Journal thai stroke society vol 14 no 1 by samart nidhinandana

www.thaistrokesociety.org

ISSN1905-372X

Journal of

Thai Stroke Society +6'.6'.%6 %C' /)1 A);1 .%1 E & Volume 14 Number 1 January - April, 2015

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ĊĕĆčĕĆčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúą Journal of Thai Stroke Society ISSN 1905-372X ĊĕĆčĕĆčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúąğþŎüĊĕĆčĕĆøĘāėĄāŋğÿąĠāĆŇ ãĐèčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúą ĊĔøùěþĆēčèåŋ úĘħĐąĜŇ

ýĆĆöĕûėâĕĆ âĐèýĆĆöĕûėâĕĆ

âĬĕĎü÷ĐĐâ āėĄāŋúĘħ

ğāĚħĐğþŎüčĚħĐâĈĕèĆēĎĊŇĕèčĄĕëėâ ğÿąĠāĆŇãŇĕĊčĕĆâėéâĆĆĄãĐèčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèģúą ĠĈēğāėħĄāĜüåĊĕĄĆĜňúĕèĊėëĕâĕĆĠâŇčĄĕëėâ ĠĈēĠāúąŋāąĕýĕĈúĔħĊģþ čĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúą ëĔĨü ĐĕåĕĆğêĈėĄāĆēýĕĆĄĘ þĿ ìĐąċĜüąŋĊėéĔą ùüüğāëĆýěĆĘ ğãøĎňĊąãĊĕè éĔèĎĊĔ÷âĆěèğúāĄĎĕüåĆ Email: thaistroke@gmail.com Ćċ āî āĆăĔúĆ ûĆĆĄčġĆë čĔèâĔ÷åöēĠāúąċĕčøĆŋ ĄĎĕĊėúąĕĈĔąûĆĆĄċĕčøĆŋ üā ğéČðĕ Đě÷ĄĄèåĈ čĔèâĔ÷ĊėúąĕĈĔąĠāúąċĕčøĆŋāĆēĄèâěñğâĈňĕ üā ğéČðĕ ğãĘąü÷ĊèéĔüúĆŋ čĔèâĔ÷åöēĠāúąċĕčøĆŋĆĕĄĕûėý÷Ę ĄĎĕĊėúąĕĈĔąĄĎė÷Ĉ āî čěĆĘĆĔøüŋ čěĊĔëĆĔèâĜĆ čĔèâĔ÷åöēĠāúąċĕčøĆŋĆĕĄĕûėý÷Ę ĄĎĕĊėúąĕĈĔąĄĎė÷Ĉ āî üăĕċĆĘ ëĔąčėüĐüĔüøŋâěĈ čĔèâĔ÷ġĆèāąĕýĕĈāîĕģú Ćċ ÷Ć üā ğāėħĄāĔüûěŋ ûĆĆĄčġĆë čĔèâĔ÷åöēĊėúąĕċĕčøĆŋ ĄĎĕĊėúąĕĈĔąĄĎė÷Ĉ þĿĈē êýĔý ĄâĆĕåĄ ğĄČĕąü āćČăĕåĄ čėèĎĕåĄ âĔüąĕąü ûĔüĊĕåĄ ýĆėČĔú éĆĔĈčüėúĊèċŋâĕĆāėĄāŋ éĬĕâĔ÷ ĠãĊèýĕèĠåğĎüĚĐ ğãøýĕèĠå âĆěèğúāĒ ġúĆ ĠĂâìŋ E-mail: info@fast-books.com www.fast-books.com

čĕĆýĔî Ďüňĕ čĕĆéĕâüĕąâčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúą

ýúýĆĆöĕûėâĕĆ

ýúåĊĕĄĊėëĕâĕĆ âĕĆāĔõüĕğåĆĚĐãŇĕąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèăĕåĐĘčĕü Ćċ üā čĄċĔâ÷ėī ğúĘąĄğâŇĕ

âĕĆāĔõüĕğåĆĚĐãŇĕąâĕĆčŇèøŇĐÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĄĎĕĊėúąĕĈĔąûĆĆĄċĕčøĆŋ (Thammasat Stroke Network) Ćċ āî āĆăĔúĆ ûĆĆĄġĆë Ćċ üā čĄýĔøė ĄěŇèúĊĘāèČĕ

âĕĆāĔõüĕĆēýýâĕĆ÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĠýýåĆýĊèéĆ 5VTQMG 0GVYQTM ġĆèāąĕýĕĈĄĎĕĆĕëüåĆğëĘąèĢĎĄŇ åöēĠāúąċĕčøĆŋ ĄĎĕĊėúąĕĈĔąğëĘąèĢĎĄŇ āî âüâĊĆĆö ĊĔëĆēċĔâ÷ėīċėĈþņ

ċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆ %QORTGJGPUKXG 5VTQMG %GPVGT āî ĐĆĐěĄĕ ëěøėğüøĆ

*[RGTJQOQE[UVGKPG KP UVTQMG RCVKGPVU 6CUCPGG 6CPVKTKVVKUCM / &

ġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨüâĔýġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè āî ăĔúĆėü ăėĆĄąŋāĕüėë

Biomarkers of ischemic stroke: current status 2GTORJCP &JCTOCUCTQLC / & 2J &

ĆĕąèĕüÿĜňþłĊąúĘħüŇĕčüĢé +PVGTGUVKPI ECUG # YQOCP YKVJ CDFQOKPCN OCUU RTGUGPVGF YKVJ UWFFGP TKIJV JGOKRCTGUKU üā öĔòāĈ ĐěďĕĆċėĈþņ Ćċ āî āĆăĔúĆ ûĆĆĄġĆë

ğĈŇĕğĆĚħĐè 5VTQMG 0GYU

þĆēëĕčĔĄāĔüûŋ

åĬĕĠüēüĬĕčĬĕĎĆĔýÿĜňğãĘąüýúåĊĕĄ

čĕĆéĕâüĕąâčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúą úŇĕüčĄĕëėâúěâúŇĕüåĆĔý ëŇĊè þĿúĘħÿŇĕüĄĕ åĊĕĄâňĕĊĎüňĕãĐèĊėúąĕâĕĆġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĄĘğāėħĄĄĕâãęĨü čĄĕåĄĒĄĘøĔĊĠúüĢü čĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĔĨèĆē÷ĔýğĐğìĘąĠþìėĂľâ ĠĈē Ćē÷Ĕýüĕüĕëĕøė úĬĕĢĎňĄĘčŇĊüĆŇĊĄâĔýèĕüĊėëĕâĕĆĆē÷Ĕý üĕüĕëĕøė åĊĕĄĆĜňğĎĈŇĕüĘĨčĕĄĕĆùùŇĕąúĐ÷ĢüĆĜþãĐèĊĕĆčĕĆøŇĕèĥ ğāĚħĐĢĎňåĊĕĄĆĜňčĕĄĕĆùåňüĎĕģ÷ňèŇĕąĠĈēúĔüčĄĔą øĈĐ÷ğĊĈĕ ĊĕĆčĕĆčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèğĈŇĄüĘĨğþŎüĐĘâğĈŇĄĎüęħèúĘħĄĘýúåĊĕĄúĘħüŇĕčüĢé ĆĊĄúĔĨèÿĜňþłĊąúĘħğþŎü âĆöĘċęâČĕ úĔĨèüĘĨčĄĕåĄĒĄĘüġąýĕąúĘħëĔ÷ğéüĢüâĕĆğÿąĠāĆŇĊĕĆčĕĆĢĎňĠâŇčĄĕëėâĠĈēčùĕýĔüâĕĆċęâČĕúěâĠĎŇè ĢĎňúĔüčĄĔąĠĈēğþŎüýúåĊĕĄãĐèĠāúąŋģúą čĄĕëėâčĕĄĕĆùĐŇĕüéĕâĊĕĆčĕĆĎĆĚĐĐŇĕüéĕâğĊþģì÷ŋãĐèčĄĕåĄģ÷ň ğëŇüâĔüúĘħ YYY VJCKUVTQMGUQEKGV[ QTI ÿĄĎĊĔèğþŎüĐąŇĕèąėħèĊŇĕčĄĕëėâéēëĚħüëĐýýúåĊĕĄĢüĊĕĆčĕĆğĈŇĄüĘĨ ĠĈēğëėîëĊüĢĎňčĄĕëėâúĘħĄĘýúåĊĕĄ ĐąĕâéēĈèĢüĊĕĆčĕĆüĘĨâĦøė÷øŇĐčŇèĄĕĢĎňýĆĆöĕûėâĕĆģ÷ňåĆĔý čě÷úňĕąøňĐèãĐãĐýåěöâĐèýĆĆöĕûėâĕĆúĘħëŇĊąâĔüúĬĕĢĎňĊĕĆčĕĆãĐèčĄĕåĄĒčĬĕğĆĦéğþŎüĆĜþğĈŇĄĠĈēčĕĄĕĆù ĐĐâģ÷ňúĔüğĊĈĕåĆĔý

čĕĄĕĆù üėûėüĔüúüŋ üĕąâčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúą

J Thai Stroke Soc: Volume 14, 2015

ýúýĆĆöĕûėâĕĆ čĊĔč÷ĘþĿĢĎĄŇåŇē āýâĔüĐĘâåĆĔĨèüēåē ĢüêýĔýüĘĨâĐèýĆĆöĕûėâĕĆģ÷ňĆĊýĆĊĄýúåĊĕĄĊėëĕâĕĆúĘħüŇĕčüĢéĐĘâ ğëŇüğåą ġ÷ąğêāĕēýúåĊĕĄğâĘħąĊâĔýâĕĆāĔõüĕğåĆĚĐãŇĕąĢüâĕĆčŇèøŇĐÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĠāúąŋÿĜňğëĘħąĊëĕî (KUJGT1 ģ÷ňğčüĐ ¾*WD CPF 5RQMG OQFGN¿ Ģü VGNGOGFKEKPG úĘħ÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐè ġ÷ą ¾JWD¿ ĎĄĕąùęè ċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘģħ ÷ňĆýĔ âĕĆĆĔýĆĐè÷ňĊąčùĕýĔüúĘğħ þŎüĎĈĔâĢüâĕĆþĆēğĄėüĄĕøĆòĕü âĕĆĆĔâČĕ EGTVKÌGF RTKOCT[ UVTQMG EGPVGT ĎĆĚĐ ġĆèāąĕýĕĈĠĄŇãĕŇ ą úĘĢħ ëňğĆĘąâåěüň ĎĜĢüþĆēğúċģúą čŇĊüġĆèāąĕýĕĈ úĘħğþŎü ¾URQMG¿ ĎĄĕąùęèġĆèāąĕýĕĈĈĜâãŇĕąúĘħéēþĆęâČĕ čŇèøŇĐÿĜňþłĊą ĆĜþĠýýĢüâĕĆ÷ĜĠĈĠĈēĢĎňâĕĆĆĔâČĕÿĜňþłĊąġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħĄĘĢëňĢüþŌééěýĔüĄĘĎĈĕąĠýý÷ĔèüĘ2Ĩ 1. ‘ship-and-drip’ model ğþŎüĆĜþĠýýúĘħğüňüâĕĆčŇèøŇĐÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģþĢüġĆèāąĕýĕĈĠĄŇãŇĕą ĢĎňğĆĦĊúĘħčě÷ğāĚħĐéēģ÷ňĆĔýąĕĈēĈĕąĈėħĄğĈĚĐ÷úĘħġĆèāąĕýĕĈĠĄŇãŇĕą ìęħèğþŎüĆĜþĠýýúĘħĢëňýŇĐąúĘħčě÷ĢüþĆēğúċģúą 2. ‘drip-and-ship’ model ğþŎüĆĜþĠýýúĘħĄĘâĕĆþĆēğĄėüÿĜňþłĊąĠĈēøĆĊéăĕāúĕèĆĔèčĘĊėúąĕãĐèčĄĐèúĘħ ġĆèāąĕýĕĈĈĜâãŇĕąĠĈēþĆęâČĕþĆēčĕúĠāúąŋÿĜňğëĘħąĊëĕî÷ňĕüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħĐąĜŇġĆèāąĕýĕĈĠĄŇãŇĕąĢü âĕĆøĔ÷čėüĢéĢĎňâĕĆĆĔâČĕÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔüĆēąēğêĘąýāĈĔü÷ňĊąąĕĈēĈĕąĈėħĄğĈĚĐ÷ ĎĈĔèéĕâĢĎň ąĕĈēĈĕąĈėħĄğĈĚĐ÷ĠĈňĊéęèčŇèÿĜňþłĊąĄĕĆĔýâĕĆĆĔâČĕúĘħġĆèāąĕýĕĈĠĄŇãŇĕąøŇĐģþ ĆĜþĠýýâĕĆ÷ĜĠĈĢüĈĔâČöēüĘĨéēčĕĄĕĆù Ĉ÷ĆēąēğĊĈĕúĘħéēøňĐèğčĘąģþâĔýâĕĆğ÷ėüúĕèğāĚħĐčŇèÿĜňþłĊąĄĕĆĔýâĕĆĆĔâČĕ úĬĕĢĎňÿĜňþłĊąģ÷ňĆĔýąĕĈēĈĕąĈėħĄğĈĚĐ÷ğĆĦĊãęĨü 3. ‘trip-and-treat’ model ğþŎüĆĜþĠýýúĘħĢëňģ÷ňĢüğãøĄĎĕüåĆ ìęħèĄĔâéēĄĘþĆēčĕúĠāúąŋÿĜňğëĘħąĊëĕî÷ňĕüġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèéĬĕüĊüĄĕâāĐĠĈēĄĘåĊĕĄāĆňĐĄčĬĕĎĆĔýâĕĆğ÷ėüúĕèģþąĔèġĆèāąĕýĕĈĈĜâãŇĕąúĘĄħ ÿĘ þňĜ Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèĆēąēğêĘąýāĈĔüģþĎĕ ġ÷ąéēĄĘâĕĆþĆęâČĕ þĆēğĄėü ĠĈēÿĜňþłĊąģ÷ňĆĔýâĕĆøĆĊéğāėħĄğøėĄĢüĆēĎĊŇĕèúĘħĆĐĠāúąŋ ÿĜňğëĘħąĊëĕîğ÷ėüúĕè ĢüĊĕĆčĕĆêýĔýüĘĨ ģ÷ňĆĊýĆĊĄøĔĊĐąŇĕèâĕĆāĔõüĕğåĆĚĐãŇĕąâĕĆ÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħþĆēčý åĊĕĄčĬĕğĆĦééĕâăĕåøŇĕèĥ úĔĨèăĕåğĎüĚĐ ăĕåĐĘčĕüĠĈēăĕåâĈĕèøĐüĈŇĕè ĄĕĢĎňúŇĕüÿĜňĐŇĕü ċęâČĕéĕâþĆēčýâĕĆöŋ éĕâĠāúąŋÿĜňğëĘħąĊëĕîúĘħĐąĜŇĢüúňĐèùėħüøŇĕèâĔü ìęħèĐĕééēĄĘýĆėýú ĊĔõüûĆĆĄ ĎĆĚĐúĆĔāąĕâĆøŇĕèâĔü ğāĚħĐĢĎňüĬĕģþþĆĔýĢëň ĢüğĊëþñėýĔøėãĐèúŇĕü ĎĆĚĐčŇèøŇĐÿĜňþłĊąãĐèğúŇĕüğãňĕĄĕĆĔýýĆėâĕĆĢüğåĆĚĐãŇĕąøŇĐģþ üĐâéĕâüĘĨąĔèĄĘýúåĊĕĄğâĘħąĊâĔý %QORTGJGPUKXG 5VTQMG %GPVGT *[RGTJQOQE[UVGKPG ìęħèğþŎüþŌééĔąğčĘħąè úĘħāýģ÷ňĢüÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèëĕĊģúą ùňĕčŇèøĆĊéğāėħĄğøėĄ ăĕĊē 1DUVTWEVKXG 5NGGR #RPGC ĢüÿĜňþłĊąġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐè ġ÷ąĠāúąŋÿĜňğëĘħąĊëĕîúĕè÷ňĕüĆēýýâĕĆĎĕąĢéĠĈēğĊëýĬĕýĔ÷Ċėâćø ĢüčŇĊüãĐè $CUKE 5EKGPEG éēğþŎüğĆĚħĐè $KQOCTMGTU KP KUEJGOKE UVTQMG ìęħèâĬĕĈĔèĐąĜŇĢüåĊĕĄčüĢéğëŇüâĔü ĢüčŇĊüãĐè ğĈŇĕğĆĚħĐè 5VTQMG 0GYU éēğĈŇĕĢĎňāĊâğĆĕĂŌèğâĘħąĊâĔýÿĈèĕüĊėéĔą ¾/4 %.'#0¿ ìĚħèğþŎüĎüęħèĢüÿĈèĕüĊėéĔąğ÷ŇüúĘħğāėħèüĬĕğčüĐĢüèĕüþĆēëěĄ 9QTNF 5VTQMG %QPHGTGPEG Ģüğ÷ĚĐüøěĈĕåĄúĘħÿŇĕüĄĕüęĨğĐè ğĐâčĕĆĐňĕèĐėè (KUJGT / &GXGNQRKPI CPF KORNGOGPVCVKPI HWVWTG UVTQMG VJGTCRKGU VJG RQVGPVKCN QH VGNGOGFKEKPG #PP 0GWTQN FG $WUVQU '/ 8WKNNKGT ( %JCXQV & /QWNKP 6 6GNGOGFKEKPG KP UVTQMG 1TICPK\KPI C PGVYQTM ¼ TCVKQPCN CPF DCUGNKPG RTKPEKRNGU %GTGDTQXCUE &KU &JCTOCUCTQLC 2# 6GNGOGFKEKPG CPF UVTQMG PGVYQTM +P &JCTOCUCTQLC 2# GF +UEJGOKE 5VTQMG $CPIMQM ,CTWPUCPKVYQPIMCPRKO

āĆăĔúĆ ûĆĆĄčġĆë ýĆĆöĕûėâĕĆ 2

J Thai Stroke Soc: Volume 14, 2015

ÐāòíĀáèāċÓòĆüÑŚāñčòÓúôüãċôĆüãùðüÖïāÓüĄùāè ò÷ èí ùð÷ĀÐãăė ċæĄñðċÐŚā 1. ùāÑāêòÿùāæöăæñā ïāÓöăÙāüāñćò÷āùäòŞ ÓâÿČíæñ÷āùäòŞ ðúāöăæñāôĀñÑüèČÐŚè 2. ÐôćŚðöă×ĀñčòÓúôüãċôĆüãùðüÖ ïāÓäÿöĀèüüÐ ċØĄñÖċúèĆü ðúāöăæñāôĀñÑüèČÐŚè 3. êòÿçāè 4FSWJDF QMBO čòÓúôüãċôĆüãùðüÖ ċÑäéòăÐāòùćÑïāí ÑüèČÐŚè ðúāùāòÓāð òśüñċüĒã ÐāûùăèçćŞ 4. òüÖêòÿçāèċÓòĆüÑŚāñéòăÐāòčòÓæĄēðĄüĀäòāÐāò ċùĄñÙĄöăäùĈÖ ċÑäéòăÐāòùćÑïāí ùĘāèĀÐÖāè úôĀÐêòÿÐĀèùćÑïāíČúŚÖÙāäă

Abstract

5IF QSFWBMFODF SBUF PG TUSPLF JT IJHI BU QBUJFOUT QFS QPQVMBUJPO JO BHF HSPVQ PG ZFBST 5IF TUBOEBSE USFBUNFOU GPS BDVUF JTDIFNJD TUSPLF JT SFDPNCJOBOU UJTTVF QMBTNJOPHFO BDUJWBUPS SU 1" XJUIJO IPVST PG TUSPLF POTFU *O UIF ȽSTU SFQPSU PG SU 1" USFBUNFOU JO 5IBJMBOE IBT CFFO QVCMJTIFE XJUI TVDDFTTGVM PVUDPNFT JO QBUJFOUT -BUFS PO UIF SU 1" IBT CFFO VTFE NPSF CVU POMZ JO VOJWFSTJUZ IPTQJUBMT BOE MBSHF QSJWBUF IPTQJUBMT NPTUMZ JO #BOHLPL *O UIF SBUF PG UIF SU 1" USFBUNFOU JO 5IBJMBOE XBT RVJUF MPX BU 5IF PUIFS NJMMJPO QFPQMF PVUTJEF #BOHLPL UIF NBKPSJUZ PG 5IBJMBOE QPQVMBUJPO IBWF WFSZ MPX DIBODF UP SFDFJWF SU 1" USFBUNFOU EVF UP MJNJUBUJPO PG $5 NBDIJOF BOE NFEJDBM QFSTPOBMT *O UIF OPSUIFBTUFSO 5IBJMBOE UIFSF XFSF NJMMJPO QFPQMF JO QSPWJODFT 0OMZ OFVSPMPHJTUT QSBDUJDFE JO CJH QSPWJODFT 5P GBDJMJUBUF SU 1" VTF GPS BDVUF TUSPLF QBUJFOUT JO 5IBJMBOE BDVUF TUSPLF DBSF TIPVME CF NBOBHFE CZ UIF JOUFSOJTUT JOTUFBE PG OFVSPMPHJTUT *O BEEJUJPO TFWFSBM GBDUPST NBZ CF BTTPDJBUFE XJUI TUSPLF PVUDPNFT TVDI BT QBUJFOU SFDPHOJUJPO TUSPLF DBSF UFBN PS BWBJMBCJMJUZ PG $5 NBDIJOF 4USPLF OFUXPSL UIFSFGPSF JT FTUBCMJTIFE UP JNQSPWF BDVUF TUSPLF DBSF 5IF TUSPLF OFUXPSL QSPKFDU JT DPNQSJTFE PG NBJO TFSWFS BOE DMJFOU IPTQJUBMT 5IF NBJO TFSWFS IPTQJUBMT BSF UFSUJBSZ DBSF IPTQJUBMT JO FBDI NFEJDBM TFSWJDF BSFB BOE CF BCMF UP QSPWJEF SU 1" USFBUNFOU GPS BMM DMJFOU IPTQJUBMT JO UIF TFSWJDF BSFBT 3PMFT PG UIF NBJO TFSWFS IPTQJUBMT BSF QSPWJEJOH SU 1" USFBUNFOU GPS BDVUF JTDIFNJD TUSPLF QBUJFOUT TFUUJOH VQ DPNQSFIFOTJWF TUSPLF VOJU BOE B DMJOJDBM HVJEFMJOF GPS TUSPLF GBTU USBDL BOE BDVUF JTDIFNJD TUSPLF DBSF GPS UIFJS TFSWJDF BSFBT CFJOH DPOTVMUBOU GPS UIFJS DMJFOU IPTQJUBMT SFHBSEJOH PG BDVUF TUSPLF DBSF NPOJUPSJOH UIF DMJFOU IPTQJUBMT BOE JNQSPWJOH UIF DMJFOU IPTQJUBMTĮ TFSWJDFT BOE QSPWJEJOH JOUFS IPTQJUBM DPOGFSFODFT SFHBSEJOH BDVUF TUSPLF DBSF BNPOH NBJO TFSWJDF IPTQJUBMT BOE DMJFOU IPTQJUBMT ZFBSMZ (J Thai Stroke Soc 2015; 14: 3-13.)

J Thai Stroke Soc: Volume 14, 2015

éæèĘā

ğüĚĐħ è÷ňĊąġĆåĎĈĐ÷ğĈĚĐ÷ğþŎüġĆåúĘāħ ýýŇĐąĠĈē âŇĐĢĎňğâė÷åĊĕĄāėâĕĆĠĈēğčĘąëĘĊėøģ÷ňčĜè âĕĆĆĔâČĕúĘħ÷Ę úĘħčě÷åĚĐâĕĆþŃĐèâĔüģĄŇĢĎňğâė÷ġĆå÷ĔèâĈŇĕĊ ĠøŇùňĕğâė÷ġĆå ãęĨüĠĈňĊ øňĐèĆĘýğãňĕčĜŇĆēýýýĆėâĕĆ 5VTQMG (CUV 6TCEM ĢĎňğĆĦĊúĘħčě÷ ÷Ĕè 5NQICP ÁúěâüĕúĘåĚĐëĘĊėø ğĆĦĊâĦĆĐ÷ þĈĐ÷ĐĔĄāĕøÂ âĕĆĆĔ â ČĕÿĜ ň þ ł Ċ ąġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèëüė ÷ ãĕ÷ğĈĚĐ÷ĄĕğĈĘĨąèúĘħ÷ĘúĘħčě÷åĚĐâĕĆĢĎňąĕ TV 2# êĘ÷ğãňĕ úĕèĎĈĐ÷ğĈĚĐ÷÷ĬĕăĕąĢüĆēąēğĊĈĕ üĕúĘüĔýøĔĨèĠøŇ ÿĜňþłĊąĄĘĐĕâĕĆéüâĆēúĔħèģ÷ňĆĔýâĕĆĢĎňąĕ TV 2# QPUGV VQ PGGFNG VKOG âĕĆĆĔâČĕ÷ňĊąĊėûĘ÷ĔèâĈŇĕĊĢüĆēąēğĆėħĄĠĆâ âŇĐü ā ċ ĄĘÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèëüė÷ ãĕ÷ğĈĚĐ÷ĄĕğĈĘąĨ èúĘģħ ÷ňĆýĔ âĕĆĆĔâČĕüňĐąĄĕâ åĚĐ üňĐąâĊŇĕ ĆňĐąĈē ğāĆĕēĄĘğāĘąèġĆèāąĕýĕĈĄĎĕĊėúąĕĈĔąĠĈē ġĆèāąĕýĕĈğĐâëüãüĕ÷ĢĎîŇĢüčŇĊüâĈĕèğúŇĕüĔĨüúĘħ čĕĄĕĆùĢĎňâĕĆĆĔâČĕģ÷ň øŇĐĄĕĢü ā ċ čĬĕüĔâèĕü ĎĈĔâþĆēâĔüčěãăĕāĠĎŇèëĕøė čþčë ģ÷ňğãňĕĄĕčüĔýčüěü ĆēýýâĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ġ÷ąĆēąēĠĆâģ÷ň ğĆėħĄĄĘâĕĆāĔõüĕĆēýý 5VTQMG (CUV 6TCEM ğêāĕēĢü ġĆèğĆĘąüĠāúąŋĠĈēġĆèāąĕýĕĈċĜüąŋčĊŇ üăĜĄăė ĕåğúŇĕüĔüĨ Ģü ā ċ ğãøýĆėâĕĆčěãăĕāčþčë ğãø ĆňĐąğĐĦ÷ ãĐüĠâŇü ĄĎĕčĕĆåĕĄ âĕďčėüûěŋ ģ÷ňĄĘâĕĆāĔõüĕĆēýý âĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ĠĈēčĕĄĕĆùĢĎňąĕ÷Ĕè âĈŇĕĊģ÷ňğêāĕēġĆèāąĕýĕĈċĆĘüåĆėüúĆŋ åöēĠāúąċĕčøĆŋ ĄĎĕĊėúąĕĈĔąãĐüĠâŇüğúŇĕüĔĨü ÷ňĊąãňĐéĬĕâĔ÷÷ĔèâĈŇĕĊ ÿĜňþłĊąìęħèĄĘăĜĄėĈĬĕğüĕĐąĜŇĎŇĕèéĕâġĆèāąĕýĕĈãňĕèøňü þĆēâĐýâĔýâĕĆãĕ÷ĠåĈüĠāúąŋÿĜňğëĘħąĊëĕî÷ňĕüĆēýý þĆēčĕúĢüøŇĕèéĔèĎĊĔ÷ġ÷ąğêāĕēăĕåøēĊĔüĐĐâğêĘąè ğĎüĚĐ ìęħèĄĘĠāúąŋ÷ňĕüþĆēčĕúĊėúąĕğāĘąè úŇĕü÷ĜĠĈ þĆēëĕëüâĊŇĕ Ĉňĕüåü ÷ĔèüĔĨüâĕĆúĘħéēĢĎňÿĜňþłĊąģ÷ňĆĔý âĕĆĆĔâČĕ÷ňĊąĊėûĘ÷ĔèâĈŇĕĊéęèéĬĕğþŎüøňĐèčĆňĕèğåĆĚĐãŇĕą âĕĆĢĎň ý Ćė â ĕĆĢĎň Ą ĕâúĘħ čě ÷ ğāĚħ Đ ğāėħ Ą ġĐâĕčâĕĆğãň ĕ ùęèĎüŇĊąýĆėâĕĆúĘħĄĘċĔâąăĕāĢĎňĄĕâúĘħčě÷ éēģ÷ňĈ÷ĐĔøĆĕ øĕąåĊĕĄāėâĕĆĠĈēâĕĆğþŎüăĕĆēãĐèÿĜňþłĊąğþŎüģþøĕĄ ğþŃĕĎĄĕąãĐèâĕĆĆĔâČĕġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè âĕĆĢĎňýĆėâĕĆ÷ĔèâĈŇĕĊøňĐèúĬĕĢĎňġĆèāąĕýĕĈ ĐĚħüĥ ĢüúěâāĚĨüúĘħüĔĨüĄĘâĕĆýĆėâĕĆúĘħĄĘþĆēčėúûėăĕā åĚĐ

J Thai Stroke Soc: Volume 14, 2015

øňĐèāĆňĐĄĢüâĕĆýĆėâĕĆúĕè÷ŇĊüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè øňĐèčĆňĕèåĊĕĄøĆēĎüĔâĢĎňþĆēëĕëü ÿĜþň Ċł ąúĆĕýĊŇĕġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèåĚĐĐēģĆ ĄĘĐĕâĕĆĐąŇĕèģĆ ĠĈēúĬĕģĄ øň Đ èĆĘ ý ĄĕāýĠāúąŋ ğĄĚħ Đ ÿĜ ň þ ł Ċ ąĄĕġĆèāąĕýĕĈĠĈň Ċ âĕĆýĆėâĕĆøňĐèĆĊ÷ğĆĦĊ ĠĈēĄĘþĆēčėúûėăĕā āĆňĐĄýĆėâĕĆ øĈĐ÷ğĊĈĕ ÷ňĊąğĎøěÿĈãňĕèøňü éęèğþŎüúĘĄħ ĕãĐèâĕĆāĔõüĕ ğåĆĚĐãŇĕąâĕĆĢĎňýĆėâĕĆġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèăĕå ĐĘčĕü + 5CP 5VTQMG 0GVYQTM

