Geçici İskemik Atak
Özet
Geçici iskemik atak (GİA) tipik olarak 24 saat içinde düzelen ,akut enfarktüs kanıtı olmaksızın, fokal beyin, omurilik veya retina iskemisinin neden olduğu geçici bir nörolojik işlev bozukluğu epizodudur. Özellikle sonrasında gelişebilecek daha ciddi serebrovasküler hastalıkların habercisi olması açısından geçici iskemik atak tanısı, tedavi ve takibi ve yaşam tarzı değişikliği( sigara kullanımı, diabet, hipertansiyon, hiperlipidemi ve fiziksel aktivite gibi değiştirilebilir faktörlerin kontrolü) hastaların mortalite ve morbidite ve yaşam kalitelerini önemli oranda etkilemektedir. Klinik özellikleri ani başlayan tek taraflı güç kaybı , görme bozukluğu, vücutta uyuşma, karıncalanma, diplopi, afazi, dizartri gibi pek çok semptom içerir. Tanısı, klinisyen tarafından hastanın semptomlarının ivedilikle tanınması ve ayırıcı tanıların dışlanması ile risk skorlamasının yapılması ile mümkündür. Laboratuar ve görüntüleme yöntemleri ile geçici iskemik atak tanısını destekler özel bir belirteç henüz yoktur. Tedavinin zamanlaması da kritiktir; çalışmalar, antiplatelet ajanların semptom başlangıcından sonraki 24 saat içinde uygulanmasının, tekrarlayan iskemik olay riskini önemli ölçüde azaltabileceğini göstermektedir. . Aspirin ve klopidogrel veya tikagrelor ile ikili antiplatelet tedavi (Dual Antiplatelet Treatment:DAPT) kullanımının özellikle yüksek riskli hastalarda etkili olduğu ve inme gelişme oranını azalttığı gösterilmiştir.
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