What should be done to prevent transient ischemic attack?

I think we need to do a good job of prevention in diet, work and rest, life, behavior and spirit.

It is necessary to do the prevention of hyperlipidemia, high blood pressure, cerebral insufficiency, cerebral infarction, diabetes, etc., and it is necessary to prevent various diseases in advance.

Transient ischemic attack is a transient neurological deficit caused by transient cerebral insufficiency. Prevention should be focused on after an attack in the following ways:

1. Risk factors: risk factors such as hypertension, hyperlipidemia, and diabetes need to be intervened;

For example, patients with hypertension need a low-salt diet, patients with hyperlipidemia need a low-fat diet, and diabetic patients need a low-sugar diet;

2. Appropriate exercise: brisk walking is advocated, and cycling is also advocated, but it is not recommended for such patients to climb mountains and exercise.

Today we will introduce the disease "transient ischemic attack".

Transient ischemic attack is a transient neurological deficit caused by local cerebral or retinal ischemia, and the clinical symptoms are generally less than 1 hour and the longest is not more than 24 hours, and there is no evidence of the responsible lesion (i.e., no clear lesion on imaging examination).

Clinical manifestations 1. General features.

It is more common in middle-aged and elderly people, more men than women, and patients are more likely to have hypertension, atherosclerosis, diabetes or hyperlipidemia and other diseases. The onset is sudden, and the local brain or retinal dysfunction lasts for a short time, with a maximum duration of no more than 24 hours, leaving no sequelae.

Depending on the blood vessels involved, it can be divided into the following two systems:

2. Internal carotid artery system.

The clinical presentation is related to the distribution of the blood vessels involved.

Middle cerebral artery: paralysis of the contralateral limb with ischemia, facial paralysis, and tongue paralysis may occur, with sensory impairment and hemianopia, and aphasia and apraxia are often present with damage to the dominant hemisphere, and spatial disorientation may occur with damage to the non-dominant hemisphere.

Anterior cerebral artery supply area: ischemia can cause personality and emotional disorders, contralateral lower limb weakness, etc.

Internal carotid artery ocular branch blood supply area: ischemia manifests as a gray sensation in front of the eyes, cloudy or blurred vision, and even transient amaurosis and blindness in one eye. Internal carotid artery trunk blood supply area:

Ischemia may present with ophthalmic artery cross paralysis (transient amaurosis in one eye on the affected side, blindness, and/or contralateral hemiplegia and sensory deficits).

3. Vertebrobasilar artery system.

The most common manifestations are vertigo, impaired balance, abnormal eye movements, and diplopia. There may be unilateral or bilateral facial and perioral numbness, alone or with contralateral limb paralysis and sensory deficits. In addition, vertebrobasilar artery system TIA can also present with the following clinical syndromes:

1) Fall seizure: It is manifested as a sudden loss of tension in the lower limbs and falling, loss of consciousness, and often quick to stand up on its own. Sometimes seen when the person turns or tilts their head.

2) Transient global amnesia: short-term memory loss occurs during the episode, disorientation to time and place, but the ability to talk, write and calculate is normal, and the general symptoms last for several hours, and then completely improve, leaving no memory damage.

3) Binocular vision impairment episodes.

Prognosis Patients are at high risk of early stroke, with the incidence of cerebral infarction occurring in 4% to 10% within 7 days of onset and 10% to 20% within 90 days of onset (mean 11%). Progressive transient ischemic attack with shortened intervals, prolonged duration, and progressively worsening clinical symptoms is a strong warning sign of impending cerebral infarction. Patients are not only susceptible to cerebral infarction, but also to myocardial infarction and sudden death.

Eventually, TIA partially progressed to cerebral infarction, some continued to attack, and some resolved spontaneously.

That's all for today.

Answer]: B Cerebral embolism: It refers to the acute occlusion of the lumen of the blood vessel by entering the intracranial artery with the blood flow, causing ischemia and necrosis and dysfunction of the brain tissue in the corresponding blood supply area.

Most of them have a sudden onset during activity, there are no prodromal symptoms, focal neurological signs reach a peak in seconds to minutes, and most of them manifest as complete stroke, so choose C in question 1. Intracerebral hemorrhage: refers to primary non-traumatic intraparenchymal hemorrhage.

Most of them have a history of hypertension, and most of them have a sudden onset of illness during emotional agitation or activities, and the slag of the disease reaches a peak within a few minutes to a few hours after the onset of the disease, and the symptoms of intracranial hypertension are obvious, so choose D in question 2. Transient ischemic attack (TIA): Each episode lasts 10 to 20 minutes, usually recovers within 1 hour, but can be reversed, and the time limit is 24 hours, so choose B for question 3.

Cerebral thrombosis: often occurs in quiet or sleep, some cases have TIA prodromal symptoms such as numbness, weakness, etc., focal signs mostly reach their peak more than 10 hours or 1 2 days after the onset of the disease, and the clinical manifestations depend on the size and location of the infarct foci, so 4 questions choose A.