ċÓòĆüÑŚāñÓĆüüÿďò

åĬĕĊŇĕ ÁğåĆĚĐãŇĕąÂ ĢüúĘüħ ĎĘĨ Ąĕąùęè âĕĆčĆňĕèúĘĄ ýĆėâĕĆġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĢüúěâ÷ňĕüâĕĆýĆėâĕĆčěãăĕā ĢĎňĄĘåĊĕĄāĆňĐĄĢüâĕĆĢĎňýĆėâĕĆ ĐąŇĕèĄĘþĆēčėúûėăĕā ĠĈēĄĘ Ą ĕøĆòĕüğ÷Ę ą ĊâĔ ü ğāĚħ Đ ĢĎň ÿĜ ň þ ł Ċ ąĢüúě â ĥāĚĨ ü úĘħ ģ÷ňĆĔýâĕĆýĆėâĕĆúĘħğþŎüĄĕøĆòĕüğ÷ĘąĊâĔü üĐâéĕâĄĘúĘĄ âĕĆýĆėâĕĆĠĈňĊ ąĔèĄĘÿúňĜ čĘħ üĔýčüěüğåĆĚĐãŇĕą ģ÷ňĠâŇ ĐèåŋâĆ ğĐâëü ĐèåŋâĆýĆėâĕĆčŇĊüúňĐèùėħü üĔâþĆēëĕčĔĄāĔüûŋ ġĆèğĆĘąü āĆē øĬĕĆĊé üĔââðĎĄĕą ĠĈēÿĜňğâĘħąĊãňĐèĐĚħüĥ ĢüĠøŇĈēġĐâĕč ìęħèúěâĀłĕąĄĘâĕĆúĬĕèĕüúĘħĄĘğþŃĕĎĄĕą ğ÷ĘąĊâĔü åĚĐ ĢĎňÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèčĕĄĕĆù ğãňĕùęèĆēýýýĆėâĕĆģ÷ňĆĊ÷ğĆĦĊúĘčħ ÷ě ìęèħ éēğāėĄħ ġĐâĕčĢĎňģ÷ň ÿĈâĕĆĆĔâČĕčĜèčě÷

ċÓòĆüÑŚāñêòÿÐüéãśöñüÿďòéśāÖ

ĐèåŋþĆēâĐýãĐèğåĆĚĐãŇĕąúĘčħ ĕĬ åĔî åĚĐ Ćēýý ýĆėâĕĆ úĘĄčěãăĕā þĆēëĕëüĠĈēÿĜňþłĊą ĆēýýýĆėâĕĆ ğüĚħĐèéĕââĕĆýĆėâĕĆĢüĐ÷Ęø ģĄŇĄĆĘ ēýýúĕè÷ŇĊü÷ĔèâĈŇĕĊ ĠĈēĢüâĕĆğĆĘąüãĐèüĔâċęâČĕ Ġāúąŋ ĠāúąŋþĆēéĬĕýňĕüâĦģĄŇĄĘâĕĆĀŀâĐýĆĄğâĘħąĊâĔý Ćēýý÷Ĕ è âĈŇ ĕ Ċ éę è øň Đ èĄĘ â ĕĆùŇ ĕ ąúĐ÷åĊĕĄĆĜ ň ø Ň Đ ĐĕąěĆĠāúąŋ ĠāúąŋĆēýýþĆēčĕú ĠāúąŋĀŀâĎĔ÷ĠĈēÿĜň ğâĘħąĊãňĐè þĆēğ÷ĦüúĘħøňĐèúĬĕåĊĕĄğãňĕĢé åĚĐ 5VTQMG (CUV 6TCEM åĚĐĐēģĆ ąĕĈēĈĕąĈėħĄğĈĚĐ÷ (rt-2# åĚĐĐēģĆ 3. 5VTQMG (CUV 6TCEM øŇĕèâĔý 5VTQMG 7PKV ĐąŇĕèģĆ ãĔüĨ øĐüâĕĆāĔõüĕĆēýýýĆėâĕĆ 5VTQMG (CUV Track 5VTQMG (CUV 6TCEM øŇĕèâĔý TV-2# ĐąŇĕèģĆ 5VTQMG (CUV 6TCEM úĬĕģĄøňĐèĄĘĆēýýüĘĨ

ĠĈēúĬĕģĄúěâčùĕüýĆėâĕĆøňĐèĄĘĆēýý 5VTQMG (CUV 6TCEM čėèħ úĘąħ ĕâúĘčħ ÷ě åĚĐ âĕĆčĆňĕèåĊĕĄĄĔüħ ĢéĢĎňâýĔ úĘĄ ýĆėâĕĆ 5VTQMG (CUV 6TCEM ġ÷ąĢëň 5NQICP ĢüâĕĆāĔõüĕ úĘĄýĆėâĕĆ ğëŇü Á5VTQMG (CUV 6TCEM ģĄŇąĕâĐąŇĕèúĘħ åė÷Â ĠĈē ÁģĄŇĄĘĐēģĆúĘħúĬĕģĄŇģ÷ňùňĕğĆĕøňĐèâĕĆúĬĕÂ ÷ĔèüĔĨüĢüëŇĊèĠĆâãĐèâĕĆğþľ÷ýĆėâĕĆ éęèøňĐèāĆňĐĄĢü âĕĆĢĎňåĕĬ þĆęâČĕğåĆĚĐãŇĕąøĈĐ÷ğĊĈĕğāĚĐħ čĆňĕèåĊĕĄĄĔüħ Ģé ýěååĈúĘħĄĘåĊĕĄčĬĕåĔîĐĘâúŇĕü åĚĐ ÿĜňĐĕĬ üĊąâĕĆ ġĆèāąĕýĕĈ ğāĆĕēĆēýý 5VTQMG (CUV 6TCEM üĔĨüøňĐè ģ÷ňĆĔýâĕĆčüĔýčüěüĐąŇĕèğøĦĄúĘħéĕâÿĜňýĆėĎĕĆ ğüĚħĐèéĕâĄĘ ÿĜğň âĘąħ ĊãňĐèåŇĐüãňĕèĄĕâĠĈēøňĐèğþŎüüġąýĕąãĐèĎüŇĊąèĕü úĘĄčěãăĕā ğþŎüĐèåŋþĆēâĐýčĬĕåĔîúĘħčě÷ ùęèĠĄňĆēýýéē÷ĘĠøŇùňĕúĘĄģĄŇāĆňĐĄâĦéēčŇèÿĈøŇĐĆēýý ýĆė â ĕĆ úĘ Ą čě ã ăĕāþĆēâĐý÷ň Ċ ąýě å åĈúě â åüĢü ġĆèāąĕýĕĈ øĔĨèĠøŇ ÿĜňýĆėĎĕĆġĆèāąĕýĕĈ ĠāúąŋÿĜňĆĔý ÿė÷ëĐý āąĕýĕĈĠĈēúĘĄĢüĎňĐèêěâğêėü âĕĆåĔ÷âĆĐè ĎĐÿĜ ň þ ł Ċ ąġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèĠĈēĎĐÿĜ ň þ ł Ċ ąĐĚħ ü ĥúĘħ ğâĘħ ą Ċãň Đ è ĆĊĄģþùę è ğéň ĕ Ďüň ĕ úĘħ ğ Đâìŋ ğ Ćąŋ ğéň ĕ Ďüň ĕ úĘħ ĎňĐè .CD ğéňĕĎüňĕúĘħüĬĕčŇèğĈĚĐ÷ ğĊĆğþĈ ğéňĕĎüňĕúĘħ þĆēëĕčĔĄāĔüûŋ ĠĈēĐĚüħ ĥ ĐĘâéĬĕüĊüĄĕâ úěâåüøňĐèĄĘğþŃĕ ĎĄĕąğ÷ĘąĊâĔü åĚĐ âĕĆúĬĕèĕüĢĎňğĆĦĊúĘčħ ÷ě ĄĘþĆēčėúûėăĕā čĜèčě÷ ğāĚĐħ ĢĎňÿĈâĕĆøĆĊéĆĔâČĕþĆēčýåĊĕĄčĬĕğĆĦéĐąŇĕè ĆĊ÷ğĆĦĊ ÷ĔèüĔĨüĠāúąŋĢüòĕüēÿĜňüĬĕúĘĄøňĐèéĔ÷âĕĆĐèåŋ åĊĕĄĆĜňúĘħğĎĄĕēčĄâĔýúĘĄèĕüúěâåü úěâĎüňĕúĘħ úěâĆē÷Ĕý ĢĎňåĆýùňĊü ĠĈēøňĐèĄĘâĕĆúýúĊüþĆēğĄėüÿĈğþŎüĆēąēĥ ğāĚħ Đ ĢĎň ğ âė ÷ âĕĆøĚħ ü øĔ Ċ ĠĈēâĕĆāĔ õ üĕĐąĜ Ň ø ĈĐ÷ğĊĈĕ úĘħ čĬĕ åĔ î ĢüòĕüēĎĔĊĎüňĕúĘĄ øňĐèĠč÷èĢĎňúěâåü ĢüúĘĄğĎĦüĊŇĕĄĘăĕĊēÿĜüň ĕĬ âĕĆúěĄŇ ğúĠĈēúĬĕéĆėèĐąŇĕè øŇĐğüĚħĐè ġ÷ąģĄŇĄĘÿĈþĆēġąëüŋúĔýìňĐü ğĄĚħĐğâė÷ þŌîĎĕøňĐèāĆňĐĄĢüâĕĆĆŇĊĄĠâňþŌîĎĕĐąŇĕèĆĊ÷ğĆĦĊ ĎĈĔââĕĆúĬĕèĕüãĐèúĘĄġĆèāąĕýĕĈċĆĘüåĆėüúĆŋ åĚĐ ÁâĔ÷ģĄŇþĈŇĐą åŇĐąĥ ğĆėħĄ ğāėħĄğåĆĚĐãŇĕą éĬĕĎüŇĕą ĐąŇĕèĆĊ÷ğĆĦĊÂ âĔ÷ģĄŇþĈŇĐą ĎĄĕąåĊĕĄĊŇĕ ùňĕğâė÷þŌîĎĕĢ÷ ĢüâĕĆúĬĕèĕüøňĐèāąĕąĕĄĠâňģãĢĎňģ÷ň ġ÷ąģĄŇąĐĄĢĎň þŌîĎĕüĔĨüĥ ğâė÷ãęĨüĐĘâ ùňĕĄĘĐěþčĆĆåĢ÷ĥ ğâė÷ãęĨüâĦøňĐè ģĄŇąĐĄĠāň øňĐèĎĕúĕèĐĐâĢĎňģ÷ň

åŇĐąĥ ğĆėĄħ ĎĄĕąåĊĕĄĊŇĕ âĕĆúĬĕèĕüéēåŇĐąĥ ğĆėħ Ą éüúĘ Ą ğâė ÷ åĊĕĄĄĔħ ü ĢéĠĈēčĕĄĕĆùúĬ ĕ ģ÷ň čĬ ĕ ğĆĦ é éęèåŇĐąĥ ãąĕąèĕüĢĎňĄĕâãęĨü ĆĊĄúĔĨèâĕĆğþľ÷ýĆėâĕĆĎĐ ÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĢüğýĚĨĐèøňüğþľ÷ýĆėâĕĆğāĘąè UVTQMG EQTPGT ğøĘąè ğĄĚħĐĄĘåĊĕĄāĆňĐĄĄĕâãęĨüâĦåŇĐąĥ āĔõüĕğþŎü UVTQMG WPKV ĢüăĕąĎĈĔè ğāėħĄğåĆĚĐãŇĕą ĎĄĕąåĊĕĄĊŇĕ âĕĆãąĕąğåĆĚĐ ãŇĕąâĕĆýĆėâĕĆĢĎňåĆĐýåĈěĄĢüúěâĥ ÷ňĕü úěâāĚĨüúĘħ ĠĈē ĢĎňğâė÷âĕĆúĬĕèĕüĢüúěâúĘĄğþŎüúĘĄčĎčĕãĕĊėëĕëĘāúĘħ čĄýĜ Ć öŋ åĆĐýåĈě Ą Ģüúě â ÷ň ĕ ü úě â āĚĨ ü úĘħ Ġ ĈēĄĘ å ĊĕĄ ğëĘħąĊëĕîĐąŇĕèĠúňéĆėè éĬĕĎüŇĕąĐąŇĕèĆĊ÷ğĆĦĊ ĎĄĕąåĊĕĄĊŇĕ ğĄĚĐħ úĕè ġĆèāąĕýĕĈøňĐèĆĔýÿĜňþłĊą CEWVG UVTQMG úěâĆĕąğãňĕĆĔý âĕĆĆĔâČĕĢüġĆèāąĕýĕĈ ĠĈēøňĐèĢĎňâĕĆĆĔâČĕúĘħåĆýĢü úěâãĔüĨ øĐü ĆĊĄúĔèĨ âĕĆĆĔâČĕĢüĆēąēąĕĊ âĕĆĂŁüŐ ĂĜ ÷ĔèüĔüĨ éęèøňĐèĄĘâĕĆčŇèâĈĔý ğāĚħĐĢĎňâĕĆĆĔâČĕøŇĐúĘħġĆèāąĕýĕĈ ĢâĈňýĕň üğĄĚĐħ āňüăĕĊēĐĔüøĆĕąĠĈňĊ âĦéēúĬĕĢĎňčĕĄĕĆùĆĔý ÿĜňþłĊąğãňĕģĊňĆĔâČĕģ÷ňúěâĆĕą ĠĈēâĕĆĆĔâČĕĢâĈňýňĕüâĦ úĬĕĢĎňĄĘþĆēčėúûėăĕāĠĈēåĊĕĄčē÷ĊâøŇĐÿĜňþłĊąĄĕâãęĨü þĆēĎąĔ÷åŇĕĢëňéŇĕąĠĈēğĊĈĕĢüâĕĆāýĠāúąŋ þĆēëĕëüĠĈēÿĜ ň þ ł Ċ ąğþŎ ü Đèåŋ þ ĆēâĐý úĘħčĬĕåĔî åĚĐ âĕĆúĘħúĘĄýĆėâĕĆĄĘåĊĕĄāĆňĐĄ ĆēýýāĆňĐĄ ĢĎňýĆėâĕĆ ĠøŇģĄŇĄĘÿĜňþłĊąĄĕĆĔýýĆėâĕĆ åĚĐ ĄĕëňĕģĄŇúĔü ĆēąēğĊĈĕ üĕúĘëĘĊėø âĦģĄŇĄĘþĆēġąëüŋĢ÷ĥ ÷ĔèüĔĨü øňĐèāąĕąĕĄúĬĕĢĎňþĆēëĕëüĄĘåĊĕĄĆĜğň âĘąħ ĊâĔýġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐè âĕĆĆĔâČĕ ĆēýýýĆėâĕĆ 5VTQMG (CUV 6TCEM âĕĆþŃĐèâĔüâĕĆğþŎüìĬĨĕ âĕĆĆĔâČĕĆēąēąĕĊ âĕĆĂŁŐüĂĜ čăĕā čėèħ čĬĕåĔîúĘčħ ÷ě åĚĐ øňĐèĢĎňþĆēëĕëüĄĘåĊĕĄøĆēĎüĔâ ĢüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĠĈēâĕĆĆĔâČĕ÷ňĊąĆēýý 5VTQMG (CUV 6TCEM

ċêŖāúðāñÐāòãĘāċèăèÐāò ģ÷ňĠâŇ

âĕĆâĬĕĎü÷ĄĕøĆòĕüâĕĆýĆėâĕĆĠøŇĈēĆē÷Ĕý čùĕüāąĕýĕĈ âĕĆğāėħĄâĕĆğãňĕùęèâĕĆýĆėâĕĆ 5VTQMG (CUV Track âĕĆĈ÷ĆēąēğĊĈĕĆĐåĐąĢüĠøŇĈēãĔĨüøĐü ğāĚħĐĢĎň QPUGV VQ PGGFNG ĠĈē FQQT VQ PGGFNG čĔĨü âĕĆĈ÷ĐĔøĆĕâĕĆøĕąĠĈēāėâĕĆ âĕĆĢëňúĆĔāąĕâĆĐąŇĕèåěňĄåŇĕ J Thai Stroke Soc: Volume 14, 2015

ČèöæāÖÐāòãĘāċèăèÖāè ĠýŇèğþŎü Ćēąē

ĆēąēúĘħ ăĕąĎĈĔ è éĕâúĘħ ġ ĆèāąĕýĕĈ ċĆĘüåĆėüúĆŋģ÷ňāĔõüĕĆēýýâĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ĐąŇĕè÷ĘĠĈēĄĘåĊĕĄĄĔħüĢéĢüĆēýýâĕĆĢĎňýĆėâĕĆéęè ģ÷ňğĆėĄħ āĜ÷åěąĠýýģĄŇğþŎüúĕèâĕĆâĔýĐĕąěĆĠāúąŋĠĈē ĎĆĚĐ ĠāúąŋÿĜňğëĘħąĊëĕî÷ňĕüþĆēčĕúĊėúąĕĢüġĆèāąĕýĕĈ ĄĎĕčĕĆåĕĄ âĕďčėüûěŋ ãĐüĠâŇü ĠĈēĆňĐąğĐĦ÷ ĎĈĔèéĕâ üĔĨüģ÷ňĠüēüĬĕĢĎňĄĘâĕĆğøĆĘąĄúĘĄĢüĠøŇĈēġĆèāąĕýĕĈ þĆēâĐý÷ňĊą ĠāúąŋĠĈēāąĕýĕĈúĘħúĬĕĎüňĕúĘħğþŎü ECUG OCPCIGT ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ìęèħ ğþŎüĎüęèħ ġĆåãĐèâĈěĄŇ âĕĆéĔ÷âĕĆğêāĕēĆĕąâĆöĘ FKUGCUG OCPCIGOGPV ĆēąēúĘ ħ ĠüēüĬĕĢĎňúĕèúĘĄĠøŇĈēġĆèāąĕýĕĈ ãňĕèøňüģ÷ňþĆęâČĕâĔýĎĔĊĎüňĕâĈěŇĄèĕüĐĕąěĆâĆĆĄĊŇĕĄĘ ĠüĊåė÷ĠĈēåĊĕĄåė÷ğĎĦüâĔýâĕĆğþľ÷ĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ĐąŇ ĕ èģĆ ùň ĕ úĕèĎĔ Ċ Ďüň ĕ èĕüĐĕąě â ĆĆĄ ÿĜňýĆėĎĕĆġĆèāąĕýĕĈĠĈēâĈěŇĄèĕüøŇĕèĥ úĘħğâĘħąĊãňĐèâĔý Ćēýý 5VTQMG (CUV 6TCEM ğĎĦü÷ňĊąâĔýĠüĊåė÷ğþľ÷ýĆėâĕĆ 5VTQMG (CUV 6TCEM úĕèúĘĄèĕüġĆèāąĕýĕĈċĆĘüåĆėüúĆŋ éēéĔ÷ĐýĆĄåĊĕĄĆĜňğâĘħąĊâĔýĆēýýâĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM øŇĐĢüĆēąēúĘħ ĆēąēúĘ ħ úĘĄèĕüġĆèāąĕýĕĈċĆĘüåĆėüúĆŋé÷Ĕ ĐýĆĄåĊĕĄĆĜňğâĘħąĊâĔýĆēýýâĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ĢüĠøŇĈēġĆèāąĕýĕĈġ÷ąĢĎňġĆèāąĕýĕĈéĔèĎĊĔ÷ ğþŎüĠĄŇãŇĕąĠĈēÿĜňĆĔýÿė÷ëĐýĆŇĊĄâĔýčþčë ġ÷ąğëėîġĆè āąĕýĕĈëěĄëüĢüéĔèĎĊĔ÷ ĠāúąŋĠÿüâĐěýĔøėğĎøěêěâğêėü ĐĕąěĆĠāúąŋġĆèāąĕýĕĈéĔèĎĊĔ÷ ĆĔèčĘĠāúąŋ ùňĕĄĘ āąĕýĕĈ ĠĈēúĘĄèĕüÿĜňğâĘħąĊãňĐèğãňĕĆŇĊĄĐýĆĄ ġ÷ąĎĔĊãňĐĎĈĔâĢü âĕĆĐýĆĄþĆēâĐý÷ňĊą čŇĊü åĊĕĄĆĜňğâĘħąĊâĔýġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèĠĈēĊėûĘâĕĆĆĔâČĕ÷ňĊąąĕĈēĈĕąĈėħĄğĈĚĐ÷ âĆēøěňüĠĈēčĆňĕèåĊĕĄĄĔħüĢéĢĎňâĔý úĘĄýĆėâĕĆĢüĠøŇĈēġĆèāąĕýĕĈĄĘåĊĕĄĄĔħüĢéĊŇĕĆēýý ýĆėâĕĆ÷ĔèâĈŇĕĊĊŇĕģĄŇąĕâĐąŇĕèúĘħåė÷ĠĈēĢĎňÿĈâĕĆĆĔâČĕ úĘ÷ħ ġĘ ÷ąĄĘ 5NQICP Á5VTQMG (CUV 6TCEM /CMG +V 'CU[Â ĠĈē Á5VTQMG (CUV 6TCEM /CMG 6JG &KHHGTGPEGÂ ĆĊĄúĔĨèëĘĨĢĎňğĎĦüĊŇĕġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèğþŎüğĆĚħĐèĢâĈňøĔĊ úěâåüĄĘġĐâĕčğþŎüġ÷ąğêāĕēāŇĐĠĄŇåüúĘğħ ĆĕĆĔâğþŎüčėèħ úĘħ úěâåüĎĈĘâğĈĘħąèģĄŇģ÷ň÷ĔèüĔĨü ğĆĕøňĐèāĔõüĕĆēýýâĕĆ ĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ğāĚĐħ úĘğħ Ćĕéēģ÷ňĄġĘ Đâĕč

J Thai Stroke Soc: Volume 14, 2015

ĢĎňâĕĆĆĔâČĕÿĜúň ğĘħ ĆĕĆĔâùňĕúŇĕüğĎĈŇĕüĔüĨ ğþŎüġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèãęĨü ğĈŇ ĕ ĢĎň ÿĜ ň ĆĔ ý âĕĆĐýĆĄúĆĕýùę è þŌîĎĕĠĈēĐěþčĆĆåøŇĕèĥ ãĐèâĕĆĢĎňýĆėâĕĆĆĊĄúĔèĨ čĆňĕè åĊĕĄğãňĕĢéúĘùħ âĜ øňĐèğâĘąħ ĊâĔý 5VTQMG (CUV 6TCEM ğāĆĕē ĄĘåĊĕĄğãňĕĢéúĘħģĄŇùĜâøňĐèğâĘħąĊâĔýâĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ġ÷ąéēâĈŇĕĊĈēğĐĘą÷ăĕąĎĈĔè ğĆĕāýĊŇĕğĄĚħĐģ÷ň÷ĬĕğüėüâĕĆúĔĨè Ćēąēãňĕèøňü øĕĄĈĬĕ÷ĔýĠĈňĊāýĊŇĕúěâġĆèāąĕýĕĈģ÷ňāĔõüĕĆēýý âĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM āĆňĐĄĢĎňýĆėâĕĆ÷ňĊą åĊĕĄğøĦĄĢéãĐèúĘĄèĕüĠĈēýĆėâĕĆ÷ňĊąåĊĕĄúěĄŇ ğúúĔèĨ čėüĨ ġ÷ąĄĘġĆèāąĕýĕĈċĆĘüåĆėüúĆŋğþŎüúĘħþĆęâČĕĢüþĿĠĆâ øŇĐĄĕğĄĚħĐúĕèúĘĄġĆèāąĕýĕĈãĐüĠâŇüĄĘåĊĕĄğãňĄĠãĦè âĦģ÷ňĆŇĊĄğþŎüĠĄŇãŇĕąĆŇĊĄâĔüâĔýġĆèāąĕýĕĈċĆĘüåĆėüúĆŋ ĢüâĕĆāĔõüĕğåĆĚĐãŇĕąĆēýýâĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ĠĈēĆēýýýĆėâĕĆġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆ ĢüġåĆèâĕĆëĚħĐ /QVQT 9C[ (CUV 6TCEM þĆēâĐý÷ňĊą 5VTQMG (CUV 6TCEM 56'/+ ĠĈē 6TCWOC ĆēąēúĘħ âĕĆøĆĊéğąĘħąĄğāĚħĐĠĈâğþĈĘħąü þĆēčýâĕĆöŋĆēĎĊŇĕèúĘĄġĆèāąĕýĕĈċĆĘüåĆėüúĆŋĠĈē ġĆèāąĕýĕĈúĘħğþľ÷ýĆėâĕĆ 5VTQMG (CUV 6TCEM ĢĎĄŇ ġ÷ą ğüňüâĕĆčĆňĕèãĊĔîâĬĕĈĔèĢéĠâňþî Ō ĎĕøŇĕèĥĢĎňğāĚĐħ ĢĎň úĘĄýĆėâĕĆĄĘåĊĕĄĄĔħüĢéĢüâĕĆĢĎňýĆėâĕĆĠĈēğāėħĄ þĆēčėúûėăĕāâĕĆĢĎňýĆėâĕĆ ģĄŇģ÷ňğüňüâĕĆþĆēğĄėüĎĆĚĐ øĆĊéčĐýĊŇ ĕ âĕĆĢĎň ý Ćė â ĕĆüĔĨ ü ĄĘ å ĊĕĄùĜ â øň Đ èĎĆĚ Đ ÿė÷āĈĕ÷éě÷ģĎü ğāĆĕēéēğâė÷åĊĕĄģĄŇāęèāĐĢéĠĈē ğâė÷åĊĕĄģĄŇĄĔħüĢé ģĄŇģĊňĊĕèĢéĢüâĕĆúĬĕèĕüĆŇĊĄâĔüúĘĄ èĕüğĆĕúĔèĨ ğãø ğüňüâĕĆúĬĕèĕüğþŎüúĘĄĠĈēğþŎüğāĚĐħ ü ĆŇĊĄèĕüìęħèâĔüĠĈēâĔü âĕĆåĊýåěĄåěöăĕāĠĈēâĕĆāĔõüĕĆēýýèĕü üĔĨüĢëňâĕĆğâĦýãňĐĄĜĈøĔĊëĘĨĊĔ÷úĘħğþŎüĄĕøĆòĕüğ÷ĘąĊâĔüúĔĨè ğãøĢüâĕĆøė÷øĕĄĠĈēāĔõüĕèĕü ğëŇü ÿĈâĕĆĆĔâČĕăĕĊē ĠúĆâìňĐü FQQT VQ PGGFNG ĆňĐąĈēãĐèÿĜňþłĊą CEWVG UVTQMG úĘħģ÷ňğãňĕčĜŇĆēýý 5VTQMG (CUV 6TCEM ĠĈēĆňĐąĈē ãĐèâĕĆģ÷ňĆĔýąĕ TV 2# ğþŎüøňü âĕĆúĬĕĢĎňÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèğãňĕùęè Ćēýý 5VTQMG (CUV 6TCEM ĠĈēčĕĄĕĆùĢĎňąĕĈēĈĕąĈėħĄ ğĈĚĐ÷ģ÷ňĄĕâčě÷ ĠĈēâĕĆýĆėâĕĆĐąŇĕèĄĘþĆēčėúûėăĕā ĢëňĎĈĔâ 7 A åĚĐ

#YCTGPGUU čĆňĕèåĊĕĄĆĜġň ĆåĎĈĐ÷ğĈĚĐ÷čĄĐè øŇĐëěĄëü #NGTV čĆňĕèåĊĕĄøĚħüøĔĊğâĘħąĊâĔýĐĕâĕĆġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐè #EVKXCVG čĆň ĕ èĆēýýĢĎň ĄĘ â ĕĆüĬ ĕ čŇ è ġĆèāąĕýĕĈúĘħčĕĄĕĆùĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷ğĆĦĊúĘħčě÷ #XCKNCDNG čĆňĕèåĊĕĄāĆňĐĄãĐèĎüŇĊąýĆėâĕĆ ĢĎňāĆňĐĄĢüúěâāĚĨüúĘħ #NTGCF[ čĆňĕèåĊĕĄāĆňĐĄãĐèġĆèāąĕýĕĈ āĆňĐĄĢĎňâĕĆĆĔâČĕøĈĐ÷ğĊĈĕ #WFKV âĕĆĆĔâČĕĆēýýþĆēğĄėüÿĈĠĈēøė÷øĕĄ ğāĚħĐĢĎňģ÷ňĄĕøĆòĕüâĕĆĆĔâČĕ #YC[ čĆňĕèåĊĕĄğãňĕĢéøŇĐþĆēëĕëüéĔ÷âĕĆ þŃĐèâĔüģĄŇĢĎňğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè åĚĐ ğþŃĕĎĄĕą čĬĕåĔîúĘħčě÷

