THE NATURAL HISTORY OF TRANSIENT ISCHAEMIC CEREBRO-VASCULAR ATTACKS.
THE NATURAL HISTORY OF TRANSIENT ISCHAEMIC CEREBRO-VASCULAR ATTACKS.
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短暂性缺血性脑血管发作的自然史。
DOI：
10.1093/oxfordjournals.qjmed.a067022
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发表时间：
1964
期刊：
影响因子：
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通讯作者：
J. Marshall
中科院分区：
文献类型：
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作者：
J. Marshall
血管疾病患者出现短暂的神经系统症状和体征早已被认识到。Hunt（1914）在讨论“颈动脉在脑血管病变中的作用”时宣称，“先兆偏瘫和脑间歇性跛行的发作是一些血管症状，应提示颈动脉梗阻的可能性”。然而，他的主要兴趣是引起人们注意颈动脉疾病可能导致大脑病变的事实。同样，Fisher（1951, 1954）虽然主要关注于证明颈动脉疾病引起的血管事件比迄今所怀疑的要多，但强调“以短暂麻痹、感觉异常和吞咽困难的形式出现的前瞻警告”可能发生。Johnson和Walker（1951）回顾了文献中101例内颈动脉和颈总动脉血栓形成的病例，以及他们自己的6例病例，发现40%的患者出现了短暂的神经紊乱，而且“这一系列短暂的发作经常以突然的偏瘫和失语而结束”。Hurwitz, Groch， Wright和McDowell（1959）描述了57例颈动脉闭塞综合征的确诊病例，发现“短暂性缺血发作可持续一年或更长时间而无残留缺损”。虽然所有这些作者都清楚地认识到颈动脉闭塞综合征中短暂性缺血发作的发生，但他们的主要兴趣是颈动脉闭塞本身的影响。仔细阅读有关椎基底系统疾病的早期文献，会发现对完全病变的解剖和病理方面也有同样的主要关注。Kubik和Adams（1946）以及Biemond（1951）的经典论文都有这个方向，Denny-Brown和Foley（1952）关于基底动脉瘤综合征的论文也是如此。最近，Williams和Wilson（1962）对与基底动脉功能不全相关的综合征进行了详细的描述。然而，在1951年，出现了一个新的方向，Denny-Brown（1951）讨论了复发性脑血管发作的管理，引入了一个更动态的因素，并提出它是“脑出血的发作性不全”
THE occurrence of short-lived, neurological symptoms and signs in patients with vascular disease has long been recognized. Hunt (1914) in discussing'the role of the carotid arteries in the causation of vascular lesions of the brain'declared that'attacks of threatened hemiplegia and cerebral intermittent claudication are some of the vascular symptoms which should suggest the possibility of carotid obstruction'. Nevertheless, his main interest was to call attention to the fact that disease in the carotid artery could be responsible for lesions in the brain. Similarly Fisher (1951, 1954), though primarily concerned with demonstrating that disease of the carotid artery caused more vascular incidents than had hitherto been suspected, stressed that'prodromal warning in the form of fleeting paralysis, paraesthesiae and dysphasia'can occur. Johnson and Walker (1951) reviewing 101 cases of thrombosis of the internal and common carotid arteries from the literature together with six of their own cases, found that transient neurological disturbances had occurred in 40 per cent, of the patients and that'not infrequently such a series of transient attacks was terminated by a sudden hemiplegia and aphasia'. Hurwitz, Groch, Wright, and McDowell (1959), describing the carotid occlusion syndrome in 57 confirmed cases, found that'transient ischaemic attacks may occur for a year or more without residual defect*. While all these authors clearly recognized t> he occurrence of transient ischaemio attacks in the carotid artery occlusion syndrome, their primary interest was in the effects of the carotid artery occlusion itself, A perusal of the earlier literature concerning disease in the vertebro-basilar system shows the same predominant concern with the anatomical and pathological aspects of the completed lesion. The classical papers of Kubik and Adams (1946) and Biemond (1951) both have this orientation, as does the paper by Denny-Brown and Foley (1952) on the syndrome of the basilar aneurysm. More recently Williams and Wilson (1962) have given a detailed account of the syndromes associated with basilar insufficiency. In 1951, however, a new orientation appeared, Denny-Brown (1951) discussing the management of recurrent cerebro-vascular episodes, introduced a more dynamic factor and suggested that it is' episodic insufficiency in the