Il y a l� les conf�rences de consensus de ladite soci�t� et d'autres si
pertinentes:
Question: Lorsque vous voyez un patient qui a subi un ICT,
l'hospitalisez-vous ou l'investiguez-vous en externe?
Je
n'ai pas trouve de bonnes references repondant a cette question.
Peut-etre aurez-vous de meilleures reponses que celles-ci... Martin. ---------------------------------------Practice variability in management of transient ischemic
attacks.Johnston SC - Eur Neurol - 1999; 42(2): 105-8
From
NIH/NLM MEDLINE, HealthSTAR
NLM Citation ID:
99406639
Full Source Title:
European Neurology
Publication Type:
Journal Article
Language:
English
Author Affiliation:
Neurovascular Service, Department of
Neurology, University of California, San Francisco, Calif 94143-0114, USA.
Authors:
Johnston SC; Smith WS
Abstract:
To define practice patterns in the
management of transient ischemic attacks (TIAs), we surveyed practicing neurologists
attending an educational conference in San Francisco, evaluating management
decisions in 2 TIA case vignettes. In a
vignette describing a hemispheric TIA 1
day prior with ipsilateral bruit, 53% chose admission, 47% elected an
outpatient work-up, 28% treated with
intravenous heparin and 70% chose aspirin, reflecting the disagreement about
medical management of carotid stenosis in the literature. There was more
agreement in the second case, a posterior circulation TIA 1 day prior with atrial fibrillation, in which
84% chose hospital admission, 74% chose intravenous heparin and 90% treated
with some form of anticoagulation. There are areas of important practice
variability in the management of TIAs.
Further research is justified to guide patient care decisions in TIA patients.
-------------------------------------------
Guidelines for the Management of Transient Ischemic Attacks
1994;71-0051
From the Ad Hoc Committee on Guidelines for the Management of
Transient Ischemic Attacks of the Stroke Council of the American Heart
Association
....
Is hospitalization justified to expedite diagnostic evaluation and
treatment of TIA? There are no prospective data on this question. The
specific type and pattern of the TIA, the efficiency with which a patient
can be evaluated, and the patient's ability to return quickly if further
symptoms occur are all factors in this decision. The diagnostic evaluation
of patients seen within 1 week of a TIA should be completed within 1 week or
less. Hospitalization is often justified to expedite evaluation and lessen
the possibility of stroke. Some patients may be at increased risk of stroke
and warrant closer observation, while the physician may elect to treat
others with intravenous medication. The decision whether to hospitalize a
patient depends on that patient's individual circumstances.
....