ČèöæāÖÐāòùèĀéùèćèċÓòĆüÑŚāñ

čėèħ úĘĠħ ĄŇãĕŇ ąĄĘåĊĕĄéĬĕğþŎüĐąŇĕèąėèħ ĢüâĕĆ÷ĬĕğüėüâĕĆ øŇĐğüĚĐħ èĎĈĔèéĕâĈĜâãŇĕąğþľ÷ĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ģ÷ňĠĈňĊåĚĐ âĕĆğþŎüāĘħğĈĘĨąèĎĆĚĐğāĚħĐüúĘħ÷ĘĢüâĕĆĢĎň åĬĕþĆęâČĕģ÷ňøĈĐ÷ğĊĈĕ ģĄŇĊŇĕéēğþŎüþŌîĎĕĢü÷ňĕü âĕĆĆĔâČĕāąĕýĕĈ âĕĆýĔüúęâğĐâčĕĆâĕĆĈèãňĐĄĜĈğāĚħĐ âĕĆğýėâéŇĕąåŇĕĆĔâČĕāąĕýĕĈ ĠĈēøňĐèåĐąčüĔýčüěü ĆēýýĢĎňĄĘåĊĕĄĄĔħüåèĠĈēąĔħèąĚüġ÷ąĠč÷èåĊĕĄéĆėèĢé ĐąŇ ĕ èøŇ Đ ğüĚħ Đ èĢüâĕĆúĬ ĕèĕüĆŇĊĄâĔüëŇĊąğĎĈĚĐâĆöĘĄĘ þŌîĎĕúĘğħ âė÷ãęüĨ ĢĎňĈâĜ ãŇĕąĆĊĄúĔèĨ âĕĆĎĕèýþĆēĄĕöĠĈē ĐěþâĆöŋúĕèâĕĆĠāúąŋúéĘħ ĕĬ ğþŎü ğëŇü èýþĆēĄĕöĢüâĕĆéĔ÷ âėéâĆĆĄĢüĠøŇĈēġĆèāąĕýĕĈ âĕĆéĔ÷ĎĕèýþĆēĄĕöğāĚĐħ éĔ÷ìĚĐĨ ğåĆĚĐħ èøė÷øĕĄčĔîîĕöëĘā ğåĆĚĐħ èëĔèħ üĬĕĨ ĎüĔâ ğåĆĚĐħ è ĢĎňčĕĆĈēĈĕąúĕèĎĈĐ÷ğĈĚĐ÷÷Ĭĕ ġ÷ąâĕĆčüĔýčüěüúĘħ÷Ę éĕâčþčë ğãø ĐąŇĕè÷ĘĄĕøĈĐ÷ üĐâéĕâüĘĨøňĐèčŇè ğčĆėĄåĊĕĄâňĕĊĎüňĕãĐèĈĜâãŇĕąčüĔýčüěüâĕĆċęâČĕĊėéĔą ĠĈēåĜĄŇ ĐĚ øŇĕèĥ ġ÷ąĆŇĊĄâĔüāĔõüĕĠĈēúĬĕĢĎňğĎĄĚĐüâĔüúĔèĨ ğãø ğāĚħ Đ ğþŎ ü âĕĆąĚ ü ąĔ ü ùę è ĄĕøĆòĕüğ÷Ę ą ĊâĔ ü úĔĨ è ğãø ĠĈēčĆňĕèåĊĕĄĄĔħüĢéĢĎňâĔýÿĜňĆĔýýĆėâĕĆĊŇĕéēģ÷ňĆĔý âĕĆĆĔâČĕ÷ňĊąĄĕøĆòĕüğ÷ĘąĊâĔüģĄŇĊĕŇ éēğãňĕĆĔýâĕĆĆĔâČĕ úĘġħ ĆèāąĕýĕĈĢ÷âĦøĕĄ ĠĈēğþŎüâĕĆčĆňĕèġĐâĕčĢĎňÿþňĜ Ċł ą ğãňĕùęèĆēýýýĆėâĕĆģ÷ňčĜèãęĨüġ÷ąĄĘĄĕøĆòĕüğ÷ĘąĊâĔü úĘħÿŇĕüĄĕğåĆĚĐãŇĕąâĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ğãø ģ÷ňĆŇĊĄĄĚĐâĔüğþŎüĐąŇĕè÷Ę ġ÷ąģ÷ňĆĔýâĕĆ

čüĔýčüěüèýþĆēĄĕöĠĈēüġąýĕąúĘħ÷Ęéĕâčþčë ğãø âĈěĄŇ ĊėéąĔ ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ăĕåøēĊĔüĐĐâğêĘąèğĎüĚĐ čĄĕåĄþĆēčĕúĊėúąĕċĕčøĆŋăĕåøēĊĔüĐĐâğêĘąèğĎüĚĐ ĠĈēåöēĠāúąċĕčøĆŋĄĎĕĊėúąĕĈĔąãĐüĠâŇü

ČèöæāÖÐāòíĀáèāċÓòĆüÑŚāñ

ĢüĆēąē þĿúĘħÿŇĕüĄĕøĔĨèĠøŇ ā ċ ùęè þŌééěýĔü ā ċ âĕĆāĔõüĕğåĆĚĐãŇĕąúĘħ÷ĬĕğüėüâĕĆéē ğüňüĎüĔâģþúĘħâĕĆāĔõüĕġĆèāąĕýĕĈúĘħĄĘċĔâąăĕāĢĎň čĕĄĕĆùĢĎňąĕĈēĈĕąĈėĄħ ğĈĚĐ÷ģ÷ň ĠøŇčèėħ úĘøħ Đň èåĬĕüęèùęèĠĈē øňĐè÷ĬĕğüėüâĕĆģþāĆňĐĄâĔüåĚĐ âĕĆãąĕąğåĆĚĐãŇĕąĢü Ćē÷ĔýġĆèāąĕýĕĈëěĄëüãüĕ÷ĢĎîŇ ãüĕ÷âĈĕèãüĕ÷ğĈĦâ ĠĈēġĆèāąĕýĕĈčŇèğčĆėĄčěãăĕāøĬĕýĈ ğāĚħĐĢĎňþĆēëĕëü ğãňĕùęèĆēýýýĆėâĕĆģ÷ňĄĕâúĘħčě÷ âĕĆ÷ĬĕğüėüâĕĆĢüġĆèāąĕýĕĈëěĄëüøňĐèğüňü ĎüĔâğĆĚħĐèâĕĆĢĎňåĊĕĄĆĜňøŇĐëěĄëüâĕĆčŇèøŇĐĠĈē ĆĔýâĈĔý úĘħĄĘþĆēčėúûėăĕā ğĆĕøňĐèúĆĕýĊŇĕĠøŇĈēġĆèāąĕýĕĈĄĘ ċĔâąăĕāĐēģĆýňĕè øňĐèčŇèğčĆėĄĠĈēāĔõüĕĢĎňøĆèâĔýãĘ÷ åĊĕĄčĕĄĕĆùãĐèčùĕüāąĕýĕĈĠĈēúĘĄčěãăĕā ğëŇü ġĆèāąĕýĕĈëěĄĠā éĔèĎĊĔ÷ãĐüĠâŇüĄĘċĔâąăĕā÷ňĕü ĐěþâĆöŋğåĆĚħĐèĄĚĐĠāúąŋ ğåĆĚħĐè %6 5ECP ĠĈēúĘĄ ýĆėâĕĆúĘħĄĘåĊĕĄĄěŇèĄĔħüúěŇĄğúĢüâĕĆĢĎňýĆėâĕĆĐąŇĕèčĜè ğĆĕéęèčĕĄĕĆùāĔõüĕĠĈēčŇèğčĆėĄĢĎňġĆèāąĕýĕĈëěĄĠā éĔ è ĎĊĔ ÷ ãĐüĠâŇ ü ğþŎ ü ĈĜ â ãŇ ĕ ąúĘħ č ĕĄĕĆùĢĎň ą ĕĈēĈĕą ĈėħĄğĈĚĐ÷ģ÷ňĠĈēĊĕèâĈąěúûŋĢĎňğþŎüġĆèāąĕýĕĈúĘħĆĔýâĕĆ čŇèøŇĐĄĕéĕâġĆèāąĕýĕĈëěĄëüãĐèéĔèĎĊĔ÷ëĔąăĜĄė ğĈą Đě÷ĆûĕüĘ ĠĈēğāëĆýĜĆöŋúĘħĐąĜŇĢâĈňġĆèāąĕýĕĈëěĄĠā ĄĕââĊŇĕġĆèāąĕýĕĈéĔèĎĊĔ÷üĔĨüĥģ÷ňĐĘâ÷ňĊą ğþŎüâĕĆĈ÷ ăĕĆēèĕüãĐèġĆèāąĕýĕĈċĆĘüåĆėüúĆŋ ĠĈēġĆèāąĕýĕĈ ãĐüĠâŇü ÿĜňþłĊąĢüğãøāĚĨüúĘħĆĔýÿė÷ëĐýãĐèġĆèāąĕýĕĈ ëěĄĠāĠĈēġĆèāąĕýĕĈãňĕèğåĘąèâĦčĕĄĕĆùğãňĕùęèýĆėâĕĆ ģ÷ňèŇĕąãęĨü ĄĘġĐâĕčģ÷ňĆĔýâĕĆĆĔâČĕ÷ňĊąĆēýýýĆėâĕĆ 5VTQMG (CUV 6TCEM ģ÷ňèŇĕąĠĈēğĆĦĊãęĨüĐąŇĕèĄĕâ ğāĆĕē ģĄŇøňĐèğ÷ėüúĕèĄĕğþŎüĆēąēúĕèğâĚĐý âėġĈğĄøĆìęħè ĢëňğĊĈĕâĊŇĕ üĕúĘéęèğāėħĄġĐâĕčģ÷ňĆĔýąĕ TV 2# ģ÷ňğāėħĄ ãęĨüĐąŇĕèĄĕâ ġĆèāąĕýĕĈëěĄĠāğþŎüġĆèāąĕýĕĈ ëě Ą ëüĠĎŇ è ĠĆâĢüăĕåøēĊĔ ü ĐĐâğêĘ ą èğĎüĚ Đ úĘħ čĕĄĕĆùĢĎňâĕĆĆĔâČĕ÷ňĊąâĕĆĢĎňąĕ TV 2# ģ÷ň ĄĘÿþňĜ Ċł ą éĬĕüĊüĄĕâģ÷ňĆýĔ âĕĆĆĔâČĕ÷ĔèâĈŇĕĊĠĈēĄĘÿĈâĕĆĆĔâČĕģĄŇ ĠøâøŇĕèâĔýġĆèāąĕýĕĈéĔèĎĊĔ÷ğþŎüģþøĕĄĄĕøĆòĕü J Thai Stroke Soc: Volume 14, 2015

âĕĆĆĔâČĕúĘĄħ åĘ ĊĕĄþĈĐ÷ăĔąĠĈēþĆēčėúûėăĕāğúŇĕğúĘąĄâĔü ĐĘâøĔĊĐąŇĕèĎüęèħ åĚĐġĆèāąĕýĕĈëěĄëüġâčěĄāėčąĔ éĔèĎĊĔ÷ĄĎĕčĕĆåĕĄĄĘĆēýýâĕĆĢĎňýĆėâĕĆÿĜþň Ċł ąġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèúĘħåĆýĊèéĆĐąĜŇĠĈňĊ ùęèĠĄňéēģĄŇčĕĄĕĆùĢĎňąĕ ĈēĈĕąĈėĄħ ğĈĚĐ÷ģ÷ň ĠøŇĄĆĘ ēýýâĕĆčŇèğčĆėĄþŃĐèâĔüâĕĆ÷ĜĠĈ ÿĜþň Ċł ą CEWVG UVTQMG ĢüġĆèāąĕýĕĈ âĕĆğąĘąħ Ąýňĕü âĕĆčŇè âĈĔýčĜŇëěĄëü úĕèġĆèāąĕýĕĈĠĄŇãŇĕąâĦøňĐèčŇèğčĆėĄ ċĔâąăĕā÷ĔèâĈŇĕĊĐąŇĕèğøĦĄúĘĆħ ĊĄúĔèĨ âĕĆĠĈâğþĈĘąħ üğĆĘąü ĆĜňĆēĎĊŇĕèġĆèāąĕýĕĈĢüğåĆĚĐãŇĕąğāĚħĐğþŎüâĕĆāĔõüĕģþ ĐąŇĕèğúŇĕğúĘąĄĠĈēāĆňĐĄâĔü čŇèÿĈĢĎňĄĘÿĜňþłĊąĆĕąĢĎĄŇ Ĉ÷ĈèĠĈēĄĘÿþňĜ Ċł ąğãňĕùęèĆēýýýĆėâĕĆ 5VTQMG (CUV 6TCEM ģ÷ňğþŎüéĬĕüĊüĄĕâ ġĆèāąĕýĕĈčŇèğčĆėĄčěãăĕāøĬĕýĈğþŎüĐĘâéě÷ ĎüęħèúĘħčĬĕåĔîĢüâĕĆāĔõüĕĆēýýâĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ĐĕéâĈŇĕĊģ÷ňĊŇĕğþŎüčėħèúĘħčĬĕåĔîúĘħčě÷âĦĊŇĕģ÷ň ğāĆĕēùňĕþĆēëĕëüĢüëěĄëüģĄŇĄĘåĊĕĄĆĜňåĊĕĄğãňĕĢéúĘħ ùĜâøňĐèþĆēëĕëüâĦģĄŇģ÷ňğãňĕĄĕĆĔýýĆėâĕĆĢüġĆèāąĕýĕĈ úĘħĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷ģ÷ň ĐąŇĕĈĚĄĊŇĕþĆēëĕëüĢüëěĄëü åĚĐ âĈěŇĄĢĎîŇúĘħčě÷ãĐèþĆēëĕëü ÷ĔèüĔĨüğéňĕĎüňĕúĘħãĐè Ćā čø éēğþŎüýěååĈúĘčħ ĕĬ åĔîĢüúĘĄâĕĆĢĎňýĆėâĕĆ úĔèĨ ÷ňĕü âĕĆčŇèğčĆėĄþŃĐèâĔü âĕĆčĆňĕèġĐâĕčĢĎňÿĜňþłĊą CEWVG UVTQMG ğãňĕùęèĆēýýâĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM âĕĆčŇèøĔĊğãňĕĆĔýâĕĆĆĔâČĕøŇĐĠĈēčŇèâĈĔýğāĚħĐâĕĆĂŁŐüĂĜ čĄĆĆùăĕāĠĈēâĕĆĢëňëĘĊėøĢüëěĄëüúĘħĄĘåěöăĕāëĘĊėø úĘħ÷ĘøŇĐģþ âĕĆĐýĆĄğāĚħĐâĕĆāĔõüĕýěåĈĕâĆĢü Ćā čø éęèğþŎüâėéâĆĆĄčĬĕåĔîúĘħãĕ÷ģĄŇģ÷ň

êŠÜúāæĄēíééŚüñĎèÐāòùòśāÖċÓòĆüÑŚāñ

éĕâþĆēčýâĕĆöŋ â ĕĆčŇ è ğčĆė Ą ĢĎň Ġ øŇ Ĉ ēġĆè āąĕýĕĈğþľ÷ýĆėâĕĆ 5VTQMG (CUV 6TCEM āýþŌîĎĕøŇĕèĥ ĠýŇèģ÷ňğþŎü ÷ňĕüģ÷ňĠâŇ ÷ňĕüåĊĕĄğãňĕĢéĆēýý 5VTQMG (CUV 6TCEM éēğþľ÷ĢĎňýĆėâĕĆģ÷ň øňĐèĄĘ 5VTQMG WPKV âŇĐü ìęħèåĊĕĄğãňĕĢéÿė÷üĘĨğþŎüčėħèúĘħāý ýŇĐąéĆėèĥ ĠĈňĊâĕĆéēğþľ÷ýĆėâĕĆ 5VTQMG (CUV 6TCEM ğāĚĐħ ĢĎňÿþňĜ Ċł ąģ÷ňĆýĔ TV 2# úĕèĎĈĐ÷ğĈĚĐ÷÷Ĭĕģ÷ňĎĆĚĐģĄŇüüĔĨ åĊĕĄéĬĕğþŎüāĚĨüòĕüúĘħøňĐèĄĘåĚĐ %6 UECP ĐĕąěĆĠāúąŋ ĠĈēâĕĆčŇèøĆĊéúĕèĎňĐèþñėýĔøėâĕĆúĘħéĬĕğþŎüþĆēâĐý ÷ňĊą %$% 2NCVGNGV EQWPV 2TQVJTQODKP VKOG +04 $NQQF UWICT $70 %T âĆöĘúĘħģĄŇĄĘğåĆĚħĐè %6 UECP

J Thai Stroke Soc: Volume 14, 2015

ĢüġĆèāąĕýĕĈĠøŇ ù ň ĕ ĄĘ Ć ēýýþĆēčĕüèĕüĆēĎĊŇ ĕ è ġĆèāąĕýĕĈâĔýċĜüąŋ %6 UECP ãĐèğĐâëüâĦčĕĄĕĆùğþľ÷ ýĆėâĕĆģ÷ň čŇĊü 5VTQMG WPKV üĔĨüģĄŇĄĘåĊĕĄéĬĕğþŎüøňĐèĄĘ ĢüĆēąēğĆėħĄøňü ĠøŇøňĐèĄĘâĕĆéĔ÷ĆēýýĊŇĕéēĢĎňÿĜňþłĊąúĘħģ÷ň ĆĔýąĕ TV 2# üĐüĆĔâČĕĢüĎĐÿĜňþłĊąĢ÷úĘħøĕĬ ĠĎüŇèĢ÷ ğëŇü ĎĐÿĜňþłĊąĊėâćø ĎĐÿĜňþłĊąĐĕąěĆâĆĆĄ ĎĐÿĜňþłĊąĐěýĔøėğĎøě êěâğêėü ğþŎüøňü ĄĘâĕĆâĬĕĎü÷ýúýĕúĎüňĕúĘãħ ĐèāąĕýĕĈ ĠāúąŋÿĜňĢĎňýĆėâĕĆĆĔâČĕāąĕýĕĈ ĠĈēĄĘĆēýýýĆėâĕĆúĘħ åĆýĊèéĆĢĎňÿĜňþłĊąúěâĆĕą âĕĆĢĎňýĆėâĕĆÿĜňþłĊą 5VTQMG (CUV 6TCEM úĘħ ġĆèāąĕýĕĈċĆĘüåĆėüúĆŋĢüëŇĊè þĿĠĆâģ÷ňâĬĕĎü÷ĢĎň ğøĘąèÿĜňþłĊąéĬĕüĊü ğøĘąèğøĘąèĈĬĕ÷ĔýúĘħ ãĐè ĎĐÿĜňþłĊąĐěýĔøėğĎøěĠĈēêěâğêėü ġ÷ąĄĘüġąýĕąãĐè ġĆèāąĕýĕĈúĘħëĔ÷ğéüĊŇĕùňĕĄĘÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè øňĐèĢĎňąĕTV 2# ùęèĠĄňğøĘąèéēğøĦĄâĦéēģĄŇĄĘâĕĆčŇèøŇĐ ġĆèāąĕýĕĈĐĚüħ ĎĆĚĐĐĘâüĔąĎüęèħ åĚĐ ģĄŇĄåĘ ĕĬ ĊŇĕğøĘąèğøĦĄ čĬĕĎĆĔýÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħøňĐèģ÷ňĆĔýąĕ TV 2# ğāĆĕēéēģ÷ňĢĎňąĕÿĜňþłĊąģ÷ňúĔüğĊĈĕ üĕúĘ ĠĈē ĄĘĆēąēğĊĈĕ QPUGV VQ PGGFNG ĠĈē FQQT VQ PGGFNG čĔĨü úĘčħ ÷ě ġ÷ąğþŎüġĆåĠĆâãĐèġĆèāąĕýĕĈċĆĘüåĆėüúĆŋúģĘħ ĄŇĄĘ âĕĆčŇèøĔĊĆĔâČĕġĆèāąĕýĕĈĐĚüħ ĥğāĆĕēğøĘąèğøĦĄ ìęèħ ğþŎü čėħèúĘħýĐâĊŇĕ ġĆèāąĕýĕĈċĆĘüåĆėüúĆŋģ÷ňĄĘüġąýĕą čüĔýčüěüâĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ĐąŇĕèğøĦĄúĘħ âĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM øňĐèĄĘ ĐĕąěĆĠāúąŋ÷ĕň üĆēýýþĆēčĕú ċĔĈąĠāúąŋĆēýýþĆēčĕú åĊĕĄğãňĕĢé÷ĔèâĈŇĕĊùĜâøňĐèĠüŇüĐüùňĕġĆèāąĕýĕĈĠĎŇè Ģ÷ĄĘĠāúąŋÿğňĜ ëĘąħ ĊëĕîâĦ÷ Ę ĠøŇåĊĕĄéĬĕğþŎüúĘøħ Đň èâĕĆĠĈē ãĕ÷ģĄŇģ÷ňüĔĨü åĚĐ ãĐĄĘğāĘąèĐĕąěĆĠāúąŋúĘħÿŇĕüâĕĆĐýĆĄ ğåąğĎĦ ü ĎĆĚ Đ ĄĘ þ ĆēčýâĕĆöŋ Ć ēĎĊŇ ĕ èâĕĆĀŀ â ĐýĆĄ âĦčĕĄĕĆùĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ĠĈēčĕĄĕĆù øĔ÷čėüĢéĢĎňąĕ TV 2# ģ÷ň ÷ĔèüĔĨüĠāúąŋúĘħøňĐèĆĔýÿė÷ëĐý Ćēýý 5VTQMG (CUV 6TCEM þĆēâĐý÷ňĊąĐĕąěĆĠāúąŋ ĎĆĚĐ ĠāúąŋğĊëċĕčøĆŋêěâğêėü ĎĆĚĐĐĕąěĆĠāúąŋ÷ňĕüĆēýý þĆēčĕúâĦģ÷ňãęĨüĐąĜŇâĔýĆēýýĠĈēåĊĕĄāĆňĐĄãĐèĠøŇĈē ġĆèāąĕýĕĈ čĬĕĎĆĔýĆĔèčĘĠāúąŋùňĕģĄŇĄĘâĦčĕĄĕĆùĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ģ÷ňğāĆĕēĐĕąěĆĠāúąŋúÿĘħ ĕŇ üâĕĆĐýĆĄ âĦčĕĄĕĆù÷Ĝ %6 UECP Ģü CEWVG EGTGDTCN KPHCTEVKQP ģ÷ň

üĐâéĕâüĘĨĐĕéĢëňĆēýýâĕĆčŇè ÌNG ăĕāþĆęâČĕĠāúąŋ ÿĜğň ëĘąħ Ċëĕîģ÷ňčĕĬ ĎĆĔýġĆèāąĕýĕĈúĘĢħ ëňĆēýýğåĆĚĐħ è %6 UECP ãĐèğĐâëüąėħèģĄŇĄĘþŌîĎĕâĕĆĐŇĕüÿĈ ğāĆĕēúĕèýĆėČĔú ğĐâëüéēĄĘ ĆĔ è čĘ Ġ āúąŋ Đ Ň ĕ üÿĈúĔ ü úĘ é ĕâčŇ Ċ üâĈĕèìęħ è þŌééěýĔüġĆèāąĕýĕĈëěĄëüčŇĊüĢĎîŇĢëňĆēýýüĘĨ âĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ğþŎüčėħèúĘħ ąĕâĄĕâøňĐèğþŎüÿĜğň ëĘąħ ĊëĕîğúŇĕüĔüĨ ùęèéēğþľ÷ĢĎňýĆėâĕĆģ÷ň åĊĕĄğãňĕĢéÿė÷üĘĨğþŎüčėħèúĘħāýýŇĐąĠĈēğþŎüĐěþčĆĆåúĘħ čĬĕåĔîúĘħčě÷ éĆėèĥĠĈňĊâĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM üĔĨüĄĘâĕĆéĔ÷ĆēýýãĔĨüøĐüĠĈēĊėûĘĢüĠøŇĈēãĔĨüøĐüĐąŇĕè ĈēğĐĘą÷ ğëŇü ĠýýþĆēğĄėüčĬĕĎĆĔýåĔ÷âĆĐè ( # 5 6 âĦ èŇĕąĄĘåĊĕĄĠĄŇüąĬĕčĜè âĕĆøĆĊéúĕèĎňĐèþñėýĔøėâĕĆâĦĄĘ ģĄŇĄĕâġĆèāąĕýĕĈéĔèĎĊĔ÷úěâġĆèāąĕýĕĈâĦčĕĄĕĆù úĬĕģ÷ňĆĊĄúĔĨèġĆèāąĕýĕĈëěĄëü ýĕèġĆèāąĕýĕĈâĦúĬĕģ÷ň âĕĆþĆēğĄėü 0+*55 âĦĄĘâĕĆĠþĈğþŎüăĕČĕģúąāĆňĐĄ ëĘĨĠéèĊėûĘâĕĆþĆēğĄėüġ÷ąĈēğĐĘą÷âĕĆčŇèøĆĊé %6 UECP DTCKP āĆňĐĄâĕĆĐŇĕüÿĈ ùňĕýĆėĎĕĆĆēýýúĘ÷ħ ĎĘ ĆĚĐĄĘâĕĆĐýĆĄ ĢĎňĐĕąěĆĠāúąŋâĦčĕĄĕĆùĐŇĕüÿĈģ÷ň ĆēýýâĕĆčŇèøĔĊ ĎĆĚĐ 5VTQMG (CUV 6TCEM ġĆèāąĕýĕĈğåĆĚĐãŇĕąâĦĄĘ þĆēčýâĕĆöŋøĆèéĕââĕĆýĆėâĕĆ 56 GNGXCVG /+ âĕĆĢĎňąĕ 5VTGRVQMKPCUG âĕĆĢĎňåĕĬ ĠüēüĬĕĠĈēąėüąĐĄĢüâĕĆĆĔâČĕ âĦĄĠĘ ýýĂĐĆŋĄúĘéħ ÷Ĕ úĬĕğþŎüĄĕøĆòĕü ÷ĔèüĔüĨ ġ÷ąĆēýýĠĈē ĊėûâĘ ĕĆøŇĕèĥ ģĄŇąĕâĠĈēģĄŇìýĔ ìňĐü ğāĘąèĠøŇĊĕŇ ĆēýýâĕĆ ĆĔâČĕüĘğĨ þŎüčėèħ ĢĎĄŇúĠĘħ āúąŋĐĕéģĄŇğåąğĆĘąüĢüãöēúĘğħ þŎü üĔâċęâČĕĠāúąŋ ĎĆĚĐãöēĀŀâĐýĆĄĐĕąěĆĠāúąŋ ĠøŇ čĬĕĎĆĔýĠāúąŋĆěŇüĢĎĄŇøĔĨèĠøŇþĿ ā ċ ğþŎüøňüĄĕ âĦéē ĄĘþĆēčýâĕĆöŋøĆèğâĚĐýúĔèĨ čėüĨ éęèčĆěþģ÷ňĊĕŇ ĆēýýâĕĆĢĎň ýĆėâĕĆ 5VTQMG (CUV 6TCEM éęèģĄŇąĕâĐąŇĕèúĘħåė÷ ğãňĕĢéĊŇĕăĕĆēèĕüéēğāėħĄãęĨüĐąŇĕèĄĕâ ġ÷ą ûĆĆĄëĕøėãĐèġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèëüė÷ãĕ÷ğĈĚĐ÷ĄĕğĈĘąĨ è ĄĔâĄĘĐĕâĕĆëŇĊèĎĈĔèøĚħüüĐü ĆŇĊĄâĔýåĊĕĄĆĜňåĊĕĄğãňĕĢé ãĐèþĆēëĕëüğâĘąħ ĊâĔýġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèąĔèĄĘüĐň ąĄĕâ âĕĆ÷ĜĠĈĆĔâČĕğĄĚħĐğâė÷ĐĕâĕĆĄĔâéēčĔèğâøĐĕâĕĆ ģĄŇĆĘý ĄĕāýĠāúąŋúĔüúĘğĎĄĚĐüĐĕâĕĆãĐèĎĔĊĢéãĕ÷ğĈĚĐ÷Ąĕ ğĈĘĨąè éĕâþĆēčýâĕĆöŋúĘħĢĎňâĕĆĆĔâČĕ÷ňĊąâĕĆêĘ÷ TV 2# ÿĜþň Ċł ąčŇĊüĢĎîŇéēĄĕĆĔýâĕĆĆĔâČĕëŇĊèğĊĈĕ üĕďľâĕ ÿĜňþłĊąĄĕĢëňýĆėâĕĆĠøŇĈēĊĔüâĦüňĐąğêĈĘħą Ćĕą øŇĐčĔþ÷ĕĎŋğúŇĕüĔüĨ úĘģħ ÷ň CEVKXCVG Ćēýý 5VTQMG (CUV 6TCEM ĢüġĆèāąĕýĕĈċĆĘüåĆėüúĆŋ ąėħèĢüġĆèāąĕýĕĈéĔèĎĊĔ÷

