本文由小咖机器人翻译整理

期刊来源：Lancet

原文链接：https://doi.org/10.1016/S0140-6736(24)00642-1

摘要内容如下：

在一些高收入国家，每五个人中就有一个人患有中风，而在低收入国家，每两个人中就有一个人患有中风。在全球范围内，它是第二大死亡原因。临床上，这种疾病的特征是突发性神经功能缺损。血管病因是缺血性卒中最常见的原因，包括大动脉疾病、心源性栓塞和小血管疾病。小血管疾病也是颅内出血最常见的原因，其次是大血管原因。对于急性缺血性卒中，多模式CT或MRI显示梗死核心、缺血半暗带和血管闭塞部位。对于脑内出血，神经影像学可以确定血肿扩大的早期放射学标记和可能的潜在原因。对于缺血性卒中的静脉溶栓，替奈普酶目前是阿替普酶的安全有效的替代品。在大血管闭塞引起的卒中患者中，血管内血栓切除术的适应症已扩大到包括较大的核心梗死和基底动脉闭塞，治疗时间窗已增加到卒中发作后24小时。对于脑内出血，及时提供由立即抗凝逆转、同步降压和预先指定的卒中单元方案组成的捆绑式护理可以改善临床结果。在潜在卒中机制的指导下，二级预防包括药物、血管或血管内干预和生活方式改变。

英文原文如下：

Abstracts

Stroke affects up to one in five people during their lifetime in some high-income countries, and up to almost one in two in low-income countries. Globally, it is the second leading cause of death. Clinically, the disease is characterised by sudden neurological deficits. Vascular aetiologies contribute to the most common causes of ischaemic stroke, including large artery disease, cardioembolism, and small vessel disease. Small vessel disease is also the most frequent cause of intracerebral haemorrhage, followed by macrovascular causes. For acute ischaemic stroke, multimodal CT or MRI reveal infarct core, ischaemic penumbra, and site of vascular occlusion. For intracerebral haemorrhage, neuroimaging identifies early radiological markers of haematoma expansion and probable underlying cause. For intravenous thrombolysis in ischaemic stroke, tenecteplase is now a safe and effective alternative to alteplase. In patients with strokes caused by large vessel occlusion, the indications for endovascular thrombectomy have been extended to include larger core infarcts and basilar artery occlusion, and the treatment time window has increased to up to 24 h from stroke onset. Regarding intracerebral haemorrhage, prompt delivery of bundled care consisting of immediate anticoagulation reversal, simultaneous blood pressure lowering, and prespecified stroke unit protocols can improve clinical outcomes. Guided by underlying stroke mechanisms, secondary prevention encompasses pharmacological, vascular, or endovascular interventions and lifestyle modifications.

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