医学
冲程(发动机)
脑血流
心脏病学
闭塞
内科学
经颅多普勒
栓塞
大脑中动脉
颈内动脉
置信区间
正电子发射断层摄影术
放射科
缺血
机械工程
工程类
作者
Catharina J.M. Klijn,L. Jaap Kappelle,Cornelis A.F. Tulleken,J. van Gijn
出处
期刊:Stroke
[Ovid Technologies (Wolters Kluwer)]
日期:1997-10-01
卷期号:28 (10): 2084-2093
被引量:282
标识
DOI:10.1161/01.str.28.10.2084
摘要
Background Over the last several years evidence has accumulated that in addition to embolism, a compromised cerebral blood flow may play an important role in causing transient ischemic attacks and ischemic stroke in patients with occlusion of the internal carotid artery. This evidence is found in both clinical features and ancillary investigations, particularly measurements of cerebral blood flow. Summary of Review On the basis of 20 follow-up studies in patients with transient ischemic attacks or minor ischemic stroke associated with an occluded carotid artery, the annual risk of stroke was 5.5% (95% confidence interval [CI], 5.0% to 6.0%), and that of ipsilateral stroke (distinguished in 11 of the 20 studies) was 2.1% (95% CI, 1.6% to 2.8%). Patients with a compromised cerebral blood flow as measured by positron emission tomography, single-photon emission CT, transcranial Doppler, or stable xenon CT (six studies) have an even higher annual risk of stroke (all strokes: 12.5%; 95% CI, 8.9% to 17.6%; ipsilateral stroke: 9.5%; 95% CI, 6.4% to 14.0%). Conclusions Because a compromised cerebral blood flow may be an important causal factor in patients with symptomatic carotid artery occlusion, medical and surgical options for treatment are reviewed in this light.
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