ÿĜňþłĊą CEWVG UVTQMG čŇĊüĢĎîŇúĘħĄĕùęèġĆèāąĕýĕĈĄĔâéē ğĈąëŇĊè üĕúĘúĐèģþĠĈňĊ âĔèĊĈĢéĊŇĕĆēąēğĊĈĕ FQQT VQ PGGFNG éēúĬĕ ģĄŇúüĔ ăĕąĢüğĊĈĕúĘâħ ĕĬ Ďü÷ üĕúĘ åĊĕĄğþŎüéĆėèĢüâĕĆ ğþľ÷ĢĎňýĆėâĕĆĢüĆēąēĠĆâĆēąēğĊĈĕ FQQT VQ PGGFNG âĦĄâĔ éēğâėü üĕúĘ čŇĊüĢĎîŇ åĚĐ üĕúĘğüĚĐħ èéĕâ ąĔèģĄŇåüňě ğåąâĔýĆēýý ĢüĆēąēøŇĐĄĕĆēąēğĊĈĕâĦéēåŇĐąĥ Ĉ÷čĔĨüĈèøĕĄþĆēčýâĕĆöŋúĘħĄĘĄĕâãęĨü ÷ĔèüĔĨüĆēąēğĊĈĕ FQQT VQ PGGFNG úĘħüĕüĄĕâĊŇĕ üĕúĘâģĦ ĄŇğþŎüĐěþčĆĆåøŇĐâĕĆğþľ÷ýĆėâĕĆ 5VTQMG (CUV 6TCEM ğāĘ ą èĠøŇ ğ Ćĕéēøň Đ èâĬ ĕ Ďü÷ĆēąēğĊĈĕĢüâĕĆ CEVKXCVG ĆēýýĢĎň÷Ę ġ÷ąøňĐèúĆĕýĆēąēğĊĈĕ FQQT VQ PGGFNG QPUGV VQ JQURKVCN ğāĚħĐğþŎüâĕĆâĬĕĎü÷ğĊĈĕ ĢüĆēýýýĆėâĕĆĊŇĕğĄĚħĐģĎĆŇéęèøňĐè CEVKXCVG ĆēýýğëŇü ğĆĕúĆĕýĊŇĕ FQQT VQ PGGFNG üĕúĘ ĆēýýéēùĜâ CEVKXCVG øŇĐğĄĚĐħ ĆēąēğĊĈĕ QPUGV VQ JQURKVCN ăĕąĢüğĊĈĕ üĕúĘğþŎüøňü ĎĈĔââĕĆğþľ÷ýĆėâĕĆĠĈňĊĆēąēğĊĈĕ FQQT VQ PGGFNG âĦéēĈ÷čĔüĨ Ĉè ÿĜþň Ċł ąâĦéēĄĘġĐâĕčģ÷ňĆýĔ ąĕ TV 2# ğāėħĄãęĨü ÷ňĕüâĕĆýĆėĎĕĆéĔ÷âĕĆĆēýý âĕĆýĆėĎĕĆĆēýý 5VTQMG (CUV 6TCEM üĔĨüģĄŇ ìĔ ý ìň Đ üĠĈēģĄŇ ąě Ň è ąĕâ ğāĆĕēúĕèčĄĕåĄġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèĠĎŇèþĆēğúċģúą ĠĈēčùĕýĔüþĆēčĕúĊėúąĕ âĆĄâĕĆĠāúąŋ âĆēúĆĊèčĕûĕĆöčěãģ÷ňéĔ÷úĬĕĆēýýĢü ĠøŇĈēãĔĨüøĐüãĐèâĕĆĆĔâČĕúĘħëĔ÷ğéüèŇĕąøŇĐâĕĆþñėýĔøė čėħèúĘħčĬĕåĔîãĐèâĕĆýĆėĎĕĆĆēýý åĚĐ åĊĕĄğĎĦüëĐýĎĆĚĐüġąýĕąúĘħëĔ÷ğéüãĐè ÿĜňýĆėĎĕĆġĆèāąĕýĕĈ âĈěŇĄèĕüĐĕąěĆâĆĆĄ âĈěŇĄèĕü ĆĔèčĘ Ċėüéė êĔą èĕüýĆėâĕĆāąĕýĕĈùňĕĄĘâĕĆþĆēčĕüèĕüĆēĎĊŇĕè ĎüŇĊąèĕü÷ĘĠĈňĊãĔĨüøĐüøŇĐģþ åĚĐ âĕĆþĆēčĕüèĕü ăĕąĢüĠøŇĈēĎüŇĊąèĕü ğëŇü âĈěŇĄèĕüĐĕąěâĆĆĄåĊĆ þĆęâČĕĎĕĆĚĐĠĈēčĆěþĠüĊúĕè âĕĆúĬĕèĕüĢĎňëĔ÷ğéüĊŇĕ ĐĕąěĆĠāúąŋÿĆňĜ ýĔ ÿė÷ëĐýåĚĐĢåĆýňĕè ùňĕ÷ĘåĊĆğþŎüâĕĆĆŇĊĄ ĄĚĐãĐèĐĕąěĆĠāúąŋ čŇĊüĢĎîŇéēģ÷ňģĄŇğþŎüâĕĆğāėħĄăĕĆē èĕüĢĎňĠāúąŋúĕŇ üĢ÷úŇĕüĎüęèħ ùňĕĄĘĐĕąěĆĠāúąŋ÷ĕň üĆēýý þĆēčĕúĢüĠÿüâĐĕąě Ć âĆĆĄâĦ å ĊĆâĬ ĕ Ďü÷ĢĎň ğ þŎ ü úĘħ þĆęâČĕ ĠøŇĄėĢëŇĄĐýĎĄĕąĢĎňğþŎü ÌTUV ECNN ĢüâĕĆ CEVKXCVG ĆēýýúěâåĆĔĨèĠĈēĆĔýÿė÷ëĐýúĔĨèĆēýý ğāĆĕēéē ğþŎüâĕĆğāėĄħ ăĕĆēèĕüøŇĐĠāúąŋúĕŇ üĢ÷úŇĕüĎüęèħ Ąĕâğâėü J Thai Stroke Soc: Volume 14, 2015

ģþ ąâğĊňüĊŇĕĠāúąŋúŇĕüüĔĨüąėü÷ĘğčüĐøĔĊãĐĆĔýÿė÷ëĐý øĔĊĐąŇĕè ğëŇü ġĆèāąĕýĕĈëěĄĠā ĄĘĐĕąěĆĠāúąŋ úŇĕü ĆŇĊĄ÷ĜĠĈġĆèāąĕýĕĈĄĎĕčĕĆåĕĄ ĐĕąěĆĠāúąŋúěâúŇĕü ĆŇĊĄ÷ĜĠĈġ÷ąĄĘĠāúąŋþĆēčĕúĊėúąĕğþŎüÿĜňĆŇĊĄ÷ĜĠĈĎĈĔâ ĠĈēğþŎüúĘħþĆęâČĕ ğëŇüğ÷ĘąĊâĔýġĆèāąĕýĕĈĆňĐąğĐĦ÷Ģü þŌ é éě ýĔ ü čŇ Ċ üĢĎîŇ ã ĐèġĆèāąĕýĕĈéēĄĐýĎĄĕąĢĎň ĐĕąěĆĠāúąŋúěâúŇĕüğþŎüÿĜňĢĎňýĆėâĕĆ ÿĜ ň Ć Ň Ċ ĄúĘ Ą éēøň Đ èþĆēâĐý÷ň Ċ ąýě å ĈĕâĆ úě â Āł ĕ ąøĔĨ è ĠøŇ úĘ Ą ĆĔ â ČĕāąĕýĕĈāüĔ â èĕüğþĈ ĠĈē þĆēëĕčĔĄāĔüûŋġĆèāąĕýĕĈ ĆĊĄúĔèĨ ğéňĕĎüňĕúĘĆħ âĔ ČĕåĊĕĄ þĈĐ÷ăĔą éĕâþĆēčýâĕĆöŋãĐèġĆèāąĕýĕĈċĆĘüåĆėüúĆŋ ĢüëŇĊèĠĆâāüĔâèĕüğĊĆğþĈģĄŇģ÷ňĐąĜŇĢüúĘĄ ğāĆĕēğĆĕĈĚĄ ĊŇĕâĕĆğãĦüğøĘąèğþŎüãĔüĨ øĐüúĘčħ ĕĬ åĔî ğāĆĕēâĕĆĆĐåėĊğĊĆ ğþĈĢüëŇĊèúĘĄħ ÿĘ þňĜ Ċł ąĢëňýĆėâĕĆéĬĕüĊüĄĕâýĕèåĆĔèĨ øňĐèĆĐ ğĊĆğþĈĄĕââĊŇĕ üĕúĘ ğéňĕĎüňĕúĘħþĆēëĕčĔĄāĔüûŋĎĆĚĐ ğéňĕĎüňĕúĘħĆĔâČĕåĊĕĄþĈĐ÷ăĔąøňĐèúĆĕýĊŇĕÿĜňþłĊąĄĘ ĐĕâĕĆĠýýĢ÷úĘħøňĐèĠüēüĬĕĢĎňÿĜňþłĊąĠĈēîĕøėğãňĕĆĔý âĕĆĆĔâČĕúĘħùĜâøňĐè âĕĆğĆėħĄğþľ÷ĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ĢüĆēąēĠĆâúĘąħ èĔ ģĄŇĄþĘ ĆēčýâĕĆöŋĎĆĚĐâĔèĊĈâĔýăĕĆēèĕü úĘħğāėħĄĄĕâãęĨü ğāĆĕēýěåĈĕâĆģĄŇğāĘąèāĐâĦčĕĄĕĆùþĆĔý ĆēýýâĕĆğþľ÷ĢĎňýĆėâĕĆğêāĕēĢüëŇĊèĊĔüğĊĈĕúĘħčē÷Ċâ âŇĐüâĦģ÷ň ģĄŇéĬĕğþŎüøňĐèğþľ÷ýĆėâĕĆøĈĐ÷ğĊĈĕĠĈēąĔèģĄŇ øňĐèþĆēëĕčĔĄāĔüûŋĢüĊèâĊňĕèéüâĊŇĕúĘĄýĆėâĕĆéēĄĔħüĢé

ĢüĆēýýĠĈēĄĘåĊĕĄāĆňĐĄğøĦĄúĘħ âĕĆĂŃĐèĆňĐèğĄĚħĐğâė÷ăĕĊēĠúĆâìňĐü âĕĆĂŃĐèĆňĐèğþŎüčėħèúĘħĠāúąŋâĔèĊĈĢéĄĕâúĘħčě÷ ğāĆĕēâĕĆĢĎňąĕ TV 2# ĄĘġĐâĕčğâė÷ăĕĊēĠúĆâìňĐü +PVTCEGTGDTCN JCGOQTTJCIG ĆňĐąĈē éĕâþĆēčýâĕĆöŋ øĆèúĘħĢĎňąĕ TV 2# ĄĕĄĕââĊŇĕ ĆĕąĠĈēĄĘăĕĊē ĠúĆâìňĐüéĬĕüĊüĎüęħèąĔèģĄŇğåąùĜâĂŃĐèĆňĐè ĠĈēĄĔħüĢé ĊŇĕâĕĆĂŃĐèĆňĐèéēģĄŇğâė÷ãęĨü ğāĆĕēâĕĆĆĔâČĕÿĜňþłĊąĄĘãĔĨü øĐüúĘħ čĬ ĕ åĔ î åĚ Đ âĕĆĐûė ý ĕąùę è ĐĕâĕĆãĔĨ ü øĐüâĕĆ Ċėüéė êĔą âĕĆĆĔâČĕ ĊėûâĘ ĕĆĆĔâČĕĠĈēâĕĆøĔ÷čėüĢéĊŇĕéēĢĎň ąĕĎĆĚĐģĄŇĢĎňąĕ ìęèħ úěâãĔüĨ øĐüĄĘâĕĆāĜ÷åěąčĚĐħ čĕĆĆēĎĊŇĕè úĘĄĆĔâČĕâĔýÿĜňþłĊąîĕøėÿĜňþłĊąøĈĐ÷ğĊĈĕ þĆēâĐýâĔý âĕĆĢĎňýĆėâĕĆúĘĄħ èŇě ĄĔüħ ĆĊ÷ğĆĦĊĠĈēéĆėèĢéúĬĕĢĎňÿþňĜ Ċł ą îĕøėÿĜňþłĊąğãňĕĢéùęèĆēýýãĔĨüøĐüâĕĆĆĔâČĕ ĠĈē åĊĕĄĄěèŇ ĄĔüħ ãĐèúĘĄÿĜĢň ĎňýĆėâĕĆąŇĐĄúĘéħ ēğþŎüâĕĆĈ÷ ġĐâĕčâĕĆĂŃĐèĆňĐè

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ğüĚħĐè÷ňĊąâĕĆġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèüĔĨüøňĐèğüňü âĕĆčŇèğčĆėĄþŃĐèâĔü ĠĈēâĕĆĂŁüŐ ĂĜčăĕāĆŇĊĄ÷ňĊą ģĄŇĢëŇĄĘ ğêāĕē 5VTQMG (CUV 6TCEM ğúŇĕüĔĨü ÷ĔèüĔĨüâĕĆčĆňĕèğåĆĚĐ ãŇĕąúĘħčĄýĜĆöŋüĔĨüøňĐèâĆēøěňüĢĎňĠøŇĈēčùĕüāąĕýĕĈĄĘ âĕĆčĆňĕèúĘĄúĘħåĆýĊèéĆĠýýĐèåŋĆĊĄ÷ňĊąğčĄĐ

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J Thai Stroke Soc: Volume 14, 2015

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âĕĆþŃ Đ èâĔ ü ġĆåĠĈēčŇ è ğčĆė Ą čě ã ăĕāĢĎň ĆĜ ň ğ úŇ ĕ ĠĈēĆĜňúĔü åĚĐ ğĆĕéēøňĐèĆĜňğúŇĕĊŇĕéēþŃĐèâĔüģĄŇĢĎňğâė÷ ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģ÷ňĐąŇĕèģĆ ĠĈēğĄĚħĐğâė÷ġĆåãęĨüĠĈňĊ øňĐèĆĜňúĔüùęèĊėûĘâĕĆĆĔâČĕĊŇĕøňĐèúĬĕĐąŇĕèģĆ ğëŇü øňĐèĆĘý ģþġĆèāąĕýĕĈúĔüúĘ ğþŎüøňü ĠüĊúĕèâĕĆ÷ĬĕğüėüèĕüþĆēâĐý÷ňĊą čŇĊü ģ÷ňĠâŇ ĆĜğň úŇĕâĕĆþŃĐèâĔüģĄŇĢĎňğâė÷ġĆå ġ÷ąâĕĆĆöĆèåŋ åĊĕĄĆĜňğâĘħąĊâĔýġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ÷ĔèüĘĨ ĐĕâĕĆãĐèġĆåčĕğĎøěþŌééĔąğčĘħąè âĕĆ÷ĜĠĈĆĔâČĕğýĚĨĐèøňüúĘħğĎĄĕēčĄ ĠĈēĆĘýāĕģþ ġĆèāąĕýĕĈúĔüúĘğĄĚħĐĄĘĐĕâĕĆ åĊĕĄéĬ ĕ ğþŎ ü ãĐèâĕĆĆĘ ý ĄĕġĆè āąĕýĕĈúĔüúĘ âĕĆĆĔâČĕ÷ňĊąâĕĆĢĎňąĕĈēĈĕąĈėħĄ ğĈĚĐ÷ĄĘãňĐ÷ĘãňĐğčĘąĐąŇĕèģĆ âĕĆĆĔâČĕøŇĐğüĚħĐèğāĚħĐþŃĐèâĔüģĄŇ ĢĎňğþŎüìĬĨĕĆĊĄúĔĨèâĕĆþĆĔýāćøėâĆĆĄğāĚħĐĈ÷þŌééĔąğčĘħąè ãĐèâĕĆğâė÷ġĆå čĆňĕèåĊĕĄĆĜňåĊĕĄğãňĕĢéúĘħùĜâøňĐè ğâĘąħ ĊâĔýġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøŇĐëěĄëüğāĚĐħ âĕĆ÷ĜĠĈëŇĊą ğĎĈĚĐÿĜňþłĊąúĘħùĜâøňĐè čĆňĕèåĊĕĄĆĜňåĊĕĄğãňĕĢéúĘħùĜâøňĐè øŇĐčĚħĐčĕĆĄĊĈëüğāĚħĐâĕĆþĆēëĕčĔĄāĔüûŋãňĐĄĜĈøŇĕèĥ úĘħ ùĜâøňĐèøŇĐčĔèåĄ čĆňĕèåĊĕĄĆĜňåĊĕĄğãňĕĢéúĘħùĜâøňĐè øŇĐåĆĜüĔâğĆĘąüğāĚħĐâĕĆčĆňĕèåĊĕĄĆĜňúĘħąĔħèąĚü âĕĆĆöĆèåŋĊüĔ 9QTNF 5VTQMG &C[ ğāĚħĐĢĎňğâė÷âĕĆøĆēĎüĔâøŇĐġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĠýý ĊèâĊňĕèúĔħĊéĔèĎĊĔ÷ĠĈēāĚĨüúĘħãňĕèğåĘąè âĕĆéĔ÷úĬĕĎüĔèčĚĐğĐâčĕĆğÿąĠāĆŇ åĊĕĄĆĜňøŇĐÿĜňþłĊąîĕøėþĆēëĕëüúĔħĊģþ âĕĆþĆēëĕčĔĄāĔüûŋÿŇĕüčĚħĐøŇĕèĥ ğëŇü Ċėúąě ġúĆúĔċüŋ ĎüĔèčĚĐāėĄāŋ ğĊĦýģì÷ŋ âĕĆéĔ÷úĬĕğāĈèĎĄĐĈĬĕğāĈèåěö ĈĬĕģąĠĈēâĕĆŋøĜüğāĚħĐâĕĆĆöĆèåŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè âĕĆéĔ÷úĬĕĎüĔèčĚĐ ĐĔüøĆĕąġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèĠĈēĎüĔèġçČöĕ

ĆĜňúĔüĊėûĘâĕĆĆĔâČĕġ÷ąâĕĆĆöĆèåŋĢĎňÿĜňþłĊąúĘħ ĄĘĐĕâĕĆğãňĕâĔýġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĆĘýģþāýĠāúąŋúüĔ úĘ ğāĆĕēâĕĆĆĔâČĕúĘħ÷ĘúĘħčě÷ĎĈĔèéĕâĄĘĐĕâĕĆ åĚĐ âĕĆĆĘýģþ ġĆèāąĕýĕĈúĔüúĘğāĚħĐĢĎňĠāúąŋģ÷ňĆĘýþĆēğĄėüĐĕâĕĆĠĈē ĢĎňâĕĆĆĔâČĕúĘħùĜâøňĐèøŇĐģþ ġ÷ąâĕĆĢëňĊėûĘâĕĆğëŇüğ÷ĘąĊ âĔýãňĐ ġ÷ąğüňüĢĎňúěâåüúĆĕýĊŇĕùňĕĄĘĐĕâĕĆúĘħğãňĕĆĔý ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøňĐèĆĘýģþġĆèāąĕýĕĈúĔüúĘġ÷ąĢëň ĆēýýĆùāąĕýĕĈ '/5 ãĐèĎüŇĊąĆĕëâĕĆĠĈēğüňüĊŇĕģĄŇ åĊĆčĔèğâøĐĕâĕĆøňĐèĆĘýģþġĆèāąĕýĕĈúĔüúĘ üĐâéĕâüĘĨąĔèúĬĕèĕüĆŇĊĄâĔüâĔýĆēýýâĕĆĢĎň ýĆėâĕĆêěâğêėü '/5 ğāĚħĐčĆňĕèåĊĕĄğãňĕĢéúĘħùĜâøňĐèĊŇĕ ĆēýýâĕĆĠāúąŋêěâğêėü '/5 üĔĨüĢĎňýĆėâĕĆÿĜňþłĊąġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐè÷ňĊąĄėĢëŇğêāĕēÿĜňþłĊąĐěýĔøėğĎøěúĕè ĆùąüøŋğúŇĕüĔüĨ ğāĆĕēúĘÿħ ĕŇ üĄĕĄĘÿþňĜ Ċł ąčŇĊüüňĐąĄĕâúĘĢħ ëň ýĆėâĕĆĆēýýâĕĆĠāúąŋêěâğêėü '/5 ĐĕéğüĚħĐèĄĕéĕâĄĘ åĊĕĄğãň ĕ Ģéÿė ÷ ãĐèþĆēëĕëüúĔħ Ċ ģþþĆēëĕčĔ Ą āĔ ü ûŋ ĎĄĕąğĈãġúĆċĔāúŋ ĠĈēĎĄĕąğĈãġúĆċĔāúŋĎňĐè êěâğêėüġĆèāąĕýĕĈğåĆĚĐãŇĕąğāĚĐħ ĢĎňÿþňĜ Ċł ąčĕĄĕĆùğãňĕùęè ĆēýýâĕĆýĆėâĕĆģ÷ňèŇĕąãęĨüéęèĄĘåĊĕĄéĬĕğþŎüĐąŇĕèąėħè âĕĆéĔ÷úĬĕãĔüĨ øĐüâĕĆ CEVKXCVG UVTQMG HCUV VTCEM ãĔĨüøĐü ĢüĆĜþĠýýãĐèăĕāąüøŋğāĚħĐĢĎňþĆēëĕëüģ÷ň ğãňĕĢéèŇĕąãęüĨ ĆĊĄúĔèĨ âĕĆúĬĕĎüĔèġçČöĕğâĘąħ ĊâĔý 5VTQMG (CUV 6TCEM ġ÷ąĄĘâĕĆüĬĕğčüĐÿŇĕüčĔèåĄĐĐüģĈüŋ

ÐāòíĀáèāòÿééùŚÖäŚüæĄēðĄêòÿùăæçăïāí ģ÷ňĠâŇ

āĔõüĕĆēýýčŇèøŇĐúěâĆē÷Ĕý éĕâĆē÷ĔýëěĄëü ùęèġĆèāąĕýĕĈúĘħčĕĄĕĆùĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷ģ÷ň ĠĈē čŇèâĈĔýğāĚħĐĢĎňâĕĆĆĔâČĕøŇĐğüĚħĐè āĔõüĕĆēýýčŇèøŇĐéĕâġĆèāąĕýĕĈúĘħģĄŇĄĘ ĆēýýýĆė â ĕĆúĕè÷Ň Ċ üġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèčŇ è øŇ Đ ġĆèāąĕýĕĈúĘħĄĘĆēýýĆĊ÷ğĆĦĊĠĈēĠĄŇüąĬĕ ğāĚħĐĢĎňÿĜňþłĊą ĄĘġĐâĕčģ÷ňĆĔýąĕĈēĈĕąĈėħĄğĈĚĐ÷

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ğþŎüĆēýýúĘħčĬĕåĔîğāĆĕēÿĜňþłĊąýĕèčŇĊüģĄŇĎĕą ğþŎüþâøėéĬĕğþŎüøňĐèģ÷ňĆĔýâĕĆĂŁŐüĂĜğāĚħĐþŃĐèâĔüăĕĊē ĠúĆâìňĐüĠĈēčŇèğčĆėĄâĕĆĂŁŐüĂĜčĄĆĆùăĕā ğāĚħĐĢĎň ÿĜňþłĊąĢëňëĘĊėøģ÷ňĐąŇĕè÷ĘúĘħýňĕü âĕĆğąĘħąĄýňĕüÿĜňþłĊąúĘħģĄŇ čĕĄĕĆù÷ĜĠĈøüğĐèģ÷ň÷âĘ ĄĦ åĘ ĊĕĄéĬĕğþŎüğāĚĐħ ğþŎüâĕĆğčĆėĄ āĈĔèĐĬĕüĕéãĐèÿĜňþłĊąĠĈēåĆĐýåĆĔĊĢüâĕĆ÷ĜĠĈčěãăĕā

J Thai Stroke Soc: Volume 14, 2015

ĠĈēąĔèčĕĄĕĆùĈ÷åŇĕĢëňéĕŇ ąĢüâĕĆğ÷ėüúĕèĄĕġĆèāąĕýĕĈ

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ğāĚħĐčĆňĕèĐèåŋåĊĕĄĆĜňĢĎĄŇġ÷ąğüňüâĕĆāĔõüĕ èĕüþĆēéĬĕčĜèŇ ĕüĊėéąĔ ĠĈēüĬĕåĊĕĄĆĜúň ģĘħ ÷ňéĕâèĕüĊėéąĔ ĄĕčĜŇ âĕĆþñėýĔøėĆĊĄúĔĨèâĕĆĠâňþŌîĎĕúĘħāýýŇĐąĢüăĕåøēĊĔü ĐĐâğêĘąèğĎüĚĐ éęèğþŎüúĘħĄĕãĐèâĕĆéĔ÷øĔĨèâĈěŇĄĊėéĔąġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐè ăĕåøēĊĔüĐĐâğêĘąèğĎüĚĐ ğāĚħĐċęâČĕ þŌîĎĕúĘħāýýŇĐąĠĈēĠâňþŌîĎĕĐąŇĕèğþŎüĆēýý ĆĊĄúĔĨè čĆňĕèĐèåŋåĊĕĄĆĜĢň ĎĄŇĠĈēüĊĔøâĆĆĄ ğëŇü ğåĆĚĐħ èëĔèħ üĬĕĨ ĎüĔâ ÿĜňþłĊąúĘħĄĘĆĕåĕùĜââĊŇĕčĔħèìĚĨĐéĕâøŇĕèþĆēğúċğþŎüøňü

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âĕĆāĔõüĕğåĆĚĐãŇĕąýĆėâĕĆ + 5CP 5VTQMG (CUV 6TCEM ğþŎüčėħèúĘħéĬĕğþŎüĄĕâĢüâĕĆĢĎňýĆėâĕĆ 5VTQMG (CUV 6TCEM ğāĆĕēĆēąēğĊĈĕ üĕúĘúĐèčĬĕĎĆĔýÿĜňþłĊąüĔĨü čĔĨüĄĕâ âĕĆčĆňĕèğåĆĚĐãŇĕąéęèğþŎüâĕĆčĆňĕèġĐâĕčĢĎň ÿĜ ň þ ł Ċ ą åĊĕĄéĆė è ĢéãĐèĠĄŇ ã Ň ĕ ąâĔ ý ĈĜ â ãŇ ĕ ąĢü âĕĆúĬĕèĕüĆŇĊĄâĔüåĊĕĄøŇĐğüĚħĐèčĄĬħĕğčĄĐğþŎüčėħè čĬĕåĔî ğāĚħĐğþŎüâĕĆčĆňĕèĄĕøĆòĕüâĕĆĢĎňýĆėâĕĆúĘħčĆňĕè åĊĕĄĄĔħ ü ĢéĢĎň âĔ ý ÿĜ ň ĆĔ ý ýĆė â ĕĆĊŇ ĕ ĄĘ Ą ĕøĆòĕüğ÷Ę ą ĊâĔ ü âĕĆúĬĕèĕüğāĘąèĈĬĕāĔèéēĄĘâĕĆāĔõüĕèĕüģ÷ňëĕň ĠĈēčĆňĕè þĆėĄĕöèĕüģ÷ňüňĐą ğþĆĘąýğčĄĚĐüâĕĆýĊâğĈã ĄĘåŇĕğúŇĕâĔý ĠøŇâĕĆāĔõüĕğåĆĚĐãŇĕąéēúĬĕĢĎňĄĘ âĕĆāĔõüĕèĕüĠĈēčĆňĕèþĆėĄĕöèĕüģ÷ňĄĕâĠýý âňĕĊâĆēġ÷÷ğþĆĘąýğčĄĚĐüâĕĆýĊâğĈã Đĕé úĬĕĢĎňĄåĘ ĕŇ ğúŇĕâĔý ĐąŇĕèģĆâĦøĕĄâĕĆčĆňĕè ğåĆĚĐãŇĕąøňĐèĄĘåĊĕĄĄěèŇ ĄĔüħ ĠĈēéĆėèĢéãĐèĠĄŇãĕŇ ą ĈĜâãŇĕą úěâåüĢüúĘĄ ĠĈēúĬĕèĕüĆŇĊĄâĔüĐąŇĕèøŇĐğüĚħĐèøĈĐ÷ģþ þŌééěýĔüğåĆĚĐãŇĕąâĕĆýĆėâĕĆġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆý ĊèéĆğãø ĄĘâĕĆāĔõüĕĐąŇĕèøŇĐğüĚħĐè âĬĕĎü÷øĔĊëĘĨĊĔ÷ ãĐèğãøĆŇĊĄâĔü ğāĚħĐâĕĆāĔõüĕúĘħĄĘğĐâăĕāĢüúėċúĕè ğ÷ĘąĊâĔüĆĊĄúĔĨèâĕĆâĬĕĎü÷ĆŇĕè UGTXKEG RNCP âĕĆčĆň ĕ èğåĆĚ Đ ãŇ ĕ ąúĘħ č ĄýĜ Ć öŋ é ēøň Đ èāĔ õ üĕ ğåĆĚĐãŇĕąâĕĆĊėéĔąĆŇĊĄ÷ňĊąğāĚħĐâĕĆāĔõüĕèĕüþĆēéĬĕčĜŇ èĕüĊėéąĔ ĠĈēüĬĕèĕüĊėéąĔ ĄĕčĜâŇ ĕĆþñėýøĔ ė ìęèħ úĕèğåĆĚĐãŇĕą ãĐèğãø âĦģ÷ňéĔ÷øĔĨèâĈěŇĄĊėéĔąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèăĕå øēĊĔüĐĐâğêĘąèğĎüĚĐğāĚħĐâĕĆāĔõüĕèĕüĊėéĔą éĕââĕĆ āĔõüĕğåĆĚĐãŇĕąâĕĆýĆėâĕĆ 5VTQMG (CUV 6TCEM ãĐè ğãø ĆňĐąĠâŇüčĕĆčėüûěŋ ĢüþŌééěĔýüþĆēëĕëüĄĘġĐâĕč

