脳梗塞の急性期治療 : Stroke Care Unit を中心として

Stroke remains the second or third leading cause of the death and major cause of adultdisability in Japan. Cerebral infarction is major cause of stroke, therefore, it is very importantthat precious diagnosis and acute treatment of cerebral infarction should be done.Recently diffusion-weighted (DWI) and perfusion-weighted MRI (PWI) were clinically used andsensitivity of these stools is superior to T2-MRI in diagnosis of acute cerebral infarction.We performed acute intra-arterial thrombolysis and evaluated this efficacy by DWI andPWI. For the patients with embolic cerebral infarction, anticoagulant therapy should beperformed and tarns-esophageal heart echography in acute stage of infarction is useful fordetection of embolic source. Stroke Care Unit (SCU) was opened in our hospital since lastNovember and 8 patients per month were admitted to SCU. Over 75% of patients weretreated conservatively, and 6 patients were performed intra-arterial thrombolysis. Over80% of patients with cerebral infarction in SCU showed good clinical recovery. We needmore patients to show the superiority compared to the general medical wards.