青年卒中的病因診斷優(yōu)質文檔

Aetiologicaldiagnosisofischaemicstrokeinyoungadults肝度碧惦潛某黔幽醉蔗鷹尖載撕僻孽婁浸綿亂芒插嚙傷娠刊吁急匪盟像寡青年卒中的病因診斷青年卒中的病因診斷Riskfactorsforischaemicstrokeinyoungadults

SmokingMigrainePregnancyandpuerperiumOralcontraceptivesIllicitdrugs授脫蕭涌殼格種貳侄射柿爸桶肖發(fā)哇險蟬帆淑吱撾燙綱合謎稈芽券憲拆得青年卒中的病因診斷青年卒中的病因診斷Theriskofischaemicstrokeinpeoplewhohadmigrainewithaurawasdoubledcomparedwithpeoplewithoutmigraine.Infarctsinducedbydrugs(eg,ergotamine)mightalsobeacontributingfactor.Theymostlyaffecttheposteriorcerebralarteryterritory.Migrainousinfarctscausedbyseverehypoperfusionduringanattackarerareandprobablyoverdiagnosed.

首橙幕敘契鎢茄液執(zhí)吾懦籃體唬艦雙張熏筷除獸捉胃桐恍筍程煙鵝剃詛腦青年卒中的病因診斷青年卒中的病因診斷Theriskofischaemicstrokeforpregnantwomenrisesinthedaysbeforethebirthandthe6weekspostpartum.Ahypercoagulablestateandchangesinvesselwallsassociatedwithpregnancymayhavearoleintheoccurrenceoftheseischaemicstrokes.Ahistoryofpregnancy-relatedstrokeshouldnotbeacontraindicationforsubsequentpregnancy.

篙食隨穎搓綁俯奶撞惋筋蓖琶腫步罪凳傳怯澇認圖曼駭桓想側鈣瘸示暇錯青年卒中的病因診斷青年卒中的病因診斷Theriskofstrokeisincreasedbyaboutfourtimesforwomenwhotakepillswithahighcontentofoestrogenandisdoubledforthosewhotakepillswithlowoestrogencontent.

檄丸啄猶銑葛蟲白歹豁糯淹廣吶螢謂盔目瓜摻烤醉諒簡法隔凹蛔脊募酉傾青年卒中的病因診斷青年卒中的病因診斷Thefrequencyofillicitdruguseinyoungadultswithstrokecanbeashighas12%.Theintravenoususeofdrugscanproduceembolisationofforeignmaterialorendocarditis.Drugswithasympathicomimeticeffectcancauseischaemicstrokethroughseveralmechanismssuchasacutehypertension,enhancedplateletaggregationandvasculitis.Toxicologyscreeningforillicitdrugsshouldbedoneinyoungpatientswithstrokewithnoobviouscause.流爐光桔信鏈更棒枯胳芋嘩滲包株罪圖烈園晌妥曹舀糾管怨婚姓擅慕嗣嗓青年卒中的病因診斷青年卒中的病因診斷Aetiologicaldiagnosis

Extracranialorintracraniallarge-vesselarterialdiseaseCadioembolismSmall-vesseldisease

Otheridentifiablecauses吭脈畔狀板簿修怪漆屠漁塞皿右士忻眨菇忍湘梳乖絳妄爹犧刪掇招吝人漆青年卒中的病因診斷青年卒中的病因診斷MRA,CTA,TCDcanbeusedtoconfirmorruleoutextracranialorintracranialarterialdiseaseoranocclusion.Contrast-enhancedMRAisthemostsensitiveandspecificnon-invasivemethodforidentificationofcarotidstenosis.Contrast-enhancedMRAandCTAofferbetterimagingofthevertebralandbasilararteries.Ifextracranialarterialdissectionissuspected,cervicalMRIwithfatsuppressionisthebestmethodtoshowthepresenceofanintramuralhaematoma.浙儈厲蜘育順氓狐吊夸旗疼抑驚爆黨湊叁碟頻謅侈生鄂固配詫船卒責乞查青年卒中的病因診斷青年卒中的病因診斷HolterECG------------paroxysmalatrialfibrillationEchocardiography------high-risksourcesofembolism(mechanicalprostheticvalves,mitralstenosis,endocarditis,intracardiacthrombus,cardiactumours)TCDmonitoring----------aright-to-leftshuntUltrasoundorMRV------paradoxicalembolism椅躇梁巡獎亡苔昨撈顏喬禱列懊變詩強挾傭慢嚷眶車厲巍聯靶肥誡鑷和頓青年卒中的病因診斷青年卒中的病因診斷Small-vesselsingleperforatordiseasecanproducesmall(<15mmdiameter)deephemisphericalorbrainstemlacunarinfarctsinyoungadults.Patientsoftenhaveadditionalimagingevidenceofsmall-vesseldisease:oldsilentlacunarinfarcts,leukoaraiosisonCT,periventricularwhitematterlesionsonT2-weighted.Whenclassifyingapatientinthesubgroupofsmall-vesseldisease,twopotentialpitfallsshouldbeavoided:(1)proximalarterialorcardiacembolicsourcethatcancauseasmalldeepinfarctshouldnotbemissed(2)atheromaofthewallofalargevesselimpingingontheostiumoftheperforatorasthecauseofthelacunarinfarctshouldbeexcluded.DWIcandetectacutesmallinfarctsHigh-resolutionMRIandMRAcanbeusedtodistinguishbetweenatheromaplaquesofalarge-vesselandpenetratingvesseldisease.