J Thai Stroke Soc: Volume 14, 2015

âĕĆğãň ĕ ùę è ýĆė â ĕĆčĜ è ĄĕâãęĨ ü ĄĘ ÿĜ ň þ ł Ċ ąģ÷ň ĆĔ ý ąĕ TV 2# åė÷ğþŎüĆňĐąĈē ãĐèÿĜňþłĊą CEWVG KUEJGOKE UVTQMG ìęħèčĜèâĊŇĕåŇĕğêĈĘħąãĐèþĆēğúċģúąúĘħĆňĐąĈē ģ÷ňĆĔý âĕĆúĬĕ %6 UECP DTCKP ĄĕââĊŇĕĆňĐąĈē ãĐèÿĜňþłĊą CEWVG UVTQMG ģ÷ňĆĔýâĕĆúĬ ĕâĕąăĕāýĬĕýĔ÷ĄĕââĊŇĕ ĆňĐąĈē úĘüħ ĕŇ ăĕåăĜĄĢė é åĚĐ âĕĆĆŇĊĄĄĚĐãĐèúĘĄčěãăĕā ĢüăĕåĐĘčĕüúěâġĆèāąĕýĕĈĠĈēğåĆĚĐãŇĕąčěãăĕāĢü úěâéĔèĎĊĔ÷ čĕĄĕĆùğþľ÷ýĆėâĕĆĆēýý 5VQMG (CUV 6TCEM ĠĈēčĕĄĕĆùĢĎňąĕ TV 2# ģ÷ňåĆýúěâġĆèāąĕýĕĈéĔèĎĊĔ÷ ĠĈēġĆèāąĕýĕĈëěĄëüãüĕ÷ĢĎîŇ čŇèÿĈĢĎňÿĜňþłĊąĢü úěâāĚĨüúĘħĄĘġĐâĕčģ÷ňĆĔýýĆėâĕĆúĘħ÷ĘĄĘåěöăĕāğúŇĕğúĘąĄâĔü úĔħĊúĔĨèăĕåĐĘčĕü ğåĆĚĐãŇĕąâĕĆýĆėâĕĆġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèéē þĆēčýåĊĕĄčĬĕğĆĦéĢüâĕĆāĔõüĕĆēýýâĕĆýĆėâĕĆġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆĎĆĚĐģĄŇ þĆēëĕëüĄĘåěöăĕā ëĘĊėøúĘħ÷ĘãęĨüĎĆĚĐģĄŇ úĔĨèĎĄ÷ĐąĜŇăĕąĢøňåĊĕĄúěŇĄğúãĐèúĘĄ čěãăĕā ăĕąĢøňĎĈĔââĕĆúĬĕèĕü åĚĐ âĕĆúĬĕèĕüúĘħĢëňĢé üĬĕ ĠĈēúĬĕèĕü÷ňĊąĎĔĊĢéãĐèúěâåü

ġëå÷ĘåĆĔýåüģúąúěâåü

éæÓĀãñŚü

åĊĕĄëěâġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĢüâĈěŇĄþĆēëĕâĆĐĕąě þĿ åĚĐ øŇĐþĆēëĕâĆ åü âĕĆĆĔâČĕčĄĐèãĕ÷ğĈĚĐ÷ğêĘąýāĈĔü÷ňĊąąĕĈēĈĕąĈėħĄğĈĚĐ÷ăĕąĢü üĕúĘ ğþŎüâĕĆĆĔâČĕĄĕøĆòĕü ġ÷ąğĆėĄħ ĄĘâĕĆĆĕąèĕüÿĈâĕĆĆĔâČĕåĆĔèĨ ĠĆâĢüþĆēğúċģúąĢüþĿ ĢüÿĜňþłĊą Ćĕą øŇĐĄĕĄĘâĕĆĢëňĄĕâãęĨü ĠøŇâĦéĬĕâĔ÷ğêāĕēĢüġĆèāąĕýĕĈğĐâëüãüĕ÷ĢĎîŇĢüâĆěèğúāĠĈēĢüġĆèğĆĘąüĠāúąŋğúŇĕüĔĨü ĢüþĿ ĐĔøĆĕ âĕĆģ÷ňĆýĔ ąĕĈēĈĕąĈėĄħ ğĈĚĐ÷øĬĕħ Ąĕâĥ åĚĐ ĆňĐąĈē ğúŇĕüĔüĨ ğāĆĕēþĆēëĕëüĢüøŇĕèéĔèĎĊĔ÷âĊŇĕ Ĉňĕüåü ģĄŇĄĘġĐâĕčģ÷ňĆĔýąĕĈēĈĕąĈėħĄğĈĚĐ÷ ğüĚħĐèéĕâãňĐéĬĕâĔ÷÷ňĕüýěååĈĕâĆ ğåĆĚħĐèĄĚĐĠāúąŋ ĠĈēúĘĄčěãăĕā ġ÷ąğêāĕēĢüăĕåøēĊĔüĐĐâğêĘąèğĎüĚĐ þĆēëĕâĆ Ĉňĕüåü ĄĘþĆēčĕúĠāúąŋğāĘąè åüĢü éĔèĎĊĔ÷ ĢĎîŇĥ ğúŇĕüĔĨü âĕĆúĘħéēúĬĕĢĎňĄĘâĕĆğãňĕùęèĆēýýâĕĆĆĔâČĕ÷ňĊąąĕĈēĈĕąĈėħĄğĈĚĐ÷ĢüÿĜňþłĊąčĄĐèãĕ÷ğĈĚĐ÷ ğêĘąýāĈĔüģ÷ňüĔĨü øňĐèĄĘâĕĆýĆėĎĕĆéĔ÷âĕĆúĘħ÷Ę ĐĕąěĆĠāúąŋčĕĄĕĆùĢĎňâĕĆĆĔâČĕĠúüþĆēčĕúĠāúąŋģ÷ň þĆēëĕëüøňĐèĄĘĊĕĄĆĜňğâĘħąĊâĔýġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè úĘĄčěãăĕāøňĐèāĆňĐĄ ğåĆĚĐèĄĚĐúĕèâĕĆĠāúąŋ ğëŇü ğĐâìğĆąŋåĐĄāėĊğøĐĆŋøĐň èĄĘâĕĆâĆēéĕąøĔĊúĘ÷ħ Ę ÷ĔèüĔüĨ ğåĆĚĐãŇĕąâĕĆýĆėâĕĆéęèĄĘåĊĕĄéĬĕğþŎüĢüâĕĆāĔõüĕĆēýý ýĆėâĕĆ ğåĆĚĐãŇĕąýĆėâĕĆþĆēâĐý÷ňĊą ĠĄŇãŇĕąĠĈēĈĜâãŇĕą ĠĄŇãŇĕąģ÷ňĠâŇ ġĆèāąĕýĕĈĆē÷ĔýøøėąăĜĄė ĄĘåĊĕĄ čĕĄĕĆùĢüâĕĆĢĎňâĕĆĆĔâČĕ÷ňĊąąĕĈēĈĕąĈėħĄğĈĚĐ÷ĠĈēčĕĄĕĆùĢĎňåĬĕþĆęâČĕøŇĐĈĜâãŇĕą ĎüňĕúĘħãĐèĠĄŇãŇĕą åĚĐ ĢĎňâĕĆĆĔâČĕ÷ňĊąąĕĈēĈĕąĈėħĄğĈĚĐ÷ ĄĘĆēýýýĆėâĕĆÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆ éĔ÷úĬĕ ĠüĊúĕèâĕĆĆĔâČĕÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĢĎňåĬĕþĆęâČĕġĆèāąĕýĕĈĈĜâãŇĕą ĄĘĆēýýøė÷øĕĄâĕĆĢĎň ýĆėâĕĆãĐèġĆèāąĕýĕĈĈĜâãŇĕą ĠĈē âĕĆþĆēëěĄĊėëĕâĕĆĆēĎĊŇĕèġĆèāąĕýĕĈĢüğåĆĚĐãŇĕąğþŎüþĆēéĬĕ âĕĆāĔõüĕğåĆĚĐãŇĕąýĆėâĕĆġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħĄĘþĆēčėúûėăĕāčŇèÿĈĢĎňâĕĆýĆėâĕĆĆĔâČĕ÷ňĊąąĕ ĈēĈĕąĈėĄħ ğĈĚĐ÷úĔĊħ úĔèĨ þĆēğúċčĜèãęüĨ ğþŎüĆňĐąĈē ĢüþĿ ġ÷ąÿĈâĕĆĔâČĕģĄŇĠøâøŇĕèâĔüĆēĎĊŇĕèþĆēčĕú ĠāúąŋĠĈēĐĕąěĆĠāúąŋ

J Thai Stroke Soc: Volume 14, 2015

ÐāòíĀáèāċÓòĆüÑŚāñÐāòùŚÖäŚüëĈśêŕöñčòÓúôüãċôĆüãùðüÖ ðúāöăæñāôĀñçòòð÷āùäòŞ 5IBNNBTBU 4USPLF /FUXPSL

ò÷ íÜ íòïĀæò çòòðùčòÙ ò÷ èí ùðéĀäă ðćŚÖæöĄíÖøā úèŚöñêòÿùāæöăæñā ïāÓöăÙāüāñćò÷āùäòŞ ÓâÿČíæñ÷āùäòŞ ðúāöăæñāôĀñçòòð÷āùäòŞ 1PSOQBUS %IBSNBTBSPKB . % 4PNCBU .VFOHUBXFFQPOHTB . % Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Thammasat University $PSSFTQPOEJOH BVUIPS 1PSOQBUS %IBSNBTBSPKB . % Associate Professor in Neurology, Division of Neurology, Faculty of Medicine, Thammasat University, Klong 1, Klong Luang, Pathumthani 12120, Thailand Email: pornpatr1@hotmail.com

J Thai Stroke Soc: Volume 14, 2015

Abstract

4USPLF JT POF PG UIF DPNNPO EJTFBTFT JO HFOFSBM QSBDUJDF *OUSBWFOPVT UISPNCPMZTJT JT BQQSPWFE BT B TUBOEBSE USFBUNFOU JO FMJHJCMF QBUJFOUT XJUI BDVUF JTDIFNJD TUSPLF XJUIJO IPVST BGUFS TUSPLF POTFU BOE XJUIPVU DPOUSBJOEJDBUJPOT XIJDI DBO JNQSPWF UIF SBUF PG HPPE SFDPWFSZ CZ 5IVT UIF QSPDFTT PG UBLJOH DBSF PG UIFTF QBUJFOUT JO BDVUF QIBTF NVTU CF XFMM PSHBOJ[FE BOE SBQJE 4USPLF 'BTU 5SBDL 4USPLF /FUXPSL BOE 5FMFNFEJDJOF CFDPNF UIF BOTXFST *NQMFNFOUBUJPO PG 5IBNNBTBU 4USPLF /FUXPSL BOE UFMFNFEJDJOF EJE JODSFBTF UIF SBUF PG JOUSBWFOPVT UISPNCPMZUJD USFBUNFOU GSPN UP XJUI HPPE SFDPWFSZ SBUF BOE MPX SBUF PG TZNQUPNBUJD JOUSBDFSFCSBM IFNPSSIBHF (J Thai Stroke Soc 2015; 14: 14-22.) ,FZXPSET 5FMFNFEJDJOF 4USPLF /FUXPSL 4USPLF

ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèğþŎüġĆåúĘħāýýŇĐąĢüğĊë þñėýøĔ ė éĕââĕĆċęâČĕ 6JCK 'RKFGOKQNQIKE 5VTQMG 6'5 úĘħúĬĕâĕĆċęâČĕĢüëŇĊèþĿ ā ċ ùęèþĿ ā ċ āýĊŇĕ åĊĕĄëěâãĐèġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĐąĜŇúĘħĆňĐąĈē ĎĆĚĐ ĆĕąøŇĐ ĢüþĆēëĕâĆĐĕąě ùęè þĿ1 ğþŎüġĆåúĘħĄĘĐĔøĆĕâĕĆğčĘąëĘĊėøĠĈēåĊĕĄāėâĕĆ čĜè ÿĜňþłĊąéēĄĕāýĠāúąŋ÷ňĊąĐĕâĕĆÿė÷þâøėúĕèĆēýý þĆēčĕúúĘħğêĘąýāĈĔü þŌééěýĔüĄĘâĕĆāĔõüĕâĕĆĆĔâČĕ ÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔü ġ÷ąğêāĕē âĕĆĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷úĕèĎĈĐ÷ğĈĚĐ÷÷Ĭĕ ğāĚħĐĎĊĔèÿĈ Ĉ÷åĊĕĄāėâĕĆéĕâġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģ÷ňùèę ĆňĐąĈē 2 ĠøŇğüĚħĐèéĕââĕĆĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷úĕèĎĈĐ÷ğĈĚĐ÷÷Ĭĕ üĔĨüéĬĕğþŎüøňĐèĢĎňĢüÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈē Đě÷øĔüăĕąĢü ëĔĊħ ġĄèåĆęèħ ĎĈĔèğâė÷ĐĕâĕĆ3 ÷ĔèüĔüĨ éęèøňĐè ĄĘâĕĆéĔ÷ĆēýýâĕĆ÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘý ĠĈēĐě÷øĔüĢüĆēąēğêĘąýāĈĔü 5VTQMG HCUV VTCEM úĘħĄĘ ĠüĊúĕèþñėýøĔ ëė ÷Ĕ ğéüĠĈēĆĊ÷ğĆĦĊ ğāĚĐħ ğāėĄħ þĆėĄĕöÿĜþň Ċł ą ĢĎňğãňĕùęèĠĈēģ÷ňĆĔýâĕĆĆĔâČĕ÷ňĊąąĕĈēĈĕąĈėħĄğĈĚĐ÷úĕè ĎĈĐ÷ğĈĚĐ÷÷Ĭĕģ÷ňúĔüăĕąĢüğĊĈĕúĘħâĬĕĎü÷ ğüĚħ Đ èéĕâĄĘ ã ň Đ éĬ ĕ âĔ ÷ ÷ň ĕ üéĬ ĕ üĊüýě å ĈĕâĆúĘħ ğëĘħąĊëĕîĢüâĕĆ÷ĜĠĈÿĜňþłĊąġĆåüĘĨ ĆĊĄùęèğåĆĚħĐèĄĚĐúĘħ úĔüčĄĔąĢüâĕĆøĆĊéĊėğåĆĕēĎŋğāėħĄğøėĄĢüþĆēğúċģúą ÷ĔèüĔĨüéęèĄĘâĕĆāĔõüĕčĆňĕèğåĆĚĐãŇĕąâĕĆčŇèøŇĐĠĈē÷ĜĠĈ ÿĜ ň þ ł Ċ ąġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèøĘ ý ĠĈēĐě ÷ øĔ ü 5VTQMG 0GVYQTM ãęĨüĄĕ ĆŇĊĄâĔýâĕĆþĆēąěâøŋĢëňğúåġüġĈąĘĢü âĕĆøė÷øŇĐčĚħĐčĕĆ ĆĔý čŇèãňĐĄĜĈúĘħĄĘåĊĕĄĈēğĐĘą÷ ùĜâøňĐè ĠĈēğëĚħĐùĚĐģ÷ň ğāĚħĐĢĎňâĕĆ÷ĜĠĈĆĔâČĕÿĜňþłĊąğþŎüģþĐąŇĕèĄĘ þĆēčėúûėăĕā ĆĊ÷ğĆĦĊ ĠĈēúĔħĊùęè ğĆĘąâĊŇĕ ġúĆğĊëâĆĆĄ (telemedicine) þŌ é éě ýĔ ü ğåĆĚ Đ ãŇ ĕ ąâĕĆčŇ è øŇ Đ ĠĈē÷Ĝ Ġ ĈÿĜ ň þ ł Ċ ą ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔü ĄěŇèğüňüúĘħâĕĆčŇèøŇĐ ÿĜňþłĊąúĘħğãňĕãŇĕąčĕĄĕĆùģ÷ňĆĔýâĕĆĆĔâČĕ÷ňĕąąĕĈēĈĕą ĈėħĄğĈĚĐ÷úĕèĎĈĐ÷ğĈĚĐ÷÷Ĭĕ éĕâġĆèāąĕýĕĈëěĄëüğãňĕčĜŇ ġĆèāąĕýĕĈĢĎîŇúĄĘħ ċĘ âĔ ąăĕāĢüâĕĆ÷ĜĠĈÿĜþň Ċł ąġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèĆēąēğêĘąýāĈĔü ğāĚħĐĢĎňÿĜňþłĊąčĕĄĕĆùģ÷ňĆĔý âĕĆĆĔâČĕ÷ňĊąąĕĈēĈĕąĈėĄħ ğĈĚĐ÷úĕèĎĈĐ÷ğĈĚĐ÷÷Ĭĕ ĎĆĚĐ âĕĆĆĔâČĕĐĚħüĥ ğëŇü GPFQXCUEWNCT VTGCVOGPVU úĘħĄĘéě÷ þĆēčèåŋĎĈĔâğāĚħĐğþľ÷ĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħĐě÷øĔüĐąŇĕèúĔü úŇ Ċ èúĘ ĄĘ â ĕĆāĔ õ üĕğåĆĚ Đ ãŇ ĕ ąĎĈĕąğåĆĚ Đ ãŇ ĕ ąĢü

þĆēğúċģúą ĢüýúåĊĕĄüĘĨéēâĈŇĕĊùęè ãýĊüâĕĆéĔ÷âĕĆ 5VTQMG (CUV 6TCEM ĠĈēğåĆĚ Đ ãŇ ĕ ąâĕĆ÷Ĝ Ġ ĈÿĜ ň þ ł Ċ ą ġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèãĐèĄĎĕĊė ú ąĕĈĔ ą ûĆĆĄċĕčøĆŋ

6JCOOCUCV 5VTQMG 0GVYQTM ìęħèĄĘâĕĆþĆēąěâøŋĢëň ġúĆğĊëâĆĆĄ VGNGOGFKEKPG ĆŇĊĄ÷ňĊąĢüâĕĆ÷ĜĠĈÿĜňþłĊą

4USPLF 'BTU 5SBDL

ğāĚħĐĢĎňâĕĆ÷ĬĕğüėüèĕüãĐè UVTQMG HCUV VTCEM ğþŎ ü ģþĐąŇ ĕ èĄĘ þ Ćēčė ú ûė ă ĕā éę è ģ÷ň ĄĘ â ĕĆĠýŇ è čŇ Ċ ü âĕĆþñėýĔøėâĕĆ UVTQMG HCUV VTCEM øĕĄĈĬĕ÷ĔýâĕĆ÷Ĭĕğüėü èĕüğþŎü čŇĊüąŇĐą åĚĐ &GVGEVKQP &KURCVEJ &GNKXGT[ &QQT &CVC &GEKUKQP &TWI ĠĈē &KURQUKVKQP ĎĆĚĐ úĘħĄĘëĚħĐąŇĐčĔĨüĥøĕĄĐĔâČĆøĔĊĠĆâãĐèĠøŇĈēãĔĨüøĐüĊŇĕ &U ġ÷ą &GVGEVKQP &KURCVEJ ĠĈē &GNKXGT[ ğþŎü ãĔüĨ øĐüúĘğħ âė÷âŇĐüÿĜþň Ċł ąĄĕùęèġĆèāąĕýĕĈ čŇĊü &GNKXGT[ &QQT &CVC &GEKUKQP &TWI ĠĈē &KURQUKVKQP ğþŎü ãĔĨüøĐüúĘħğâė÷ĎĈĔèÿĜňþłĊąĄĕùęèġĆèāąĕýĕĈĠĈňĊ3 - Detection ĎĄĕąùęè âĕĆúĘħþĆēëĕëüúĔħĊģþ čĕĄĕĆùýĐâùęèĐĕâĕĆãĐèġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģ÷ňĐąŇĕè ĆĊ÷ğĆĦĊøĔĨèĠøŇğĆėħĄĄĘĐĕâĕĆ GCTN[ TGEQIPKVKQP ġ÷ąøňĐè ĄĘâĕĆĢĎňåĊĕĄĆĜĠň âŇþĆēëĕëüğâĘąħ ĊâĔýĊėûâĘ ĕĆčĔèğâøĐĕâĕĆ úĘħ è Ň ĕ ąĠĈēĄĘ þ Ćēčė ú ûė ă ĕā Ċė ûĘ â ĕĆúĘħ ĄĘ Ģ ëň Ģ üþŌ é éě ýĔ ü ĄĘ ĢĎň ğ ĈĚ Đ âĎĈĕąĆēýý ĠøŇ Ć ēýýúĘħ üė ą ĄĢëň Ą ĕâúĘħ čě ÷ åĚ Đ %KPEKPPCVK 2TG JQURKVCN 5VTQMG 5ETGGPKPI ìęħèĆēýýüĘĨ ĄĘâĕĆċęâČĕúĘħąĚüąĔüģ÷ňĊŇĕ ĄĘåĊĕĄğĎĄĕēčĄĢüâĕĆüĬĕĄĕ ĢëňĆŇĊĄâĔý UVTQMG HCUV VTCEM ĠĈē âĕĆĢĎňąĕĈēĈĕąĈėħĄ ğĈĚ Đ ÷úĕèĎĈĐ÷ğĈĚ Đ ÷÷Ĭ ĕ ĐĘ â úĔĨ è ĄĘ â ĕĆċę â ČĕúĘħ ąĚ ü ąĔ ü ĊŇ ĕ čĕĄĕĆùčĐüĢĎň þ ĆēëĕëüúĔħ Ċ ģþğãň ĕ Ģéģ÷ň è Ň ĕ ą ċĜ ü ąŋ ğ ëĘħ ą ĊëĕîġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐè ĄĎĕĊė ú ąĕĈĔ ą ûĆĆĄċĕčøĆŋ éęèģ÷ň÷Ĕ÷ĠþĈè %KPEKPPCVK 2TG JQURKVCN 5VTQMG 5ETGGPKPI ĄĕĢëňĢĎňåĊĕĄĆĜňĠâŇþĆēëĕëü ĠĈē ýěåĈĕâĆúĕèâĕĆĠāúąŋ ÷ĔèĠč÷èĢüĆĜþúĘħ 5 āýĊŇĕ čĕĄĕĆùüĬĕĄĕĢëňâĔý UVTQMG HCUV VTCEM ģ÷ňğþŎüĐąŇĕè÷Ę

J Thai Stroke Soc: Volume 14, 2015

ĆĜþúĘħ Cincinnati Pre-hospital Stroke Screening úĘħúĕè ċĜüąŋğëĘħąĊëĕîġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĄĎĕĊėúąĕĈĔąûĆĆĄċĕčøĆŋ üĬĕĄĕþĆēąěâøŋĢëň - Dispatch ĎĄĕąùęè âĕĆģþĆĔýÿĜňþłĊąĐĐâ éĕâéě÷ğâė÷ğĎøěğāĚħĐüĬĕčŇèĐąŇĕèĆĊ÷ğĆĦĊĠĈēùĜâøňĐè øĕĄ ĄĕøĆòĕüčĕâĈøňĐèĄĘĆēýýýĆėâĕĆéĕâăĕåĆĔòĆĐèĆĔý âĕĆĠéňèĐĕâĕĆğýĚĐĨ èøňüéĕâÿĜþň Ċł ąĎĆĚĐîĕøė ĠĈēğĄĚĐħ ģ÷ňĆýĔ ĠéňèĠĈňĊøňĐèĄĘýĆėâĕĆčŇèĆùêěâğêėüģþĆĔýÿĜþň Ċł ąĐĐâéĕâéě÷ ğâė÷ğĎøě ÿĜúň ģĘħ þĆĔýøňĐèĄĘåĊĕĄĆĜğň âĘąħ ĊâĔýġĆå čĕĄĕĆùåĔ÷âĆĐè ğýĚĨĐèøňüģ÷ňĊŇĕÿĜňþłĊąüŇĕéēğþŎüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĄĘ ĐěþâĆöŋúéĘħ ĕĬ ğþŎüøŇĐâĕĆëŇĊąëĘĊøė êěâğêėü ĢĎňâĕĆ÷ĜĠĈğýĚĐĨ èøňü ýĕèĐąŇĕèģ÷ň ĆĜňéĔâĊėûĘâĕĆğĀŃĕĆēĊĔèğýĚĨĐèøňüâĆöĘÿĜňþłĊąĄĘ ĐĕâĕĆĠąŇĈèĎĆĚĐĄĘăĕĊēêěâğêėü ĠĈēĐĕéøňĐèĢĎňâĕĆþòĄ āąĕýĕĈğýĚĨĐèøňüýĕèĐąŇĕè ãňĐĎňĕĄýĕèþĆēâĕĆĆēĎĊŇĕè âĕĆüĬĕčŇè ğëŇü ģĄŇåĊĆĢĎňąĕĈ÷åĊĕĄ÷ĔüġĈĎėø PKHGFKRKPG ĐĄĢøňĈėĨü ùňĕģĄŇĄĘãňĐéĬĕâĔ÷Ģ÷ĥåĊĆĆĘýüĬĕÿĜňþłĊąãęĨüĆù êěâğêėüĢĎňğĆĦĊúĘčħ ÷ě ğúŇĕúĘéħ ēúĬĕģ÷ň ìęèħ ĢüþĆēğúċģúą ĄĘåĊĕĄ āąĕąĕĄĢëňĎĄĕąğĈã ĢüâĕĆĆĔýĠéňèĐĕâĕĆğýĚĐĨ èøňü ĠĈēéĔ÷ĎĕĆùêěâğêėüģþĆĔýÿĜňþłĊą ĠøŇĆēýýüĘĨâĦąĔèģĄŇģ÷ňĆĔý âĕĆāĔõüĕ éĕâþĆēčýâĕĆöŋâĕĆĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷ úĕèĎĈĐ÷ğĈĚĐ÷÷ĬĕãĐèċĜüąŋğëĘħąĊëĕîġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐè ĄĎĕĊėúąĕĈĔąûĆĆĄċĕčøĆŋāýĊŇĕĄĘÿþňĜ Ċł ąġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèĆēąēğêĘąýāĈĔüùĜâüĬĕčŇèĄĕąĔèĎňĐèêěâğêėüġ÷ą

J Thai Stroke Soc: Volume 14, 2015

ÿŇĕüúĕèĆēýý ġ÷ąøĆèüňĐąĄĕâ ģĄŇùęèĆňĐąĈē ġ÷ąÿĜňþłĊąčŇĊüĢĎîŇĢëňāĕĎüēčŇĊüøĔĊĢüâĕĆ FKURCVEJ5 - Delivery ĎĄĕąùęè âĕĆčŇèÿĜňþłĊąģþąĔèčùĕü āąĕýĕĈúĘħĄĘċĔâąăĕāčĕĄĕĆùĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷úĕè ĎĈĐ÷ğĈĚĐ÷÷Ĭĕģ÷ň ġ÷ąģĄŇøňĐèĠĊēøĕĄčùĕüāąĕýĕĈúĘħ ģĄŇĄċĘ âĔ ąăĕāĒ ìęèħ øňĐèĄĘâĕĆĊĕèĠÿüčĆňĕèčùĕüāąĕýĕĈ úĘħĄĘċĔâąăĕāĢĎňğāĘąèāĐåĆĐýåĈěĄāĚĨüúĘħčŇĊüøŇĕèĥãĐè þĆēğúċ ġ÷ąúĔĊħ ģþğĊĈĕúĘĢħ ëňğ÷ėüúĕèéĕâéě÷ğâė÷ğĎøěģþąĔè čùĕüāąĕýĕĈüĔĨüĥģĄŇåĊĆĢëňğĊĈĕğâėü ëĔħĊġĄè ìęħèĢü þĆēğúċģúą čùĕüāąĕýĕĈúĘħĄĘċĔâąăĕāąĔèĄĘþĆėĄĕö éĬĕâĔ÷ ĐĘâúĔĨèąĔèģĄŇĄĘâĕĆĊĕèĠÿüĢĎňğâė÷âĕĆâĆēéĕąøĔĊ ãĐèýěåĈĕâĆúĘħĄĘċĔâąăĕā úĬĕĢĎňÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèéĬĕüĊüĄĕâğčĘąġĐâĕčĢüâĕĆĆĔâČĕ÷ňĊąâĕĆĢĎňąĕ ĈēĈĕąĈėħĄğĈĚĐ÷úĕèĎĈĐ÷ğĈĚĐ÷÷Ĭĕ úĕèĠâňãĐèþŌîĎĕüĘĨ úĕèĎüęèħ âĦåĐĚ âĕĆčĆňĕèĆēýýčĕĆčüğúċåĊĕĄğĆĦĊčĜè ĎĆĚĐ 6GNGOGFKEKPG ğāĚħ Đ ÿĜ ň þ ł Ċ ąúĘħ Đ ąĜ Ň Ď Ň ĕ èģâĈéĕâčùĕü āąĕýĕĈċĔâąăĕāčĜèģ÷ňğãňĕùęèâĕĆĆĔâČĕģ÷ňúüĔ ğĊĈĕ ìęèħ ĄĘ âĕĆċęâČĕğýĚĐĨ èøňüĢüþĆēğúċģúąġ÷ąċĜüąŋğëĘąħ ĊëĕîġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐè ĄĎĕĊėúąĕĈĔąûĆĆĄċĕčøĆŋĊŇĕĠüĊåė÷üĘĨ üŇĕéēĢëňģ÷ňÿĈ

