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后循环缺血性卒中和短暂性缺血发作

         

摘要

在所有短暂性缺血发作( TIA)和卒中,1/5发生于后循环供血区。后循环缺血性事件尽管很重要,但受到的关注远不如颈动脉供血区。最近的研究表明,后循环缺血性事件的早期卒中复发风险高,特别是伴有椎基底动脉狭窄者,因此有效的二级预防很重要。有效的二级预防需要准确的临床诊断、探查根本病因以及有效的内科、外科或神经介入治疗,但新近的研究结果正在改进对这个领域的理解。该文主要关注后循环卒中和TIA 的诊断、辅助检查和二级预防以及近来的一些进展。%A fifth of all transient ischemic attacks(TIA) and ischemic strokes are in the territory of the vertebrobasilar(also known as posterior) circulation.Despite their importance,ischemic events in this loca-tion have received much less attention than those in the carotid artery territory .Recent studies have shown that they are associated with a high risk of early recurrent stroke particularly when there is associated verte-brobasilar stenosis,therefore effective secondary prevention is important .Such an approach needs accurate clinical diagnosis,detection of the underlying cause,and effective medical and surgical or neurointerventional treatments.Posterior circulation ischemia presents particular challenges in diagnosis,investigation,and treat-ment,but recent research and ongoing studies are improving our understanding in this area .Here is to make a review of progress in the diagnosis,investigation,and secondary prevention of posterior circulation ischemic stroke and TIA.

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