1. Anti-platelet aggregation**.

It mainly inhibits the aggregation and release of platelets, so that they cannot form microthrombosis. These drugs are safe, simple, and easily accepted by patients. Enteric-coated aspirin, 50 100 mg once daily; Dipyridine 50 100 mg, 3 times a day.

2. Expansion **.

Low-molecular-weight dextran and 706 generations of plasma have the effects of expanding dissolution, improving microcirculation and reducing blood viscosity, and low-molecular-weight dextran or 706 generations of plasma 500 ml intravenous drip are commonly used, once a day, 14 days for a course of treatment.

3. Anticoagulation**.

If the patient has frequent seizures, does not respond well to other drugs, and has no contraindications to bleeding disorders, anticoagulation can be used**. Commonly used drugs heparin, dicoumarin, etc. For example, heparin can be used in ultra-small doses of 1500 2000 plus 5% 10% glucose 500 ml intravenously, once a day, 7 10 days for 1 course of treatment.

It can be repeated if necessary, with a course interval of 1 week, but during the application, attention should be paid to bleeding complications.

Sodium alginate is a new type of heparin-like drug, which can reduce fibrinogen and factor-related antigens, prolong prothrombin time, and have the effects of anticoagulation, thrombolysis, lipid reduction and viscosity reduction. It can be taken orally or on a drip of 50 100 mg orally three times a day; Intravenous drip 2 4 mg plus 10% glucose 500 ml, 20 30 drops, 10 days for 1 course of treatment, can be used for 2 3 courses of treatment.

4. Vasodilation**.

Petadine, cerebral yizine, cibilin, Xidezhen, Karan tablets and so on can be used. Usual dose: petadine 10 mg 3 times a day; Cerebral prozine 25 mg, 3 times a day; Sibilin 6 mg twice daily; Xidezhen 3 mg, 3 times a day; Karan tablets 5 mg, 3 times a day, orally.

5. Traditional Chinese medicine to invigorate blood circulation and eliminate blood stasis.

Salvia, Chuanxiong, peach kernel, safflower, etc., have the effect of invigorating blood and removing blood stasis, improving microcirculation, reducing blood viscosity, and have a certain effect on transient ischemic attack, which can be used. Surgery may be considered in patients with intracranial artery stenosis confirmed by cerebral angiography or Doppler and when drugs are ineffective.

Transient ischemic attack, or TIA for short, is also known as a transient ischemic attack or mini-stroke.

It refers to brain dysfunction caused by a decrease in cerebral blood flow for a short period of time, and each episode lasts for a short time, usually seconds, minutes, or hours, and does not exceed 24 hours.

It is often easy to be ignored because the symptoms come and go away quickly, and there are no sequelae after recovery. In fact, although the symptoms of TIA are mild, but the consequences are serious, if not timed**, according to statistics, 25% to 40% of patients will have a serious cerebral infarction within 5 years and threaten the patient's life.

Therefore, medical scientists often see it as a precursor or red flag of cerebrovascular disease.

There are many reasons for the occurrence of TIA, such as hypertension, hyperlipidemia, atherosclerosis, and diabetes mellitus. Excessive use of the brain, emotional agitation, coldness, and exertion can promote its occurrence.

TIA symptoms are varied, ranging from mild to severe, ranging from mild to several times a year, to several times a day, and dozens of times a month. Symptoms can be broadly divided into two groups. One is hemi-foot weakness, hemiplegia, sudden blackness or blindness and aphasia in one eye due to ischemia of the carotid artery system; The first is vertigo, nausea, vomiting, tinnitus, deafness and facial sensory impairment caused by vertebrobasilar ischemia.

Both groups of symptoms may occur separately in the same patient, or they may occur sequentially or simultaneously.

After the occurrence of TIA, it must not be ignored and should be actively prevented. First of all, under the guidance of a doctor, we should appropriately choose traditional Chinese medicine and other vasodilators that promote blood circulation and remove blood stasis, and should also actively participate in physical exercise, such as walking, jogging, tai chi, qigong, etc. However, do not engage in excessively strenuous activities, and at the same time avoid overwork, maintain a regular life, put an end to alcoholism, strictly quit smoking, arrange a reasonable diet, eat less animal fat and high-cholesterol foods, and eat more soy products, fish, fresh vegetables and fruits.

You should also go to the hospital regularly to check blood pressure, blood lipids, blood sugar, cholesterol, fundus, electrocardiogram and cardiac function, and if you find abnormalities, you should be active**.

Guidance: Transient ischemic attack is a transient or transient, focal brain or retinal dysfunction caused by intracranial vascular lesions, characterized by transient aphasia, paralysis or sensory impairment caused by reverse, each episode lasts a few minutes, and usually recovers completely within 60 minutes.