ĢüčŇĊüãĐè &QQT &CVC &GEKUKQP éüùęè &TWI ğþŎ ü čŇ Ċ üúĘħ ÷Ĭĕ ğüėüâĕĆĢüġĆèāąĕýĕĈ ġ÷ąĐĕċĔąâĕĆ ýĆėĎĕĆéĔ÷âĕĆĠýýčĎĊėëĕëĘā éĬĕğþŎüøňĐèĄĘâĕĆþĆēčĕü ĠĈēâĬĕĎü÷ĎüňĕúĘħãĐèÿĜňþñėýĔøėèĕüĐąŇĕèëĔ÷ğéü ģ÷ňĠâŇ '4 6TKCIG 0WTUG åĔ÷âĆĐèÿĜňþłĊąúĘħĄĘĐĕâĕĆøĕĄ %KPEKPPCVK 5VTQMG 5ETGGPKPI ĠĈēğĆėħĄ UVTQMG HCUV VTCEM ğĄĚħĐ QPUGV QH U[ORVQOU ëĔħĊġĄè ġ÷ąĆĕąèĕü ĠāúąŋþĆēéĬĕ ĎňĐèêěâğêėü ĠāúąŋþĆēéĬĕĎňĐèêěâğêėü Ćĕąèĕü TGUKFGPV úĘħĆĔýÿė÷ëĐý ĠĈē UVTQMG CVVGPFKPI ğüĚĨĐĎĕãĐèâĕĆ ĆĕąèĕüøňĐèþĆēâĐý÷ňĊą Ćĕąèĕü XKVCN UKIPU ġ÷ąğêāĕē $2 ĠĈē 2WNUG TCVG Ćĕąèĕü VKOG QH QPUGV ğþŎüğĊĈĕ čĕâĈ ğëŇü ģĄŇåĊĆĆĕąèĕü ġĄè čėħèúĘħéĬĕğþŎü øŇĐâĕĆøĔ÷čėüĢéĢĎňâĕĆĆĔâČĕ÷ňĊą TV2# ģ÷ňĠâŇ 2CUV OGFKECN UWTIKECN JKUVQT[ #NNGTIKGU /GFKECVKQPU ġ÷ą ğêāĕē 9CTHCTKP ĢĎňùĕĄğĊĈĕĈŇĕčě÷úĘħģ÷ňĆĔýąĕ÷ňĊą %CRKNNCT[ INWEQUG øė÷øŇĐÿĜňğâĘħąĊãňĐèĐĚħüĥģ÷ňĠâŇ 4CFKQNQIKUV ĎĆĚĐ ğéňĕĎüňĕúĘħþĆēéĬĕĎňĐè %6 .CD +%7 '4 0WTUG úĬĕ NGCF '%) ĠĈē ğøĆĘąĄĐěþâĆöŋ øŇĕèĥúĘħéĬĕğþŎüčĬĕĎĆĔýâĕĆğåĈĚħĐüąňĕąÿĜňþłĊąģþúĬĕ %6 ģ÷ňĠâŇ QZ[IGP ĠĈē OQPKVQT '-) $2 ýĔüúęâ XKVCN UKIPU úěâ üĕúĘ ğþľ÷ K X ğčňü ÷ňĊą ECVJGVGT 0Q ġ÷ąğĈĚĐâĠúèúĘħýĆėğĊöúňĐèĠãüğþŎüĐĔü÷ĔýĠĆâ ĢĎň QZ[IGP ġ÷ąþĆĔýĆē÷ĔýøĕĄåĊĕĄğĎĄĕēčĄġ÷ąĢĎň 12 5CV ğøĆĘąĄâĕĆčŇè NCD ÷ĔèøŇĐģþüĘ Ĩ %$% RNCVGNGVU 26 266 +04 øė÷øĕĄÿĜňþłĊąģþĎňĐè %6 üĬĕąĕ TV2# ģþ úĘħĎňĐè %6 ÷ňĊąĢüâĆöĘúĘħéĬĕğþŎüøňĐèğĆėħĄąĕúĘħĎňĐè %6 ğøĆĘ ą ĄāĆň Đ ĄúĘħ é ēğĆėħ Ą ąĕģ÷ň úĔ ü úĘ ğ ĄĚħ Đ ģ÷ň ÿ Ĉ %6 ğëŇ ü þĆēğĄėüüĬĨĕĎüĔâĠĈēåĬĕüĊöãüĕ÷ąĕğøĆĘąĄģĊňĈŇĊèĎüňĕ ĎňĕĄĢčŇ 0) VWDG ĎĆĚĐ (QNG[¿U %CVJGVGT éüâĊŇĕéēĄĘ åĬĕčĔħèéĕâ 5VTQMG CVVGPFKPI .CDQTCVQT[ ğøĆĘąĄâĕĆğĆŇè÷ŇĊüčĬĕĎĆĔý GOGTIGPE[ NCD %$% RNCVGNGVU 26 266 +04 ĆĕąèĕüÿĈ NCD ĐąŇĕè úĔüúĘúüĔ Ģ÷ ġ÷ąåŇĕĢ÷úĘģħ ÷ňÿĈâŇĐüĢĎňĆĕąèĕüâŇĐü ģĄŇøĐň è ĆĐĢĎňģ÷ňÿĈéüåĆýúěâøĔĊ

5VTQMG 7PKV øňĐèĄĔħüĢéĊŇĕĄĘğøĘąèāĆňĐĄĆĔý ÿĜňþłĊąģ÷ňúĔüúĘ ĠĈēğøĆĘąĄ OQPKVQT øŇĕèĥĢĎňāĆňĐĄ 4GUKFGPV 5VTQMG #VVGPFKPI øė÷øŇĐâĈĔýúĔüúĘúģĘħ ÷ňĆýĔ 5VTQMG (CUV 6TCEM øĆĊéĊėüėéêĔąġĆåĎĆĚĐăĕĊēúĘħğþŎüãňĐĎňĕĄĢüâĕĆĢĎňąĕ TV2# ģ÷ňĠâŇ CEWVG /+ CQTVKE FKUUGEVKQP QVJGT EQ OQTDKF EQPFKVKQP QT PQP UVTQMG GVKQNQI[ K G UVTQMG OKOKE CPF OGFKECN EQPVTCKPFKECVKQPU VQ TV2# þĆēğĄėü UGXGTKV[ QH PGWTQNQIKE FGÌEKV ĠĈē ăĕĊēĐĚħüĥúĘħĐĕééē ğþŎü EQPVTCKPFKECVKQPU øŇĐâĕĆĢĎň +8 TV2# þĆēğĄėüåŇĕ 0+*55 ąĚüąĔü VKOG QH QPUGV úĘħĠüŇüĐü øĆĊéčĐý KPENWUKQP ĠĈē GZENWUKQP ETKVGTKC ĠĈēĢĎňğĎøěÿĈùňĕĄĘãňĐ ĎňĕĄĢüâĕĆĢĎňąĕ TV2# úýúĊü PQP EQPVTCUV %6 ĎĆĚĐ /4 DTCKP KOCIKPI ÷ňĊąøüğĐè ĎĆĚĐĆŇĊĄâĔý TCFKQNQIKUV čŇè KPXGUVKICVKQP ĐĚħüĢüâĆöĘúĘħéĬĕğþŎüøŇĐâĕĆĊėüėéêĔąĎĆĚĐ âĕĆĆĔâČĕ ĠøŇøňĐèģĄŇúĬĕĢĎňğĊĈĕãĐèâĕĆğĆėħĄąĕ TV2# øňĐè ğĈĚħĐüĐĐâģþ ĐăėþĆĕąãňĐ÷Ę ãňĐğčĘąãĐèâĕĆĢĎňąĕ TV2# âĔýÿĜňþłĊą ĠĈē ĎĆĚĐîĕøė ýĐâúĕèğĈĚĐâĐĚħüĢüâĕĆĆĔâČĕ ģĄŇéĕĬ ğþŎüøňĐèĢĎňÿþňĜ Ċł ąĎĆĚĐîĕøėğìĦüëĚĐħ Ģü EQPUGPV HQTO ğāĆĕēéēúĬĕĢĎňâĕĆğĆėħĄąĕøňĐèğĈĚħĐüĐĐâģþ ĠøŇåĊĆğãĘąü ãňĐåĊĕĄĈèĢüğĊëĆēğýĘąüĊŇĕģ÷ňĐûėýĕąãňĐ÷Ę ãňĐğčĘąĢĎň ğãňĕĢéĠĈňĊ ĠĈēğþŎüúĘħąĐĄĆĔý ąâğĊňüĢüâĆöĘúĘħåė÷ĊŇĕĐĕé ĄĘþî Ō ĎĕğĆĚĐħ èåĊĕĄģĄŇğãňĕĢé âĦčĕĄĕĆùĢĎňÿþňĜ Ċł ąĎĆĚĐîĕøė ğìĦüëĚĐħ Ģü EQPUGPV HQTO âŇĐüâĕĆĢĎňąĕ øĕĄåĊĕĄğĎĄĕē ĢüčùĕüâĕĆöŋ ãňĐĄĜĈúĘħåĊĆĢĎňĠâŇÿĜňþłĊąĠĈēîĕøėâŇĐüĢĎň TV2# ĄĘ÷èĔ üĘ Ĩ ÿĜþň Ċł ąĄĘĎĈĐ÷ğĈĚĐ÷ĢüčĄĐèĐě÷øĔü ğüĚĐħ èéĕâ ÿĜňþłĊąčĕĄĕĆùĄĕġĆèāąĕýĕĈģ÷ňĐąŇĕèĆĊ÷ğĆĦĊăĕąĢü ëĔĊħ ġĄèåĆęèħ ĎĈĔèéĕâğâė÷ĐĕâĕĆ éęèğþŎüġĐâĕčĐĔü÷ĘúÿĘħ þňĜ Ċł ą éēģ÷ňĆĔýąĕĈēĈĕąâňĐüğĈĚĐ÷úĘħĐě÷øĔüĎĈĐ÷ğĈĚĐ÷čĄĐè ìęħèğþŎüąĕúĘħģ÷ňĆĔýâĕĆĆĔýĆĐèéĕâúĔħĊġĈâĊŇĕĄĘþĆēčėúûėÿĈ čĜèčě÷ĢüþŌééěýüĔ ġ÷ąÿĜþň Ċł ąĄĘġĐâĕč÷ĘãüęĨ ĎĈĔèâĕĆĢĎňąĕùęè ĐąŇĕèģĆâĦøĕĄġĐâĕčğčĘħąèãĐèăĕĊēğĈĚĐ÷ĐĐâĢü čĄĐèĠĈēúĬĕĢĎňĐĕâĕĆğĈĊĈèğâė÷ģ÷ňþĆēĄĕö ìęèħ Đĕé éēğþŎüĐĔüøĆĕąùęèëĘĊėøģ÷ňþĆēĄĕö čăĕāåĊĕĄğþŎüéĆėèúĘħğâė÷ãęĨüĢüþĆēğúċģúą þĆēëĕëüģĄŇ ĄĘ å ĊĕĄĆĜ ň ğ âĘħ ą ĊâĔ ý ġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐè J Thai Stroke Soc: Volume 14, 2015

ģĄŇúĆĕýĐĕâĕĆğýĚĨĐèøňüãĐèġĆå ĠĈēģĄŇĄĘĆēýýĆĔýčŇè êě â ğêė ü ÿĜ ň þ ł Ċ ąġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèčŇ Ċ üĢĎîŇ Ą ĕùę è ġĆèāąĕýĕĈğâėü ëĔħĊġĄèĎĈĔèğâė÷ĐĕâĕĆ ýĕèĆĕąúĘħ ĄĕúĔüğĊĈĕâĦğþŎüğāĆĕēĐąĜŇĢâĈňġĆèāąĕýĕĈ ĎĆĚĐýĔèğĐėî ĄĘîĕøėúĘħčĕĄĕĆùüĬĕčŇèģ÷ňúĔüúĘ ĠøŇģĄŇĢëŇğāĆĕēĄĘåĊĕĄ ğãňĕĢéğâĘħąĊâĔýġĆå éęèĠúýģĄŇāýãĔĨüøĐü &GVGEVKQP &KURCVEJ ĠĈē &GNKXGT[ ĢüúĕèþñėýĔøė ċĜüąŋğëĘħąĊëĕî ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĄĎĕĊėúąĕĈĔąûĆĆĄċĕčøĆŋ éęèģ÷ň ĆėğĆėħĄğåĆĚĐãŇĕąâĕĆčŇèøŇĐÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĢü ĆēąēğêĘąýāĈĔüãęĨü

ÐāòêòÿñćÐäŞĎÙśčæòċöÙÐòòðČôÿċÓòĆüÑŚāñÐāò ãĈČôëĈśêŕöñčòÓúôüãċôĆüãùðüÖäĄéČôÿüćãäĀè òÿñÿċØĄñéíôĀèÑüÖðúāöăæñāôĀñçòòð÷āùäòŞ 5IBNNBTBU 4USPLF /FUXPSL 54/

ãĔĨüøĐüĢüâĕĆ÷ĬĕğüėüèĕüãĐè 650 ÷ĔèüĘĨ ĐýĆĄýěåĈĕâĆúĕèâĕĆĠāúąŋúĘħğâĘħąĊãňĐè ĢüġĆèāąĕýĕĈûĆĆĄċĕčøĆŋĒĢĎňğĎĦüùęèþĆēġąëüŋãĐè âĕĆģ÷ňĆĔýąĕĈēĈĕąĈėħĄğĈĚĐ÷ éĔ÷øĔèĨ úĘĄèĕü÷ĜĠĈÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ġ÷ąâĕĆþĆēčĕüèĕüâĔýčĎčĕãĕĊėëĕëĘā ğëŇü þĆēčĕú ċĔĈąĠāúąŋ ĠāúąŋğĊëċĕčøĆŋêěâğêėü ĆĔèčĘĠāúąŋ Ġāúąŋ čĕãĕğĊëċĕčøĆŋ Ă Ł Ő ü ĂĜ ğúåüė å âĕĆĠāúąŋ āąĕýĕĈ þĆēëěĄğāĚħĐĠĈâğþĈĘħąüåĊĕĄåė÷ğĎĦü éĔ÷úĬĕĠüĊúĕèâĕĆ÷ĜĠĈÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèúĘħĄĘĐĕâĕĆăĕąĢü ëĔħĊġĄèĢĎňģ÷ňĆĔýâĕĆ÷ĜĠĈ ĠĈēčŇèøĆĊéğāėħĄğøėĄĐąŇĕèĆĊ÷ğĆĦĊ UVTQMG HCUV VTCEM ĠĈēéĔ ÷ úĬ ĕ ĠýýčĔħ è âĕĆĆĔ â Čĕ QTFGT UJGGV úĘħ Ģ ëň Ģ ü âĕĆĢĎňâĕĆĆĔâČĕ čĆňĕèğåĆĚĐãŇĕąġ÷ąğëėîĠāúąŋĠĈēýěåĈĕâĆ úĘħ Đ ąĜ Ň Ġ ÿüâêě â ğêė ü ãĐèġĆèāąĕýĕĈĈĜ â ãŇ ĕ ą ĆĊĄùę è þĆēčĕüèĕüâĔ ý čĬ ĕ üĔ â èĕüčĕûĕĆöčě ã éĔ è ĎĊĔ ÷ úĘħ ĄĘ ġĆèāąĕýĕĈĈĜ â ãŇ ĕ ąĐąĜ Ň ĄĕĢĎň å ĊĕĄĆĜ ň ĠĈâğþĈĘħ ą ü åĊĕĄåė÷ğĎĦü ĠĈēĊĕèĠüĊúĕèâĕĆčŇèøŇĐÿĜþň Ċł ąúĘĄħ ġĘ Đâĕč éēģ÷ň ĆĔ ý ąĕĈēĈĕąĈėħ Ą ğĈĚ Đ ÷ĆŇ Ċ ĄâĔ ü éĔ ÷ úĬ ĕ ġþčğøĐĆŋ þĆēëĕčĔ Ą āĔ ü ûŋ Đ ĕâĕĆúĘħ č èčĔ ą ĊŇ ĕ ğþŎ ü ġĆåĎĈĐ÷ğĈĚ Đ ÷ čĄĐè ĠĈēĠüĊúĕèþñėýĔøėĢüâĆöĘúĘħāýÿĜňþłĊąúĘħğãňĕãŇĕą čĕĄĕĆùģ÷ňĆĔýąĕĈēĈĕąĈėħĄğĈĚĐ÷ ĎĈĔèéĕâþñėýøĔ âė ĄĦ âĘ ĕĆğâĦýãňĐĄĜĈĠĈēþĆēğĄėü

J Thai Stroke Soc: Volume 14, 2015

ÿĈ ĢüÿĜňþłĊąúĘħĄĕāýĠāúąŋăĕąĢü ëĔħĊġĄèĠĈňĊģĄŇģ÷ň ąĕĈēĈĕąĈėħĄğĈĚĐ÷âĦĄĘâĕĆøĆĊéčĐýąňĐüĎĈĔèĊŇĕĄĘþŌîĎĕ úĘħéě÷Ģ÷ĎĆĚĐĄĘãňĐĎňĕĄĢüâĕĆĢĎňąĕ ĠĈēĄĘâĕĆþĆēëěĄğåĆĚĐ ãŇĕąğþŎüĆēąēĥ ğāĚħĐĆĔýĂŌè ĠâňģãþŌîĎĕúĘħāýĆŇĊĄâĔü

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Ðāò÷ąÐøāÐāòêòÿñćÐäŞĎÙś UFMFNFEJDJOF Čôÿ 5IBNNBTBU 4USPLF /FUXPSL8 ÿĜ ň ğ ãĘ ą üĠĈēåöē ģ÷ň úĬ ĕ âĕĆċę â ČĕĊė éĔ ą þĆēčėúûėăĕāĠĈēåĊĕĄþĈĐ÷ăĔąãĐèâĕĆþĆēąěâøŋĢëň VGNGOGFKEKPG ĠĈē 650 ĄĕëŇĊąĢüâĕĆĆĔâČĕÿĜňþłĊąġĆå ĎĈĐ÷ğĈĚ Đ ÷čĄĐèøĘ ý ĠĈēĐě ÷ øĔ ü ĆēąēğêĘ ą ýāĈĔ ü ÷ň Ċ ą ąĕĈēĈĕąĈėħĄğĈĚĐ÷úĕèĎĈĐ÷ğĈĚĐ÷÷Ĭĕ Ģüğ÷ĚĐüĄėùěüĕąü ā ċ ğĆėħĄĄĘâĕĆéĔ÷Ćēýý UVTQMG HCUV VTCEM Ģü ġĆèāąĕýĕĈûĆĆĄċĕčøĆŋĒ ĠĈēĄĘâĕĆĢëň VGNGOGFKEKPG Ģü

âĕĆ÷ĜĠĈÿĜňþłĊą ğüĚħĐèéĕâĄĘþĆēčĕúĠāúąŋÿĜňğëĘħąĊëĕî ÷ňĕüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè åü ìęħèéēčĈĔýâĔüĐąĜŇğĊĆğāĚħĐ ĢĎň â ĕĆþĆę â ČĕĠĈēĆĔ â ČĕÿĜ ň þ ł Ċ ąġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐè øĈĐ÷ ëĔĊħ ġĄè ÷ĔèüĔüĨ éęèĄĘâĕĆþĆēąěâøŋĢëňğúåġüġĈąĘĄĕ

ÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħĄĘ ĐĕâĕĆăĕąĢü ëĔħĊġĄè āýĠāúąŋúĘħġĆèāąĕýĕĈĈĜâãŇĕą

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ĠāúąŋúĘħêěâğêėü 2

5VTQMG URGEKCNKUV ÷Ĝ %6 ÿŇĕüúĕè internet 9

ĠāúąŋúĘħêěâğêėü 5 ÿĜňþłĊąčŇèøĔĊĄĕúĘħĆāû

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ġĆèāąĕýĕĈĈĜâãŇĕą

ġĆèāąĕýĕĈûĆĆĄċĕčøĆŋĒ Ćāû

ĆĜþúĘħ ĠüĊúĕèâĕĆčŇèøĔĊÿĜňþłĊąĢü 6JCOOCUCV 5VTQMG 0GVYQTM Ġāúąŋêâě ğêėüġĆèāąĕýĕĈĈĜâãŇĕąøĆĊéÿĜþň Ċł ąĊŇĕčĕĄĕĆùģ÷ňĆýĔ âĕĆĆĔâČĕ÷ňĊąąĕĈēĈĕąĈėĄħ ğĈĚĐ÷ĎĆĚĐģĄŇ ġúĆċĔāúŋ ĆĕąèĕüĐĕâĕĆÿĜþň Ċł ą ĢĎňĠāúąŋêěâğêėüĆāû ĠāúąŋġúĆĆĕąèĕüĐĕâĕĆÿĜňþłĊąĠâŇþĆēčĕúĠāúąŋÿĜňğëĘħąĊëĕî÷ňĕüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĢüâĕĆøĔ÷čėüĢéĊŇĕéēĆĔý ÿĜňþłĊąĄĕĆĔýâĕĆĆĔâČĕĎĆĚĐģĄŇ ĠāúąŋêěâğêėüġúĆċĔāúŋýĐâĠāúąŋúĘħġĆèāąĕýĕĈĈĜâãŇĕąĊŇĕéēĆĔýÿĜňþłĊąĎĆĚĐģĄŇ ÿĜňþłĊąčŇèøĔĊĄĕĆĔýâĕĆ ĆĔâČĕúĘĆħ āû ĠāúąŋúêĘħ âě ğêėüúĘĆħ āû čĔèħ øĆĊéğýĚĐĨ èøňü ĠĈē ġúĆċĔāúŋýĐâĠāúąŋþĆēéĬĕýňĕüþĆēčĕúĊėúąĕ ĠāúąŋþĆēéĬĕýňĕüþĆēčĕú ĊėúąĕþĆēğĄėü 0+*55 ãňĐĎňĕĄĢüâĕĆąĕĈēĈĕąĈėħĄğĈĚħĐ÷ĠĈēġúĆċĔāúŋĆĕąèĕüþĆēčĕúĠāúąŋ ĢüâĆöĘúĘħþĆēčĕúĠāúąŋģĄŇģ÷ňĐąĜŇĢüĆāû þĆēčĕúĠāúąŋ÷Ĝ %6 ÿŇĕüúĕè KPVGTPGV ĢüâĆöĘúĘħģĄŇģ÷ňĐąĜŇĢüĆāû ĠĈēøĔ÷čėüĢéĊŇĕéēĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷ĎĆĚĐģĄŇ

ġĆèāąĕýĕĈĈĜâãŇĕąĢü 650 þŌééěýĔüĄĘéĬĕüĊü ĄĕââĊŇĕ ġĆèāąĕýĕĈ ğëŇü ġĆèāąĕýĕĈġĆåúĆĊèĐâ ġĆèāąĕýĕĈâĆĄëĈþĆēúĕü ġĆèāąĕýĕĈéĔ è ĎĊĔ ÷ þúě Ą ûĕüĘ ġĆèāąĕýĕĈéĔ è ĎĊĔ ÷ Đąě û ąĕ ġĆèāąĕýĕĈ éĔèĎĊĔ÷ĐŇĕèúĐè ġĆèāąĕýĕĈåĈĐèĎĈĊè ġĆèāąĕýĕĈ þĆēëĕûėþŌøąŋ ġĆèāąĕýĕĈĎüĐèğčĚĐ ġĆèāąĕýĕĈÿĔâģĎŇ ġĆèāąĕýĕĈúŇĕğĆĚĐ ġĆèāąĕýĕĈĈĬĕĈĜââĕ ġĆèāąĕýĕĈ ăĕëĘ ċĜüąŋâĕĆĠāúąŋåĜåø ġĆèāąĕýĕĈĈĕ÷ĎĈěĄĠâňĊ ġĆèāąĕýĕĈĈĕ÷ýĔĊĎĈĊè ġĆèāąĕýĕĈûĔîýěĆ Ę ġĆèāąĕýĕĈ čĄğ÷ĦéāĆēčĔèçĆĕë üåĆĎĈĊè ġĆèāąĕýĕĈýĕèģúĆ ġĆèāąĕýĕĈýĕèþēĐėü ġĆèāąĕýĕĈüāĆĔøüŋ ġĆèāąĕýĕĈ ğĐâþúěĄ ġĆèāąĕýĕĈĠāúąŋĆĔèčėø ġĆèāąĕýĕĈāĆëĔą

ġĆèāąĕýĕĈþúěĄğĊë ĆēąēúĕèéĕâġĆèāąĕýĕĈĈĜâãŇĕą ùę è ġĆèāąĕýĕĈûĆĆĄċĕčøĆŋ Ē ğêĈĘħ ą âė ġ ĈğĄøĆ

¼ âėġĈğĄøĆ ĎĆĚĐğĊĈĕĢüâĕĆğ÷ėüúĕèġ÷ąĆùąüøŋ øĔĨèĠøŇ üĕúĘ ġ÷ąâŇĐüĎüňĕúĘħéēĄĘĆēýý 650 ģĄŇ ĄĘ ÿĜ ň þ ł Ċ ąġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèøĘ ý ĠĈēĐě ÷ øĔ ü Ćēąē ğêĘąýāĈĔüúĘģħ þāýĠāúąŋúġĘħ ĆèāąĕýĕĈĈĜâãŇĕąģ÷ňĆýĔ âĕĆ ĆĔ â Čĕ÷ň Ċ ąąĕĈēĈĕąĈėħ Ą ğĈĚ Đ ÷ğĈą ġĆèāąĕýĕĈĆē÷Ĕ ý ĐĬĕğăĐčŇĊüĢĎîŇģĄŇĄĘğåĆĚħĐè %6 ĠĈēģĄŇĄĘþĆēčĕúĠāúąŋ ĢüâĕĆ÷ĜĠĈÿĜňþłĊąĢüëŇĊèğ÷ĚĐüĄėùěüĕąü ā ċ ùęèğ÷ĚĐüâěĄăĕāĔüûŋ ā ċ ĄĘÿĜňþłĊąġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔüĆēąēğêĘąýāĈĔü åüģ÷ňĆýĔ ąĕ ĈēĈĕąĈėħĄğĈĚĐ÷úĕèĎĈĐ÷ğĈĚĐ÷÷Ĭĕ éĕâéĬĕüĊüÿĜňþłĊąġĆå

J Thai Stroke Soc: Volume 14, 2015

ĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔü åüúĘħĄĕĆĔâČĕúĘħ ġĆèāąĕýĕĈûĆĆĄċĕčøĆŋĒ ĎĆĚĐåė÷ğþŎüĆňĐąĈē Ģüğ÷ĚĐü ĄĘ ü ĕåĄ ā ċ ģ÷ň ğ Ćėħ Ą Ģëň Ć ēýý 650 ĐąŇ ĕ èĄĘ þĆēčėúûėăĕāĠĈēåĆĐýåĈěĄ éēāýĊŇĕĢüëŇĊèøĔĨèĠøŇğ÷ĚĐü ĄĘüĕåĄ ā ċ ùęèğ÷ĚĐüĄĘüĕåĄ ā ċ ĄĘÿĜňþłĊą éĬĕüĊü åü ĆňĐąĈē ģ÷ňĆĔýąĕĈēĈĕąĈėħĄğĈĚĐ÷

éĕâÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔüéĬĕüĊü åüúĘħĄĕāýĠāúąŋĢüëŇĊèğĊĈĕ÷ĔèâĈŇĕĊ ĎĆĚĐâĈŇĕĊ ĐĘâüĔąĎüęħèåĚĐâĕĆþĆēąěâøŋĢëň VGNGOGFKEKPG ĠĈē 650 úĬĕĢĎňĄĘéĬĕüĊüÿĜňþłĊąúĘħģ÷ňĆĔýąĕĈēĈĕąĈėħĄğĈĚĐ÷čĜèãęĨü éĕâĆňĐąĈē 9 ãĐèéĬĕüĊüÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè øĘýĠĈēĐě÷øĔü ğāėħĄğþŎüĆňĐąĈē ĎĈĔèâĕĆþĆēąěâøŋĢëň VGNGOGFKEKPG ĐąŇ ĕ èğ÷Ę ą Ċ ĠĈēğāėħ Ą ğþŎ ü Ćň Đ ąĈē

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10 (2-33)

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ġĆåğýĕĎĊĕü ĆňĐąĈē

13 (20)

19 (33)

ģãĄĔüĢüğĈĚĐ÷čĜè ĆňĐąĈē

22 (33)

ġĆåĎĈĐ÷ğĈĚĐ÷ĎĔĊĢé ĆňĐąĈē

13 (22)

ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔü ĆňĐąĈē

1 (7)

#VTKCN ÌDTKNNCVKQP ĆňĐąĈē

10 (17)

čĜýýěĎĆĘħ ĆňĐąĈē

10 (17)

Ćē÷ĔýåĊĕĄ÷ĔüġĈĎėøâŇĐüģ÷ňĆĔýąĕĈēĈĕąĈėħĄğĈĚĐ÷ ĄėĈĈėğĄøĆþĆĐú 5[UVQNKE åŇĕğêĈĘħą Ů 5& &KCUVQNKE åŇĕğêĈĘħą Ů 5&

Ů Ů

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ĆēąēğĊĈĕøĔĨèĠøŇğĆėħĄĄĘĐĕâĕĆùęèġĆèāąĕýĕĈûĆĆĄċĕčøĆŋĒ üĕúĘ åŇĕğêĈĘħą Ů 5&

Đĕąě åŇĕğêĈĘħą Ů 5&

J Thai Stroke Soc: Volume 14, 2015

ĆēąēğĊĈĕøĔĨèĠøŇĄĕùęèġĆèāąĕýĕĈûĆĆĄċĕčøĆŋĒéüģ÷ňĆĔýąĕĈēĈĕąĈėħĄğĈĚĐ÷ üĕúĘ

åŇĕğêĈĘħą Ů 5&

ĆēąēğĊĈĕøĔĨèĠøŇğĆėħĄĄĘĐĕâĕĆùęèģ÷ňĆĔýąĕĈēĈĕąĈėħĄğĈĚĐ÷ üĕúĘ åŇĕğêĈĘħą Ů 5&

ÿĈâĕĆĆĔâČĕúĘħ÷ĘãöēĐĐâéĕâġĆèāąĕýĕĈ ĆňĐąĈē

(17.5)

ÿĈâĕĆĆĔâČĕúĘħ÷ĘúĘħ ğ÷ĚĐü ĆňĐąĈē

2 (3)

1 (1.7)

21 (33.3)

23 (39.7) 17 (29.3) -

ğĈĚĐ÷ĐĐâĢüčĄĐèúĘħúĬĕĢĎňĐĕâĕĆĠąŇĈè ĆňĐąĈē ëüė÷ãĐèġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔü ĆňĐąĈē .## 5#1 %' 70&

.## NCTIG CTVGT[ CVJGTQUENGTQUKU 5#1 UOCNN CTVGT[ QEENWUKQP %' ECTFKQGODQNKUO 70& UVTQMG QH WPFGVGTOKPGF ECWUG 1% UVTQMG QH QVJGT FGVGTOKPGF ECWUG 5& ĎĄĕąùęè UVCPFCTF FGXKCVKQP åŇĕğýĘħąèğýüĄĕøĆòĕü

