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Stroke och TIA

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Sakkunnig:
Definition:
Stroke är ett samlingsnamn för akuta neurologiska symtom (plötsligt insättande fokalt eller globalt bortfall av kroppsfunktioner), som orsakas av rubbningar i hjärnans blodcirkulation. Stroke delas in i intracerebrala blödningar (inklusive subaraknoidalblödning) och ischemisk stroke. TIA är ett övergående bortfall av kroppsfunktioner inom 24 timmar.
Förekomst:
25 000–30 000/år personer i stroke och 10 000/år i TIA.
Symtom:
Akut (sekunder–minuter) uppkomst av fokala neurologiska symtom (ibland efter uppvaknande) är den viktigaste uppgiften i anamnesen. Vanliga symtom är svaghet i arm/ben och egenrapporterad språkstörning.
Fynd:
Unilateral pares i arm/ben, språkstörning (dysfasi, dysartri) och ataxi är vanligast som fynd.
Diagnostik:
Vid misstanke om stroke/TIA bör patienter remitteras direkt till akutsjukhus. Radiologisk undersökning är en viktig del av diagnostiken. Utredning av eventuell orsak till stroke/TIA görs på sjukhus.
Behandling:
Vid ischemisk stroke trombolys/trombektomi, vid intracerebral blödning blodtryckssänkning och eventuellt korrektion av blödningsbenägenhet. Sekundärprofylax. Strokerehabilitering.
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  • Remy Waardenburg, specialist i allmänmedicin, medicinsk redaktör Medibas