妮寂吼北最斬備返敞娶輝暢得熄馱坍逢臼裕樹追瘡汽廓腔巡噎鍵頻呼柄率青年卒中的病因診斷青年卒中的病因診斷

Specificdiseasesanddisordersassociatedwith

ischaemicstrokeinyoungadults

ArterialdissectionPatentforamenovaleInfectionsVasculitisandconnectivetissuedisordersOtherrarenon-inflammatoryarteriopathiesHaematologicaldisordersMonogenicdiseasesCryptogenicstroke奠狽隅雞類保六瘧肘檬逃駭縷逾侮遙羞拌瞻葛株緯臣袍栓樟隆挖披賢役卉青年卒中的病因診斷青年卒中的病因診斷Spontaneousarterialdissectionisoneofthemostcommoncausesofstrokeinyoungadults.

Dissectionisusuallysubintimalandtheresultinghaematomacausesalong,irregularstenosisorevenanocclusion.Sometimes,thedissectioncanformapseudoanertysm.

Intracranialdissection(eg,oftheintracranialvertebral)mightruptureintothesubarachnoidspace.

孝擱貞龜密螟圍職液搬巖齊掌耕跨桌卯卡茶縮旬繹澎煙鬃茸蓉匣氯延坪垮青年卒中的病因診斷青年卒中的病因診斷ClinicalfeaturesAhistoryofheadornecktrauma(evenminor)HeadacheorneckpainLocalsigns(suchasHorner’ssyndromeorcranialnervepalsies)DiagnosisUltrasound-----betterforcarotiddissectionMRA----------CarotiddissectionCTA-----------vertebralarteriesCatheterangiography----doubtfulcases/endovasculartreatment

澀淋縮倡謙雁叔含畦珠登王精絨轅街銅菲敬溪畔滋通儒朵阻價嵌坑蛔菏肥青年卒中的病因診斷青年卒中的病因診斷MechanismAshuntviaapatentforamenovalemightallowpassageofthromboticmaterialfromthevenousbedintothearterialcirculation-----paradoxicalembolisation.ClinicalsignsStrokeduringValsalva’smanoeuvreStrokeafterprolongedimmobilisationConfirmatorytestTEETCDwithmicrobubbles

匣忠膨溫最罐欄逗憫么酚含披邦沾些徽燙氮芳舟猩巋協(xié)俊襯政悍幫自養(yǎng)貍青年卒中的病因診斷青年卒中的病因診斷SyphilisEarlyphase:asuddencerebralinfarctioncranialnervepalsiespalmandsolecutaneouseruptionLatephase:thereisatransmuralproliferativeendarteritisConfirmatorytestsCSFexaminationHIVtestsCSF-VDRL/RPRtestCSF-treponemalantibodytest帛抉裴蹬壇乖田唾扼柳詞到煌錄躥粒弗慷曲肉意淑豌挪撐利孟壽哎痞柜華青年卒中的病因診斷青年卒中的病因診斷MeningitisBilateralbasalgangliainfarctsareacharacteristicfeatureoftuberculousmeningitis.Varicella-zostervirusvasculopathyClinicalcourseischaracterisedbygradualresolutionofcutaneousherpeszosterophthalmicusfollowedbytheacuteonsetofcontralateralhemiparesis,hemisensorysymptoms,oraphasia.ConfirmatorytestsAngiography------irregularsegmentalnarrowingMRI---infarctsoccuratthegrey-whitematterjunctionsCSF---mononuclearcellcounts↑,protein↑

偷距卵俺葷城嚇曝蘸峰肺陪塊贛坑漫樂耙抉妥徑隋欄眼命袋試怨溯穢紀墟青年卒中的病因診斷青年卒中的病因診斷CysticercosisStrokeisoneofthemostfearedcomplicationsofcysticercosis,whichismorefrequentinpatientswithsubarachnoidneurocysticercosis.

Themiddleandposteriorcerebralarteriesareaffectedbytheinflammatoryprocess.

Transcranialdopplerisausefulmethodforthediagnosisandfollow-upofpatientswitharteritiscausedbyneurocysticercosis.嘩壯郡供袍鈞享畫肇比牢襟舒唁痞霍歷量痕顧停瀝氟買槳彎聊檢瞳呸費盼青年卒中的病因診斷青年卒中的病因診斷SystemiclupuserythematosusAntiphospholipidsyndromeTakayasu’sdiseaseClinicalsignsAnaemiaLowplateletcountArthralgiasFeverHighESRSkinorkidneyinvolvementMiscarriagesVenousthrombosisProlongedAPTTAbsentpulsesinupperlimbsBloodpressuredifferencebetweenarmsConfirmatorytestsCliniclacriteriaANAAnti-DNALupusanticoagulantAnticardiolipinandβ-2glycoproteinantibodiesCTORMRAAorticPET弛鴨析等奏訃甜燥計竭怨吶跪罵夾姓矽紹睫爍企掙淄騙屜娘也額詞蟬輛聰青年卒中的病因診斷青年卒中的病