ãňĐĠøâøŇĕèúĘħčĬĕåĔîãĐè VGNGOGFKEKPG ĠĈē 650 âĔýâĕĆċęâČĕĎĈĔâĢüøŇĕèþĆēğúċúĘħþĆēąěâøŋĢëň VGNGOGFKEKPG ĠĈē UVTQMG PGVYQTM ĢüâĕĆëŇĊąøĔ÷čėüĢé ĆĔâČĕÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔüĆēąē ğêĘąýāĈĔü÷ňĊąąĕĈēĈĕąĈėĄħ ğĈĚĐ÷ĢüþĆēğúċúĕèøēĊĔüøâ åĚĐ âĕĆċęâČĕüĘĨĢëňâĕĆøė÷øŇĐčĚħĐčĕĆúĕèġúĆċĔāúŋ Ģü þĆēğúċúĕèøēĊĔüøâčŇĊüĢĎîŇĢëň YC[ 86% ĠĈē÷ĜÿĈ %6 ÿŇ ĕ üúĕèĐė ü ğúĐĆŋ ğ üĦ ø ĄĘ â ĕĆċę â ČĕğþĆĘ ą ýğúĘ ą ý ĆēĎĊŇĕèâĕĆčĚħĐčĕĆÿŇĕüúĕè YC[ 86% åü âĔý úĕèġúĆċĔāúŋ åü ĢüâĕĆøĔ÷čėüĢéĢĎňâĕĆĆĔâČĕ ÿĜňþłĊą÷ňĊąąĕĈēĈĕąĈėħĄğĈĚĐ÷ āýĊŇĕâĕĆøĔ÷čėüĢéĢüĢĎň âĕĆĆĔâČĕġ÷ąÿŇĕüúĕè YC[ 86% ĄĘåĊĕĄùĜâøňĐè ĄĕââĊŇĕÿŇĕüúĕèġúĆċĔāúŋ ĆňĐąĈē ğúĘąýâĔý ĆňĐąĈē QFFU TCVKQ 14 EQPÌFGPEG KPVGTXCN

%+ R ĐąŇĕèģĆâĦøĕĄÿĈâĕĆĆĔâČĕ úĘħ÷ĘúĘħ ĊĔü ģĄŇĠøâøŇĕèĐąŇĕèĄĘüĔąčĬĕåĔîúĕèčùėøė 14 %+ R ĐĔøĆĕâĕĆğčĘąëĘĊøė âĦģĄŇĠøâ øŇĕèĐąŇĕèĄĘüąĔ čĬĕåĔîúĕèčùėø ė 14 %+ 2 ĠĈēĐĔøĆĕâĕĆğâė÷ğĈĚĐ÷ĐĐâĢüčĄĐè ģĄŇĠøâøŇĕè ĐąŇĕèĄĘüĔąčĬĕåĔîúĕèčùėøė ĆňĐąĈē ğúĘąýâĔý ĆňĐąĈē 14 %+ R 10 ĠĈēãňĐĠøâøŇĕèéĕâ âĕĆċęâČĕčŇĊüĢĎîŇĢüþĆēğúċúĕèøēĊĔüøâåĚĐ ĢüĆēýý

650 âĕĆĢĎň ą ĕĈēĈĕąĈėħ Ą ğĈĚ Đ ÷éĬ ĕ ğþŎ ü øň Đ èĢĎň ą ĕĢü ġĆèāąĕýĕĈĠĄŇãŇĕą ğüĚħĐèéĕâþŌîĎĕâĕĆãĕ÷ĠåĈü þĆēčĕúĠāúąŋ þĆēčĕúċĔĈąĠāúąŋĠĈē %6 ĢüġĆèāąĕýĕĈ ĈĜâãŇĕąčŇĊüĢĎîŇãĐè 650 ÷ĔèüĔĨüġĆèāąĕýĕĈĈĜâãŇĕą éę è éĬ ĕ ğþŎ ü úĘħ é ēøň Đ èčŇ è øĔ Ċ ÿĜ ň þ ł Ċ ąĄĕĆĔ ý âĕĆĆĔ â ČĕúĘħ ġĆèāąĕýĕĈûĆĆĄċĕčøĆŋĒ úĬĕĢĎňčî Ĝ ğčĘąğĊĈĕčŇĊüĎüęèħ ģþ âĔýâĕĆğ÷ėüúĕèčŇèøĔĊÿĜňþłĊą ìęħèğĊĈĕúĘħğčĘąģþĄĕâĎĆĚĐ üňĐąčĔĄāĔüûŋâĔýĆēąēúĕèéĕâġĆèāąĕýĕĈĈĜâãŇĕąâĔý ġĆèāąĕýĕĈĠĄŇãŇĕą čĆěþ ĢüâĕĆĆĔâČĕÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘý ĠĈēĐě ÷ øĔ ü ĆēąēğêĘ ą ýāĈĔ ü éĬ ĕ ğþŎ ü øň Đ èĄĘ â ĕĆýĆė Ď ĕĆ éĔ÷âĕĆĆēýý UVTQMG HCUV VTCEM úĘħ÷ĘĠĈēĄĘþĆēčėúûėăĕā úĬĕĢĎňÿþňĜ Ċł ąğãňĕùęèâĕĆĆĔâČĕĄĕøĆĕòĕüĢüğĊĈĕĐĔüĆĊ÷ğĆĦĊ üĐâéĕâüĘĨâĕĆāĔõüĕĆēýýâĕĆ÷ĜĠĈĠĈēčŇèøŇĐÿĜňþłĊąģþ ąĔèġĆèāąĕýĕĈúĘħĄĘċĔâąăĕāĢüâĕĆĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷ ĎĆĚĐâĕĆĆĔâČĕúĘĄħ èŇě ğüňüğþľ÷ĎĈĐ÷ğĈĚĐ÷ĢüĆēąēğêĘąýāĈĔü éēĄĘþĆēġąëüŋëĊŇ ąğāėĄħ ġĐâĕčâĕĆĂŁüŐ øĔĊâĈĔýĄĕğþŎüþâøė Ĉ÷åĊĕĄāėâĕĆãĐèÿĜňþłĊąĠĈēĈ÷ĐĔøĆĕâĕĆğčĘąëĘĊėøģ÷ň âĕĆāĔõüĕĆēýý÷ĔèâĈŇĕĊéĬĕğþŎüøňĐèĐĕċĔąåĊĕĄĆŇĊĄĄĚĐ éĕâĎĈĕąăĕåčŇĊüĠĈēøňĐèþĆĔýãýĊüâĕĆúĬĕèĕüĢĎň ğĎĄĕēčĄâĔýĆēýýčĕûĕĆöčěã ċĔâąăĕāĠĈēúĆĔāąĕâĆ úĘħĄĘĢüčùĕüĆĔâČĕāąĕýĕĈüĔĨüĥ ĠĈēåĊĆĄĘâĕĆþĆēğĄėü

J Thai Stroke Soc: Volume 14, 2015

ÿĈâĕĆþðė ýĔ øė ĠĈň Ċ üĬ ĕ ÿĈĄĕĢëň þ ĆĔ ý ãýĊüâĕĆĢĎň ĄĘ þĆēčėúûėăĕāğāėħĄãęĨüøŇĐģþ #EMPQYNGFIGOGPV ýúåĊĕĄüĘģĨ ÷ňĆýĔ âĕĆčüĔýčüěüéĕâ ġåĆèâĕĆĄĎĕĊė ú ąĕĈĔ ą ĠĎŇ è ëĕøė ã ĐèčĬ ĕ üĔ â èĕüåöē âĆĆĄâĕĆĐě÷ĄċęâČĕ

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éæÓĀãñŚü

ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔüğþŎüġĆåúĘāħ ýģ÷ňýĐŇ ąĢüğĊëþñėýøĔ ė þŌééěýüĔ āýĊŇĕâĕĆĢĎňąĕĈēĈĕą ĈėħĄğĈĚĐ÷úĕèĎĈĐ÷ğĈĚĐ÷÷ĬĕĢüÿĜňþłĊąúĘħĄĐĘ ĕâĕĆăĕąĢü ëĔħĊġĄèĠĈēģĄŇĄãĘ ňĐĎňĕĄĢüâĕĆĢĎňąĕüĔĨü čĕĄĕĆùĈ÷ ĐĔøĆĕåĊĕĄāėâĕĆúĘħéēğâė÷ãęĨüģ÷ňĆňĐąĈē ğĄĚħĐğúĘąýâĔýÿĜňþłĊąúĘħģĄŇģ÷ňĆĔýąĕ÷ĔèâĈŇĕĊ ÷ĔèüĔĨüâĕĆéĔ÷âĕĆĆēýý ĠĈēãýĊüâĕĆĢüâĕĆ÷ĜĠĈÿĜňþłĊąğĎĈŇĕüĘĨéęèĄĘåĊĕĄčĬĕåĔî ĄĘâĕĆĢëňãýĊüâĕĆ 5VTQMG (CUV 6TCEM 5VTQMG 0GVYQTM ĠĈē 6GNGOGFKEKPG ĄĕëŇĊąĢĎňÿĜňþłĊąģ÷ňĆĔýâĕĆĆĔâČĕĐąŇĕèĆĊ÷ğĆĦĊøĕĄĄĕøĆòĕüčĕâĈ âĕĆþĆēąěâøŋ Ģëň ġ úĆğĊëâĆĆĄĠĈēğåĆĚ Đ ãŇ ĕ ąâĕĆ÷Ĝ Ġ ĈÿĜ ň þ ł Ċ ąġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèøĘ ý ĠĈēĐě ÷ øĔ ü ĆēąēğêĘ ą ýāĈĔ ü ãĐè ĄĎĕĊėúąĕĈĔąûĆĆĄċĕčøĆŋğāėĄħ ĐĔøĆĕâĕĆģ÷ňĆýĔ ąĕĈēĈĕąĈėĄħ ğĈĚĐ÷úĕèĎĈĐ÷ğĈĚĐ÷÷ĬĕĢüÿĜþň Ċł ąéĕâĆňĐąĈē ğþŎü ĆňĐąĈē ġ÷ąĐĔøĆĕâĕĆĂŁüŐ øĔĊ÷Ęú Ęħ ğ÷ĚĐüāýĢüÿĜþň Ċł ąĆňĐąĈē ĐĔøĆĕâĕĆğâė÷ğĈĚĐ÷ĐĐâĢüčĄĐèúĘúħ ĕĬ ĢĎň ĐĕâĕĆĠąŇĈèāýğāĘąèĆňĐąĈē åĬĕčĬĕåĔî ġúĆğĊëâĆĆĄ ğåĆĚĐãŇĕąâĕĆ÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè

J Thai Stroke Soc: Volume 14, 2015

ÐāòíĀáèāòÿééÐāòãĈČôëĈśêŕöñčòÓúôüãċôĆüãùðüÖ ČééÓòéöÖ×ò 4USPLF /FUXPSL

čòÖíñāéāôðúāòāÙèÓòċÙĄñÖĎúðŚ ÓâÿČíæñ÷āùäòŞ ðúāöăæñāôĀñċÙĄñÖĎúðŚ ü íÜ ÐèÐöòòâ öĀÙòÿ÷ĀÐãăė÷ăôêř

(J Thai Stroke Soc 2015; 14: 23-34.)

ġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèğþŎ ü ġĆåúĘħ ā ýýŇ Đ ąĠĈēğþŎ ü þŌ î Ďĕ čĕûĕĆöčěãúĘčħ ĕĬ åĔîãĐèúěâþĆēğúċġ÷ąāýğþŎüčĕğĎøěâĕĆøĕą éĕâ úěâčĕğĎøěãĐèþĆēëĕâĆúĔħĊġĈâ ğþŎüčĕğĎøěâĕĆğčĘąëĘĊėøĐĔü÷Ĕý Ģü åüĐĕąěĄĕââĊŇĕ þĿĠĈēĐĔü÷Ĕý ĢüåüĐĕąě þĿ ĢüĠøŇĈēþĿ úĔħĊġĈâĄĘåü ĈňĕüåüğþŎü UVTQMG üĔħüåĚĐúěâĥĎüęħèĢü åüéēĄĘġĐâĕč ğþŎü UVTQMG ĐąŇĕèüňĐąĎüęħèåĆĔĨèĢüĎüęħèëĔħĊëĘĊėøĠĈēþĆēĄĕö Ģü ãĐè âĈěĄŇ ÿĜğň čĘąëĘĊøė āýĢüþĆēğúċâĬĕĈĔèāĔõüĕ üĐâéĕâüĔüĨ ąĔèāýĊŇĕğþŎüčĕğĎøě ãĐèåĊĕĄāėâĕĆĐĔü÷ĔýĠĆâġ÷ąāýĊŇĕ ãĐèåüģãňúĘħģĄŇğčĘąëĘĊėøéēĄĘ åĊĕĄāėâĕĆĎĈèğĎĈĚĐĐąĜĄŇ ĕâüňĐąĠĈňĊĠøŇåĊĕĄĆěüĠĆèãĐèġĆå éĕâãňĐĄĜĈ âĆēúĆĊèčĕûĕĆöčěãþĿ āýÿĜňþłĊąğþŎüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè åüĢüþĆēëĕâĆ åü ĄĘÿĜňþłĊąĢĎĄŇþĿĈēþĆēĄĕö Ćĕą ĠĈē ĄĘÿğňĜ čĘąëĘĊøė þĿĈē åü ĆĕąèĕüăĕĆēġĆååüģúąþĿ Ġč÷èĊŇĕ ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèğþŎüčĕğĎøěâĕĆøĕąĐĔü÷Ĕý ãĐèåüģúą úĔĨèëĕąĠĈēĎîėè ğþŎüåĊĕĄčĜîğčĘąþĿčěãăĕĊēãĐèþĆēëĕâĆģúąĐĔü÷Ĕý ãĐèåüģúąğāċëĕąĠĈēĐĔü÷Ĕý ãĐèåüģúąğāċĎîėè ĐĕâĕĆãĐèġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèĄĘčĕğĎøěĎĈĔâĥčĐèĐąŇĕèġ÷ąğâė÷éĕââĕĆãĕ÷ğĈĚĐ÷éĕâ ğčňüğĈĚĐ÷čĄĐèøĘýĎĆĚĐĐě÷øĔüĠĈēâĕĆĄĘğĈĚĐ÷ĐĐâĢüčĄĐèġ÷ąÿĜňþłĊąčŇĊü ĄĕâþĆēĄĕöĆňĐąĈē ğâė÷éĕââĕĆãĕ÷ğĈĚĐ÷ ĢüčŇĊüãĐèâĕĆĆĔâČĕāý ĊŇĕĢüčŇĊüãĐèġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħğâė÷éĕââĕĆĄĘğĈĚĐ÷ĐĐâģĄŇģ÷ňĄĘâĕĆ ĄĘâĕĆāĔõüĕâĕĆĆĔâČĕúĘğħ þĈĘąħ üĠþĈèÿĈĢüâĕĆ÷ĜĠĈÿĜþň Ċł ąĢüøĈĐ÷čėýþĿúĘħ ÿŇĕüĄĕĄĕâüĔâĢüãöēúĘħĢüâĈěŇĄúĘħğâė÷éĕââĕĆãĕ÷ğĈĚĐ÷ģ÷ňĄĘâĕĆĆĔâČĕúĘħ ğþĈĘħąüĠþĈèģþéĕâğ÷ėĄĐąŇĕèĄĕâġ÷ąģĄŇĢëŇğþŎüğāĘąèâĕĆĆĔâČĕĠýýþĆē åĔýþĆēåĐèğëŇüğ÷ėĄĠøŇāýĊŇĕ âĕĆĆĔâČĕġ÷ąâĕĆĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷Ģü ÿĜňþłĊąúĘħĄĘĐĕâĕĆčĄĐèãĕ÷ğĈĚĐ÷ìęħèĠøŇğ÷ėĄøňĐèģ÷ňĆĔýąĕăĕąĢü ëĔħĊġĄè ĎĈĔèĄĘĐĕâĕĆ ĠĈēğāėħĄĄĕğþŎüăĕąĢü ëĔħĊġĄèĢüþŌééěýĔü âĕĆĆĔýÿĜňþłĊą ģĊň÷ĜĠĈĢüĎĐÿĜňþłĊąğêāĕēġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè UVTQMG WPKV âĕĆģ÷ňĆĔý ąĕĠĐčģāĆėüăĕąĢü ëĔħĊġĄè ĠĈēâĕĆúĬĕÿŇĕøĔ÷ğāĚħĐĈ÷ăĕĊēčĄĐèýĊĄ

&GEQORTGUUKXG ETCPKGEVQO[ ĢüÿĜňþłĊąúĘħĄĘčĄĐèýĊĄğþŎüâĕĆĆĔâČĕúĘħ ĄĘĎĈĔâòĕüúĕèâĕĆĠāúąŋëĔ÷ğéü GXKFGPEG DCUGF OGFKEKPG ĊŇĕëŇĊą Ĉ÷ĐĔøĆĕâĕĆøĕąĠĈēåĊĕĄāėâĕĆģ÷ňĐąŇĕèĄĘüĔąčĬĕåĔîúĕèčùėøė üĐâéĕâ üĔĨüąĔèĄĘâĕĆĆĔâČĕġ÷ąĊėûĘĐĚħüĥğëŇüâĕĆĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷úĕèčĕąčĊü ĎĈĐ÷ğĈĚĐ÷Ġ÷è âĕĆğĐĕĈėħĄğĈĚĐ÷Đě÷øĔüĢüĎĈĐ÷ğĈĚĐ÷čĄĐèĐĐâúĕèčĕą J Thai Stroke Soc: Volume 14, 2015

čĊüĎĈĐ÷ğĈĚĐ÷Ġ÷èĠøŇąèĔ ĄĘãĐň éĬĕâĔ÷ğüĚĐħ èéĕâøňĐèĐĕċĔą ĠāúąŋÿĜňĄĘåĊĕĄğëĘħąĊëĕîğþŎüāėğċČ ĐąŇĕèģĆâĦøĕĄĄĘ ÿĜňþłĊąúĘħğãňĕùęèâĕĆĆĔâČĕăĕąĢü ëĔħĊġĄè ğāĘąèĆňĐąĈē ĠĈēâĕĆĆĔâČĕ÷ĔèâĈŇĕĊĄĘåŇĕĢëňéŇĕąčĜè ÿĜňþłĊąúĘħģĄŇģ÷ň ĆĔýâĕĆĆĔâČĕúĘğħ ĎĄĕēčĄéęèâŇĐĢĎňğâė÷ğâė÷åĊĕĄāėâĕĆĠĈē ğčĘąëĘĊøė ğþŎüăĕĆēåŇĕĢëňéĕŇ ąúĕèčĔèåĄĠĈē âĕĆ÷ĜĠĈĢüâĕĆ ĢëňëĘĊėøþĆēéĬĕĊĔü ĠĈēĎĕâğâė÷åĊĕĄāėâĕĆĠĈňĊ éēğþŎü ăĕĆēøŇĐåĆĐýåĆĔĊ ĠĈēčĔèåĄ âĕĆéē÷ĬĕğüėüâĕĆĢĎňýĆėâĕĆ âĕĆĆĔâČĕ÷ĔèâĈŇĕĊéęèéĬĕğþŎüøňĐèĄĘâĕĆéĔ÷ĆēýýâĕĆĆĔâČĕ āąĕýĕĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħùĜâøňĐè ğĎĄĕēčĄ þĈĐ÷ăĔą ĆĊ÷ğĆĦĊ ĠĈēģ÷ňĄĕøĆòĕü ĢüčŇĊüãĐèéĔèĎĊĔ÷ğëĘąèĢĎĄŇìęħèğþŎüúĘħøĔĨèãĐè ġĆèāąĕýĕĈĄĎĕĆĕëüåĆğëĘ ą èĢĎĄŇ úĘħ ğ þŎ ü úĔĨ è čùĕü āąĕýĕĈĠĈēğþŎüčŇĊüĎüęħèãĐèâĕĆéĔ÷âĕĆğĆĘąüâĕĆčĐü ãĐèåöēĠāúąċĕčøĆŋ ĄĎĕĊėúąĕĈĔąğëĘąèĢĎĄŇğþŎüġĆè āąĕýĕĈĆē÷Ĕ ý øøė ą ăĜ Ąė Ģ üâĕĆčŇ è øŇ Đ âĕĆĆĔ â Čĕ čùė øė éĬĕüĊüÿĜňþłĊąĢüúĘħğãňĕüĐüĢüġĆèāąĕýĕĈĄĎĕĆĕë÷ňĊą ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĐě÷øĔüãüĕ÷ĢĎîŇ /KFFNG EGTGDTCN KPHCTEV þĿ ĄĘéĬĕüĊü åü øĕĄĈĬĕ÷Ĕý ĠĈēÿĜňþłĊąúĘħùęèĠâŇâĆĆĄĠøŇĈēþĿéĕâġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèğúĘąýğþŎüĐĔøĆĕâĕĆøĕąĆňĐąĈē ùňĕģĄŇøĕąâĦāâė ĕĆ ĠøŇĄÿĘ þňĜ Ċł ąúĘčħ ĕĄĕĆùğãňĕ ùęèýĆėâĕĆĐąŇĕèúĔüúŇĊèúĘüňĐąâĊŇĕĆňĐąĈē ġ÷ąğĆėħĄĄĘ âĕĆéĔ÷ĆēýýčŇèøŇĐéĕâġĆèāąĕýĕĈëěĄëüĠøŇąèĔ ģĄŇģ÷ňĠąâ ĐĐâøĕĄġĆåøŇĕèĥĐąŇĕèëĔ÷ğéüøĕĄåĊĕĄčĬĕåĔîğĆŇè÷ŇĊü éęèąĔèğþŎüĆēýýúĘħģĄŇĄĘþĆēčėúûėăĕā ãĕ÷ĠÿüâĕĆ÷Ĭĕğüėü

èĕüĐąŇĕèğþŎüĆēýý ăĕąĢüġĆèāąĕýĕĈâĦąĔèģĄŇčĆňĕè ĆēýýăĕąĢüğāĚħĐĆĐèĆĔýâĕĆ÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèìęħèøňĐèâĕĆåĊĕĄĆĊ÷ğĆĦĊĐąŇĕèĄĕâ ĠĈēåĊĕĄĆĜňĢü úĕèúćČðĘąèĔ ģĄŇüĕĬ ĈèčĜâŇ ĕĆþñėýøĔ éė ĆėèĢüġĆèāąĕýĕĈġ÷ą úĔĨèÿĜňĆĔýĠĈēÿĜňĢĎňýĆėâĕĆąĔèĄĘåĊĕĄâĔèĊĈğüĚħĐèéĕâąĔèãĕ÷ åĊĕĄĄĔħüĢéĢüâĕĆĢĎňâĕĆĆĔâČĕ÷ňĊąąĕĈēĈĕąĈėħĄğĈĚĐ÷ ĆŇĊĄâĔýþĆēëĕëüĢüëüýú ëĕąĠ÷ü āĚĨüúĘħăĜğãĕğ÷ėüúĕè ĈĬĕýĕâ ğþŎüĐěþčĆĆåøŇĐâĕĆğãňĕùęèýĆėâĕĆăĕąĢüĆēąē ğĊĈĕúĘģħ ÷ňÿĈ ġĆèāąĕýĕĈĄĎĕĆĕëüåĆğëĘąèĢĎĄŇĠĈēċĜüąŋ ġĆåčĄĐèăĕåğĎüĚĐøĆēĎüĔâùęèåĊĕĄčĬĕåĔîĆĘý÷ŇĊüãĐè þŌîĎĕüĘĨ úĘħéēøňĐèëŇĊąâĔüåĊýåěĄåĊĕĄğčĘħąè ýĆėĎĕĆ éĔ÷âĕĆĆēýýâĕĆéĔ÷ýĆėâĕĆĢĎňþî Ō ĎĕġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ýĆĆğúĕğýĕýĕèĈè ĎĆĚĐčĕĄĕĆùĢĎňâĕĆĆĔâČĕúĘùħ âĜ øňĐèúĔü úŇĊèúĘéęèģ÷ňĆėğĆėħĄúĘħéēéĔ÷øĔĨèĎĐÿĜňþłĊąğêāĕēġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèãęĨüğþŎüĠĎŇèĠĆâĢüăĕåğĎüĚĐ ĢüãöēüĔĨüğþŎüëŇĊèğĊĈĕğ÷ĘąĊâĔýúĘħčĬĕüĔâèĕü ĎĈĔâþĆēâĔüčěãăĕāĠĎŇèëĕøė čþčë ĆŇĊĄâĔýĄĜĈüėûė čüĔýčüěüčùĕýĔüþĆēčĕúĊėúąĕâĬĕĈĔèĄĘġåĆèâĕĆāĔõüĕ ĆēýýâĕĆ÷Ĝ Ġ ĈġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèåĆýĊèéĆ ġ÷ą ĊĕèĠÿüéēğĆėħĄ÷ĬĕğüėüâĕĆüĬĕĆŇĐèĢü Ćā ğãøăĜĄėăĕåúĘħĄĘ åĊĕĄāĆňĐĄĠĈēĄĘċĔâąăĕāøĕĄĄĕøĆòĕüúĘħÿĜňğëĘħąĊëĕî ÷ň ĕ üġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèâĬ ĕ Ďü÷ Ģüğ÷Ě Đ üøě Ĉ ĕåĄ ā ċ ùęèğ÷ĚĐüûĔüĊĕåĄ ā ċ éĬĕüĊü ĠĎŇè

øĕĆĕèúĘħ ìęħèġĆèāąĕýĕĈĄĎĕĆĕëüåĆğëĘąèĢĎĄŇģ÷ň ğãňĕĆŇĊĄ ğþŎüâĈěŇĄüĬĕĆŇĐèğĄĚħĐğ÷ĚĐüāćċéėâĕąü

øĕĆĕèúĘħ ĆĕąëĚħĐĎüŇĊąýĆėâĕĆĆēąēĠĆâ 1 2 3 5 7

Ćā ĄĎĕĆĕëüåĆğëĘąèĢĎĄŇ Ćā čěĆĕČðĆŋûĕüĘ Ćā Ďĕ÷ĢĎîŇ Ćā čĆēýěĆĘ čùĕýĔüþĆēčĕúĊėúąĕ Ćā ĄĎĕĆĕëüåĆĆĕëčĘĄĕ Ćā āěúûëėüĆĕë Ćā ċĆĘüåĆėüúĆŋ

J Thai Stroke Soc: Volume 14, 2015

9 10 11 12 13 15

Ćā ąġčûĆ Ćā ëĈýěĆĘ Ćā ĈĬĕþĕè ûĆĆĄċĕčøĆŋğêĈėĄāĆēğâĘąĆøė Ćā āĆēĄèâěðğâĈňĕ Ćā āĆēþâğâĈňĕ Ćā éěďĕĈèâĆöŋ

ġ÷ąġĆèāąĕýĕĈüĬĕĆŇĐèéēúĬĕĎüňĕúĘħğþŎüĠĄŇãŇĕą ĎĈĔâĢĎňâýĔ ġĆèāąĕýĕĈëěĄëüúĘğħ ãňĕĆŇĊĄġåĆèâĕĆğþŎüğåĆĚĐ ãŇ ĕ ą üĔ ý éĕâā ą ġĆèāąĕýĕĈĄĎĕĆĕëüåĆ ğëĘąèĢĎĄŇ åöēĠāúąċĕøĆŋ ĄĎĕĊėúąĕĈĔąğëĘąèĢĎĄŇģ÷ňĆĊŇ Ą ĄĚĐâĔý čþčë ĠĈē ġĆèāąĕýĕĈĢüğãøéĔèĎĊĔ÷ğëĘąèĢĎĄŇ ĈĬĕāĜü ĠāĆŇ ĠĄŇđĐŇ èčĐü ģ÷ňğĆėĄħ āĔõüĕĆēýýğåĆĚĐãŇĕąġ÷ą âŇĐüâĕĆ÷ĬĕğüėüèĕüĄĘþŌééĔą÷ĔèøŇĐģþüĘĨĢëňğþŎüĎĈĔââĕĆĢü âĕĆāĔõüĕĆēýý åĚĐ

ÑśüðĈôíĆĔèßāèÑüÖüÖÓŞÐòÐŚüèÐāòíĀáèā

ġĆèāąĕýĕĈĄĎĕĆĕëüåĆğëĘąèĢĎĄŇ ĄĘéĬĕüĊü ğøĘąèúĔèĨ ĎĄ÷øĕĄâĆĐýğøĘąè ğøĘąè ğþŎüġĆèāąĕýĕĈ ğüňüğĆĚħĐèâĕĆğĆĘąüâĕĆčĐüĠĈēğþŎüġĆèāąĕýĕĈøøėąăĜĄė Ćē÷ĔýčĜè ĠĈē ğþŎü UWRRGT GZEGNNGPV EGPVGT

