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短暂脑缺血发作的临床表现与成因短暂脑缺血发作(TIA)一般不超过24小时,发作数分钟以内与数小时以上者在发病机理方面可能不同。在欧美,颈内动脉系统的典型TIA 病例,多由颈内动脉病变的微栓塞引起,发作持续的时间多在10分钟以内。笔者对北里大学医院除患心脏病外,由颈内动脉系统原因所致的27例TIA 症状持续时间与血管造影改变相比较,说明持续10分钟以内的病例多为颈内动脉粥样硬化性病变,随持续时间的延长,则发生率减低。发作2次以上的病例,颈内动脉病变明显增多。以往的报告提示,日本颅外动脉病变的发生率比美国低,其原因与其说与种族差异有关,不如说与生活环境,特别是饮食生活相关。久山町1961～1981年20年间的剖检结果提示,过去日本人具有特征性的颅内小动脉纤维蛋白样血管坏死,目前已明显减少。不久的将来,TIA 很有成为欧美型的可能。有报告说对大脑中动脉主干部高度狭窄的病例,进行浅层颅动脉—大脑中动脉吻合术中,组织学上确认血小板栓子流入
The clinical manifestations and causes of transient ischemic attacks are generally no more than 24 hours for transient ischemic attacks (TIA) and may differ in pathogenesis within minutes and hours of onset. In Europe and the United States, the typical TIA cases of the internal carotid artery system are mostly caused by micro-embolism of the internal carotid artery. The episode lasts for more than 10 minutes. In addition to Bei Li University Hospital in addition to heart disease, the 27 cases of TIA symptoms caused by the reasons of the internal carotid artery system duration compared with angiographic changes, indicating that more than 10 minutes of cases are mostly internal carotid atherosclerotic lesions , With the duration of the extension, the incidence decreased. Cases of more than 2 episodes of internal carotid artery disease increased significantly. Previous reports suggest that the incidence of extracranial arterial disease in Japan is lower than that in the United States, the reason for which is not so much racial differences, rather than living conditions, especially dietary life. The results of autopsy from 1961 to 1981 in 1941-1981 in Furuyama-machi suggested that in the past, Japanese people had a characteristic intracranial arteriolar fibrin-like vascular necrosis that has been significantly reduced to date. In the near future, TIA is likely to become a European-American type. It has been reported that in the case of a highly stenosed middle cerebral artery trunk, a shallow cranial artery-middle cerebral artery anastomosis was performed to histologically confirm the inflow of platelet emboli