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  会員専用

• ホーム
• 50巻11号
• 臨床神経, 50：783−786, 2010
• 50巻11号目次

第51回日本神経学会総会

＜Education Program 1＞
急性期虚血性脳血管障害の診断と治療

木村　和美

川崎医科大学脳卒中医学〔〒701―0192 倉敷市松島577〕

Recently, diagnosis and treatment for transient ischemic attack (TIA) and acute stroke is greatly changing in Japan. Now, TIA is closed up because it has been clarified that TIA attack is very high risk for following stroke. Therefore, TIA patients should be immediately evaluated TIA etiology and be treated after TIA attack as soon as possible in order to prevent following stroke. Medical equipment for stroke such as ultrasound and MRI is improving. In particular, development of MRI study including DWI, T₂^*, FLAIR, and MRA resulted in accurate diagnosis and etiology of super acute ischemic stroke, and paradoxical embolism, arterial dissection, and aortogenic embolism can be diagnosed in acute stroke patients. t-PA therapy has been approved by Japanese government since 1995, October. t-PA therapy can improve patient outcome due to early recanalization of occluded brain artery. The early recanalization rate was approximately 50% of major artery occlusion. We reported that early recanalization depended on time from stroke onset to IV-t-PA administration. Furthermore, we shown that the large ischemic lesions on diffusion-weighted imaging done before-PA infusion and presence of M1 susceptibility vessel sign were predictor for no-early recanalization and poor outcome. Stroke unit consisting stroke doctors, stroke nurse, and rehabilitation staff can improve patient outcome. In this way, management for acute stroke is greatly changing in Japan.
Full Text of this Article in Japanese PDF (363K)

(臨床神経, 50：783−786, 2010)
key words：急性期脳卒中，一過性脳虚血発作，t-PA，脳性ナトリウム利尿ペプチド，ストロークユニット

（受付日：2010年5月20日）