to be best predicted with ABCD2 score, which is calculated by summing up points for five independent factors: (1) age, (2) blood pressure, (3) clinical features of TIA, (4) duration of TIA and (5) diabetes. The ABCD2 score of this patient is 5 which classified as moderate risk. Conclusion : These patients require a comprehensive approach and additional an imaging consideration because there are a moderate to higher chance of stroke recurrence. Keywords : Atrial Fibrillation, ABCD2 Score, Stroke, Transient Ischemic Attack
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