VTCWOC ECPEGT ECTFKCE EGPVGT ĢüčŇĊüãĐèéĔèĎĊĔ÷ ğëĘąèĢĎĄŇìèęħ ğþŎüúĘøħ èĔĨ ãĐèġĆèāąĕýĕĈĒĄĘþĆēëĕâĆğêāĕē ĢüéĔèĎĊĔ÷þĆēĄĕö Ĉňĕüåü ĄĘ ĐĬĕğăĐ āĘĨüúĘħčŇĊü ĢĎîŇğþŎüăĜğãĕĄĘéĔèĎĊĔ÷ëĕąĠ÷üøė÷âĔýāĄŇĕĢüĎĈĕą āĚĨ ü úĘħ úĬ ĕ ĢĎň â ĕĆğ÷ė ü úĕèĈĬ ĕ ýĕâĢüâĕĆüĬ ĕ čŇ è ýĆė â ĕĆ úĕèâĕĆĠāúąŋ ÷ĔèĠč÷èĢüĆĜþúĘħ ĠĈēĄĘëüâĈěŇĄüňĐą ğþŎü Ąňè âĆēğĎĆĘħąè ģúąĢĎîŇĠĈēāĄŇĕĐĕċĔąĐąĜŇġ÷ąĄĕ úĬĕèĕüúĔĨèĢüğĄĚĐèĠĈēøĕĄøēğãĦýëĕąĠ÷ü ġ÷ąĄĘġĆè āąĕýĕĈëě Ą ëüéĬ ĕ üĊü Ćā úĘħ ãęĨ ü âĔ ý âĆēúĆĊè čĕûĕĆöčěãúĘĢħ ĎňâĕĆ÷ĜĠĈÿĜþň Ċł ą ĠøŇùĕň ÿĜþň Ċł ąĄĘĐĕâĕĆğâėü âĊŇĕúĘéħ ē÷ĜĠĈģ÷ňøĐň èčŇèġĆèāąĕýĕĈĄĎĕĆĕëüåĆğëĘąèĢĎĄŇ ìęħèğþŎüġĆèāąĕýĕĈĆē÷ĔýøøėąăĜĄėĢüâĕĆčŇèøŇĐâĕĆĆĔâČĕ âŇ Đ üâĕĆéĔ ÷ úĬ ĕ ġåĆèâĕĆüĘĨ ġ ĆèāąĕýĕĈĄĎĕĆĕëüåĆ ğëĘąèĢĎĄŇĄĘÿĜňğãňĕùęèýĆėâĕĆģ÷ňąĕĈēĈĕąĈėħĄğĈĚĐ÷ģ÷ňğāĘąè åü ġ÷ąþŌééĔąúĕèăĜĄėþĆēğúċĄĘÿĈĢüâĕĆüĬĕčŇèÿĜňþłĊą ĢĎňúĔüğĊĈĕĆĔýâĕĆĆĔâČĕġ÷ąĐĬĕğăĐúĘħĆēąēúĕèģâĈčě÷åĚĐ ĐĬĕğăĐĐĄâŊĐąĆēąēúĕè âĄ ĠøŇğüĚĐħ èéĕâğþŎüúĕèğĈĦâ ĐĕéĢëňğĊĈĕğ÷ėüúĕè ëĔħĊġĄèĠĈēĢüâĆöĘãĐèÿĜňþłĊąĢü ğãøāĚĨüúĘħéĔèĎĊĔ÷ĠĄŇđŇĐèčĐüéĬĕğþŎüøňĐèĐĕċĔąâĕĆãüčŇè úĕèĐĕâĕċ

êŠÜúāÐŚüèÐāòãĘāċèăèÐāò

ãĕ÷åĊĕĄĆĜňġ÷ą úĔĨèÿĜňþłĊąĠĈēîĕøė ýěåĈĕâĆ úĕèâĕĆĠāúąŋģĄŇúĆĕýĐĕâĕĆğøĚĐüãĐèġĆå YCTPKPI UKIP ãĕ÷ĆēýýâĕĆčŇèøŇĐúĘħĄĘþĆēčėúûėăĕā ğāĆĕē ãĕ÷âĕĆğëĚħĐĄġąèāĜ÷åěą þĆēčĕüèĕüĐąŇĕèğþŎüĆēýý

ýě å ĈĕâĆãĕ÷åĊĕĄĄĔħ ü ĢéĠĈēâĔ è ĊĈÿĈ ãňĕèğåĘąèéĕââĕĆĢĎňâĕĆĆĔâČĕğüĚħĐèéĕâąĔèãĕ÷åĊĕĄĆĜň åĊĕĄğãňĕĢéĐąŇĕèĠúňéĆėèúĬĕĢĎňğâė÷åĊĕĄâĔèĊĈ ġĆèāąĕýĕĈąĔèģĄŇčĆňĕèĆēýýăĕąĢüğāĚħĐ ĆĐèĆĔýâĕĆ÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèìęħèøňĐèâĕĆ åĊĕĄĆĊ÷ğĆĦĊĐąŇĕèĄĕâ ãĕ÷čùĕüúĘĢħ üâĕĆ÷ĜĠĈÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèġ÷ąğêāĕē åĊĕĄĆĜňĢüúĕèúćČðĘąĔèģĄŇüĬĕĈèčĜŇâĕĆþñėýĔøė éĆėèĢüġĆèāąĕýĕĈ þĆēëĕëüĢüëüýú ëĕąĠ÷ü āĚĨüúĘħăĜğãĕğ÷ėü úĕèĈĬĕýĕâ ğþŎüĐěþčĆĆåøŇĐâĕĆğãňĕùęèýĆėâĕĆăĕąĢü ĆēąēğĊĈĕúĘħģ÷ňÿĈ ÿĜþň Ċł ąãĕ÷âĕĆĂŁüŐ ĂĜčĄĆĆùăĕāĐąŇĕèøŇĐğüĚĐħ è ģĄŇĄĘâĕĆčĚħĐčĕĆĐąŇĕèğþŎüĆēýýĆēĎĊŇĕèġĆè āąĕýĕĈ

üÖÓŞêòÿÐüéĎèÐāòãĘāċèăèÐāò ġ÷ąĄĕéĕââĕĆĆŇĊĄĄĚĐãĐèčĎčĕãĕĊėëĕëĘā øňĐè

ĄĘâĕĆĠøŇèøĔèĨ ğþŎüĈĕąĈĔâČöŋĐâĔ ČĆĠĈēĆĊýĆĊĄéĔ÷ĎĕğāĚĐħ ĢĎňğĆėħĄ÷ĬĕğüėüâĕĆģ÷ň ĐèåŋþĆēâĐýĢüâĕĆ÷ĜĠĈÿĜþň Ċł ą þĆēâĐý÷ňĊą éĔ÷øĔèĨ úĘĄ÷ĜĠĈÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĆēąēğêĘąýāĈĔü #EWVG UVTQMG VGCO éĔ÷úĬĕĠüĊúĕè÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèúĘħğþŎüĈĕąĈĔâČöŋĐĔâČĆ 9TKVVGP ECTG RTQVQEQNU ĐýĆĄĢĎňýĆėâĕĆúĕèâĕĆĠāúąŋêěâğêėü

'OGTIGPE[ OGFKECN UGTXKEGU '/5 ğāĚħĐĆĐèĆĔýâĕĆ ÷ĜĠĈÿěňþłĊą CEWVG UVTQMG HCUV VTCEM ğøĆĘąĄåĊĕĄāĆňĐĄĠÿüâêěâğêėüĠĈēúĘĄ Ġāúąŋ āąĕýĕĈĠĈēúĘĄğåĈĚħĐüąňĕąÿĜňþłĊą 'OGTIGPE[ FGRCTVOGPV éĔ ÷ øĔĨ è ĎĐÿĜ ň þ ł Ċ ąġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐè (Stroke unit) âĕĆýĆė â ĕĆ÷ň ĕ üċĔ Ĉ ąâĆĆĄþĆēčĕú

0GWTQUWTIKECN UGTXKEGU úĘħčĕĄĕĆùĢĎňýĆėâĕĆģ÷ňøĈĐ÷ ëĔħĊġĄè âĕĆýĆėâĕĆĆĔèčĘĊėüėéêĔą čĄĐè ĎĔĊĢéĠĈē ĎĈĐ÷ğĈĚ Đ ÷ +OCIKPI UGTXKEGU DTCKP EGTGDTCN XCUEWNCVWTG ECTFKCE úĘħčĕĄĕĆùĢĎňýĆėâĕĆģ÷ňøĈĐ÷ J Thai Stroke Soc: Volume 14, 2015

ëĔĊħ ġĄè ġ÷ąĢüãöēüĔüĨ úĕèġĆèāąĕýĕĈģ÷ňø÷ė øĔèĨ Ćēýý âĕĆĐŇĕüÿĈ QPNKPG úĬĕĢĎňĄåĘ ĊĕĄčē÷ĊâĆĊ÷ğĆĦĊąėèħ ãęüĨ ĠĈē ĄĘĎĐň èøĆĊé %6 øė÷âĔýĎňĐèêěâğêėüúĬĕĢĎňâĕĆøĆĊéĊėüéė êĔą čĕĄĕĆùúĬĕģ÷ňĐąŇĕèĆĊ÷ğĆĦĊ âĕĆøĆĊéúĕèĎňĐèþñėýøĔ âė ĕĆ .CDQTCVQT[ UGTXKEGU ġ÷ąĄĘâĕĆþĆēëěĄúĬĕãňĐøâĈèğāĚħĐãĐþĆēâĔü ğĊĈĕĢĎňģ÷ňĆĔýÿĈğĈĚĐ÷ĢüâĆöĘÿĜňþłĊą HCUV VTCEM ģĄŇğâėü üĕúĘġ÷ąéēĄĘâĕĆþĆēúĔýøĆĕčĔîĈĔâČöĚâĆöĘğþŎüĠĈþ fast track ĠÿüâğăčĔëâĆĆĄ éĔ÷ğøĆĘąĄąĕøĕĄĆňĐèãĐ ĢĎňúüĔ øŇĐğĊĈĕġ÷ąčĕĄĕĆùğýėâéŇĕąąĕģ÷ňøĈĐ÷ ëĔĊħ ġĄè ġ÷ąþâøėģĄŇģ÷ňĄĘâĕĆčĬĕĆĐèąĕģĊňúĘħĎňĐèêěâğêėüğüĚħĐèéĕâ ąĕĄĘ Ć ĕåĕĠāèĠĈēĎň Đ èąĕĐąĜ Ň øė ÷ âĔ ý Ġÿüâêě â ğêė ü ĄĘğăčĔëâĆøĈĐ÷ ëĔħĊġĄè čĕĄĕĆùüĬĕčŇèąĕģ÷ňăĕąĢü üĕúĘ âĕąăĕāýĬĕýĔ÷ĠĈēĂŁŐüĂĜčĄĆĆùăĕā

4GJCDKNKVCVKQP UGTXKEGU ĐèåŋþĆēâĐý÷ňĕüâĕĆýĆėĎĕĆéĔ÷âĕĆĠĈē čüĔýčüěüĢüâĕĆ÷ĜĠĈÿĜňþłĊą ġĆèāąĕýĕĈĎĆĚĐčùĕýĔüĢĎňâĕĆčüĔýčüěü ĠĈē ĄĘÿĜňĐĬĕüĊąâĕĆċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĄĕøĆòĕü ğþŎüÿĜň÷ĬĕğüėüâĕĆĢüăĕāĆĊĄ ĄĘâĕĆĈèúēğýĘąüÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐè ãýĊüâĕĆ÷ĜĠĈ ĠĈēĄĘâĕĆþĆēğĄėüÿĈâĕĆĆĔâČĕġ÷ą âĕĆğâĦýøĔĊëĘĨĊĔ÷ 5VTQMG TGIKUVT[ YKVJ QWVEQOGU CPF 3+ EQORQPGPVU âĕĆåĊĕĄĆĜĠň âŇýåě ĈĕâĆúĕèâĕĆĠāúąŋĠĈē þĆēëĕëüúĔħĊģþ 'FWECVKQPCN RTQITCOU âĕĆþĆēğĄėüĠĈēĆĔýĆĐèğāĚħĐğþŎüċĜüąŋġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèĄĕøĆòĕü %GTVKÌGF RTKOCT[ UVTQMG center) éĕâãňĐĄĜĈãňĕèøňüüĬĕĄĕčĜŇâĕĆāĔõüĕĆēýýâĕĆ ÷ĜĠĈÿĜňþłĊąġ÷ąĄĘâĕĆĠýŇèâĕĆ÷ĬĕğüėüğþŎüãĔĨüøĐü÷ĔèüĘĨ ĆēąēúĘħ āĔõüĕĆēýýăĕąĢüġĆèāąĕýĕĈ éĔ÷þĆēëěĄëĘĨĠéèúĬĕåĊĕĄğãňĕĢéýěåĈĕâĆĢü Ćā ğĐè ĠĈēĢĎňåĊĕĄĆĜňğâĘħąĊâĔýġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĐĕâĕĆğøĚĐüâĕĆĆĔâČĕġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýøĔü÷ňĊąąĕ ĈēĈĕąĈėħĄğĈĚĐ÷ĠĈēâĕĆ÷ĜĠĈÿĜňþłĊąéĕâġĆå÷ĔèâĈŇĕĊĠĈē

J Thai Stroke Soc: Volume 14, 2015

ëĘĨĠéèĠüĊúĕèâĕĆĆĔâČĕúĘħâĈĔèéē÷Ĭĕğüėüèĕü âĕĆéĔ ÷ øĔĨ è ĎĐÿĜ ň þ ł Ċ ąġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐè ÿĜýň ĆėĎĕĆġĆèāąĕýĕĈĄĎĕĆĕëüåĆğëĘąèĢĎĄŇģ÷ňĐüěğåĆĕēĎŋ čùĕüúĘħ÷Ĕ÷ĠþĈèĎĐÿĜňþłĊąġĆåþĐ÷ğ÷ėĄúĘħģĄŇģ÷ňĢëňèĕü ĄĕúĬĕâĕĆéĔ÷øĔèĨ ĎĐÿĜþň Ċł ąĊėâćøėġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĠĈē ġ÷ąåĊĕĄĆŇĊĄĄĚĐéĕâċĜüąŋġĆåčĄĐèăĕåğĎüĚĐĠĈēċĜüąŋ ċĆĘ āĔ õ üŋ Ģ Ďň â ĕĆčüĔ ý čüě ü ÷ň ĕ üýě å åĈĕâĆ ĆŇ Ċ ĄâĔ ý úĘ Ą ýěåĈĕâĆĠāúąŋ āąĕýĕĈ ğéňĕĎüňĕúĘħĎüŇĊąþñėýĔøėâĕĆ âĈĕè ĎüŇĊąĆĔèčĘĊėüėéêĔą ăĕåĊėëĕĂŁŐüĂĜĒĄĕĆŇĊĄĄĚĐâĔü ĢüĈĔâČöēãĐèčĎčĕãĕĊėëĕëĘā ġ÷ąâĕĆčüĔýčüěü÷ňĕü åĊĕĄĆĜňĢüâĕĆ÷ĬĕğüėüâĕĆéĔ÷øĔĨè âĕĆĀŀâĐýĆĄýěåĈĕâĆĢü ĎĐÿĜňþłĊąĠĈēâĕĆþĆēğĄėüåĊĕĄāĆňĐĄġ÷ąúĘĄĐĕéĕĆąŋ ÿĜňğëĘħąĊëĕîéĕâčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúąĠĈē čùĕýĔüþĆēčĕúĠĈēģ÷ňÿŇĕüâĕĆğąĘħąĄčĬĕĆĊéğāĚħĐĆĔýĆĐè âĕĆĢĎňýĆėâĕĆ÷ĜĠĈĆĔâČĕÿĜňþłĊą #EWVG UVTQMG ĠĈēĢĎňąĕ êĘ÷ĈēĈĕąĈėĄħ ğĈĚĐ÷éĕâčùĕýĔüþĆēčĕúĊėúąĕğĄĚĐħ ĊĔüúĘ ħ āćċéėâĕąü čĕĄĕĆùğĆėħĄğþľ÷÷ĬĕğüėüâĕĆĆĔýÿĜňþłĊą ģ÷ňåĆĔĨèĠĆâéĬĕüĊü ğøĘąèéĕâġåĆèâĕĆúĘħĊĕèģĊňúĔĨèĎĄ÷ ğøĘąèøĔĨèĠøŇ ûĔüĊĕåĄ âĕĆéĔ÷úĬĕECTG OCR ĠĈē UVCPFKPI QTFGT ğĄĚħĐĄĘÿĜňþłĊą HCUV VTCEM úĔĨèĢüĠĈēüĐâġĆèāąĕýĕĈġ÷ą ĄĘâĕĆþĆēëěĄĆŇĊĄĆēĎĊŇĕèúĘĄčĎčĕãĕĊėëĕëĘāúĔèĨ ýěåĈĕâĆ úĕèâĕĆĠāúąŋ þĆēčĕúĠāúąŋ þĆēčĕúċĔĈąċĕčøĆŋ ĆĔèčĘĠāúąŋ ĠāúąŋğĊëċĕčøĆŋĂŁŐüĂĜ ĠāúąŋğĊëċĕčøĆŋ êěâğêėü ýěåĈĕâĆúĕèĀłĕąâĕĆāąĕýĕĈ ýěåĈĕâĆĀłĕą ĎňĐèþñėýĔøėâĕĆĠĈē ğéňĕĎüňĕúĘħĢüâĕĆğåĈĚħĐüąňĕąÿĜňþłĊą ğāĚħĐāĔõüĕĆēýýèĕüĢüâĕĆ÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèĄĘâĕĆĆŇĕèECTG OCRčĬĕĎĆĔýâĕĆĆĐèĆĔýÿĜňþłĊąúĘħ éĕâúĔĨèĢüĠĈēüĐâġĆèāąĕýĕĈ÷ĔèĆĜþúĘħ ĠýýčŇèøŇĐĠĈē ĆĔýâĈĔýĆēĎĊŇĕèġĆèāąĕýĕĈ ĄĘâĕĆéĔ÷úĬĕ UVCPFKPI QTFGT ĠĈē VJTQODQN[VKE EJGEM NKUV ĄĘâĕĆéĔ÷øĔĨèåöēâĆĆĄâĕĆ 2%6 UVTQMG ĠĈēĄĘâĕĆéĔ÷þĆēëěĄúěâčĐèùęèčĕĄğ÷ĚĐü éĔ÷úĬĕ IWKFGNKPG âĕĆĆĔâČĕġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘý øĔü÷ňĊąąĕĈēĈĕąĈėħĄ ğĈĚ Đ ÷ğĆėħ Ą øň ü úĘħ Ď ň Đ èêě â ğêė ü øĕĄĠüĊúĕèãĐèčùĕýĔ ü þĆēčĕú éĔ÷úĬĕøĔĊëĘĊĨ ÷Ĕ ġ÷ąĐňĕèĐėèøĕĄğâöôŋĄĕøĆòĕüĢü Ćē÷ĔýčĕâĈĠĈēãĐèčùĕýĔüþĆēčĕúĊėúąĕĠĈēüĬĕĄĕþĆĔý ĢëňĢĎňğĎĄĕēčĄøĕĄýĆėýúĢüþŌééěýüĔ ğāĚĐħ ĢĎňčĕĄĕĆùüĬĕĄĕ ĢëňğþĆĘąýğúĘąýĆē÷ĔýåĊĕĄčĕĄĕĆùĢüâĕĆ÷ĜĠĈÿĜþň Ċł ąâĈěĄŇ

ġĆåğ÷ĘąĊâĔü ĄĘâĕĆĆĕąèĕüåĊĕĄâňĕĊĎüňĕÿĈâĕĆ÷Ĭĕğüėü èĕü ĠĈēĄĘâĕĆ HGGF DCEM þŌîĎĕĠĈēĄĘ âĕĆéĔ÷âĕĆ÷ňĊą âĕĆāĜ÷åěąþĆęâČĕğëėèĆēýýúěâåĆĔĨèğĄĚħĐğâė÷þŌîĎĕ ĄĘâĕĆâĬĕĎü÷Ćēýý ECNN EGPVGT ìęħè ğþŎüğýĐĆŋâĈĕèĐąĜŇú Ęħ Ćā üåĆāėèåŋ ĎĆĚĐ ìęħè ğþŎüğýĐĆŋøĆèãĐèġĆèāąĕýĕĈĄĎĕĆĕë ġ÷ą ECNN EGPVGT éēğþŎüÿĜþň ĆēčĕüâĕĆøė÷øŇĐĆēĎĊŇĕèÿĜüň ĕĬ čŇèâĔýġĆèāąĕýĕĈ þĈĕąúĕèĢüúĘüħ åĘĨ ĐĚ ġĆèāąĕýĕĈĄĎĕĆĕëĒ ġ÷ąâĕĆøė÷øŇĐ éēùĜâþĆēčĕüĄĕġ÷ąøĆèùęèąĔèĠāúąŋĆēýýþĆēčĕúġĆè āąĕýĕĈĄĎĕĆĕëĒâŇĐüúěâĆĕą ĄĘâĕĆâĬĕĎü÷øĕĆĕèâĕĆ ĐąĜŇğĊĆëĔ÷ğéüøĈĐ÷ ëĔħĊġĄèúěâĊĔü ğĄĚħĐģ÷ňĆĔýâĕĆ ąĚüąĔüéēĄĘâĕĆüĬĕčŇèÿĜňþłĊąĄĕąĔèġĆèāąĕýĕĈĄĎĕĆĕëĒ ġ÷ąøĆèġ÷ąģĄŇ éĬ ĕ ğþŎ ü øň Đ èĆĔ ý âĕĆøĆĊéğāėħ Ą ğøė Ą ğāĚħ Đ âĕĆĊėüėéêĔąĐĚħüĢ÷âŇĐüąâğĊňüĄĘåĊĕĄéĬĕğþŎüúĘħÿĜňþłĊąøňĐè ģ÷ňĆýĔ øňĐèĆĔâČĕêěâğêėüĐĚüħ âŇĐüâĕĆüĬĕčŇè÷ĔèĠč÷èĢü ÍQY EJCTV úĘħģ÷ňâĈŇĕĊģþĠĈňĊ ğĄĚħĐÿĜňþłĊąĄĕùęèġĆèāąĕýĕĈ ĄĎĕĆĕëĒĠĈňĊĆùüĬĕčŇèéēøňĐèĆĐéüâĊŇĕÿĜňþłĊąéēģ÷ňĆĔý âĕĆąĚüąĔüğãňĕĆĔýâĕĆĆĔâČĕĢüġĆèāąĕýĕĈéęèéēâĈĔýģþ ąĔèġĆèāąĕýĕĈøňüúĕèģ÷ň ĢüâĆöĘúĘħÿĜňþłĊąģĄŇĢëŇÿĜňþłĊąúĘħ čĕĄĕĆùĢĎňâĕĆĆĔâČĕ÷ňĊąąĕĈēĈĕąĈėħĄğĈĚĐ÷÷ňĊąčĕğĎøě Ģ÷âĦøĕĄĠøŇĄĘãňĐýŇèëĘĨĢüâĕĆĆĔýüĐüĢü UVTQMG WPKV ğüĚħĐè ÷ňĊąğĎøěĐĚħüğëŇüĆā øňüúĕèģĄŇčĕĄĕĆùĢĎňâĕĆ÷ĜĠĈģ÷ň ğüĚĐħ èéĕâĐĕéĄĘăĕĊēĠúĆâìňĐüøĕĄĄĕéĕâčĕğĎøěĎĈĐ÷ ğĈĚĐ÷čĄĐèøĘý ĠøâĢüåĆĔĨèüĘĨğëŇüâĕĆĄĘčĄĐèýĊĄ ğĈĚĐ÷ ĐĐâğāėħĄãęĨüğþŎüøňü éēģ÷ňĆĔýâĕĆĆĔâČĕğëŇüâĔü âĕĆāĔõüĕĆēýýâĕĆĢĎňýĆėâĕĆĠĈēâĕĆøė÷øĕĄ ÿĜňþłĊą ġ÷ąâĕĆĢëňĆēýý ECUG OCPCIGT ğþŎüÿĜňøė÷øĕĄ ÿĜňþłĊąøĈĐ÷ĠüĊúĕèâĕĆĆĔâČĕ ĄĘâĕĆéĔ÷úĬĕġåĆèâĕĆ ĊĕèĠÿüéĬĕĎüŇĕąÿĜňþłĊąġ÷ąğþŎüâĕĆþĆēğĄėüčăĕāãĐè ÿĜňþłĊąĠĈēĊĕèĠÿü÷ĜĠĈāąĕýĕĈøĈĐ÷éüâĕĆĢĎňãňĐĄĜĈ ĠĈēåĊĕĄĆĜňĢüâĕĆþñėýĔøėøüğĆėħĄøĔĨèĠøŇĊĔüĠĆâúĘħĆĔýâĕĆ ĆĔâČĕ ĠĈēĢĎňîĕøėĄĘčŇĊüĆŇĊĄĢüâĕĆøĔ÷čėüĢé ĠĈēëŇĊą ğĎĈĚĐÿĜňþłĊąĐąŇĕèĢâĈňëė÷ âĕĆĂŁŐüĂĜčĄĆĆĆùăĕāăĕąĎĈĔèğâė÷ĐĕâĕĆ ùňĕģĄŇĄĘăĕĊēĠúĆâìňĐüġ÷ąþâøėéēğĆėħĄúĬĕğĆĦĊúĘħčě÷ġ÷ą úĘ Ą âĕąăĕāýĬĕ ýĔ÷ãĐèåöēĠāúąċĕčøĆŋ ĠĈēåöē ğúåüėåâĕĆĠāúąŋĆĊĄúĔèĨ ğéňĕĎüňĕúĘāħ ąĕýĕĈëŇĊąĢĎňîĕøė ĄĘ č Ň Ċ üĆŇ Ċ ĄĢüâĕĆĀŀ â ĀüúĬ ĕ âĕąăĕāýĬ ĕ ýĔ ÷ ãň ĕ èğøĘ ą è âĆöĘ úĘħ ÿĜ ň þ ł Ċ ąąĔ è åèĄĘ Đ ĕâĕĆĐŇ Đ üĠĆèĠĈēîĕøė ąĔ è ģĄŇ

čĕĄĕĆùþñėýøĔ ģė ÷ňìèęħ éĬĕğþŎüøňĐèéĬĕĎüŇĕąģ÷ňü÷Ĕ ĢĎňîĕøėāĕ ÿĜňþłĊąĄĕúĬĕâĕąăĕāýĬĕýĔ÷øŇĐúĘħĎňĐèúĬĕâĕąăĕāýĬĕýĔ÷ âĆöĘčèŇ øŇĐÿĜþň Ċł ąģþĆĔâČĕúĘġħ ĆèāąĕýĕĈëěĄëüğāĚĐħ āĔâĂŁüŐ ĎĆĚĐúĬĕâĕąăĕāýĬĕýĔ÷øŇĐ ĠāúąŋéēğãĘąüĆĕąèĕüãňĐĄĜĈ âĕĆčŇèøŇĐĠĈēéĔ÷âĕĆþĆēčĕüčŇèøŇĐøĕĄĠüĊúĕèãĐè ECNN EGPVGT úĘħĄĘĠüĊúĕèâĕĆþĆēčĕüĆēĎĊŇĕèéĔèĎĊĔ÷ĠĈňĊ ĠøŇãĐüĔ÷ÿĜňþłĊąğāĚħĐâĈĔýĄĕ÷ĜĐĕâĕĆăĕąĢü ğ÷ĚĐü ĎĈĔèéĕâüĔĨüĠāúąŋĐĕéāėéĕĆöĕĢĎňÿĜňþłĊąčĕĄĕĆùĆĔâČĕ øŇĐģ÷ňúĘħġĆèāąĕýĕĈğ÷ėĄġ÷ąğãĘąüčĆěþãňĐĄĜĈâĕĆĆĔâČĕ āąĕýĕĈĢü TGHGT čŇèâĈĔý ĆēąēúĘħ âĕĆāĔõüĕğåĆĚĐãŇĕą þĆēëěĄãňĐøâĈèĆŇĊĄâĔüĆēĎĊŇĕè Ćā øŇĕèĥĢü ãĐýğãøāĚüĨ úĘúħ âĘħ ĕĬ Ďü÷éĔ÷øĔèĨ åöēúĬĕèĕüĆē÷ĔýğåĆĚĐãŇĕą ġ÷ąþĆēëěĄĆŇĊĄâĔýčþčë ğãø ĠĈēġĆèāąĕýĕĈþĆēčĕú ğāĚħĐĠýŇèğãøġĆèāąĕýĕĈĢüåĊĕĄĆĔýÿė÷ëĐý ĠĈēéĔ÷úĬĕ ğĐâčĕĆåĜĄŇ ĐĚ UVTQMG HCUV VTCEM ĆēýýâĕĆčŇèøŇĐĠĈēĆĔýâĈĔý ġ÷ąĄĘâĕĆāĔõüĕğåĆĚĐãŇĕąåĆĐýåĈěĄġĆèāąĕýĕĈøŇĕèĥ ġ÷ąğãøġĆèāąĕýĕĈĈĜâãŇĕąĢüëŇĊèĠĆâĆēĎĊŇĕèþĿ ā ċ ĄĘéĕĬ üĊüġĆèāąĕýĕĈĈĜâãŇĕą ĠĎŇè åĈĐý åĈěĄ éĔèĎĊĔ÷ ģ÷ňĠâŇ Ćā üåĆāėèåŋ Ćā čĔüâĬĕĠāè Ćā ÷ĐąčēğâĦ÷ Ćā ĠĄŇĐĐü Ćā ĠĄŇĊĕè Ćā čēğĄėè Ćā āĆňĕĊ Ćā ÷ĐąğøŇĕ Ćā ĐĄâŊĐą Ćā ÷ĐąĎĈŇĐ Ćā ĈĬĕāĜü Ćā ĠāĆŇ ùĔ÷ĄĕĢüþĿ ā ċ þĆĔýğāėħĄğþŎü ġĆèāąĕýĕĈĈĜâãŇĕą Ćā üåĆāėèåŋ Ćā čĔüâĬĕĠāè Ćā ÷ĐąčēğâĦ÷ Ćā ĠĄŇĐĐü Ćā ĠĄŇĊĕè Ćā čēğĄėè Ćā āĆňĕĊ Ćā ÷ĐąğøŇĕ Ćā ĐĄâŊĐą Ćā ÷ĐąĎĈŇĐ Ćā ĈĬĕāĜü Ćā ċėĆėğĊë ĈĬĕāĜü Ćā ĠĄŇúĕ Ćā ýňĕüġđŇè Ćā ĈĘĨ Ćā úěŇèĎĔĊëňĕè Ćā þłĕìĕè Ćā ýňĕüûė Ćā ĠāĆŇ Ćā čĄğ÷Ħ é āĆēąě ā Ćĕëğ÷Ň ü ëĔ ą Ćā Ćň Đ èâĊĕè Ćā ĈĐè Ćā čĜèğĄŇü Ćā čĐè Ćā ĊĔèëėĨü Ćā ĎüĐèĄŇĊèģãŇ Ćā ğëĘąèĢĎĄŇĢâĈňĎĄĐ Ćā ĠĄŇĈĕüňĐą Ćā ĠĄŇčēğĆĘąè Ćā čýğĄą øĔĨèĠøŇþĿ ā ċ ĠĈē Ćā ĠāĆŇ ĠĈē Ćā üåĆāėèåŋ ģ÷ňāõ Ĕ üĕċĔâąăĕāéüčĕĄĕĆùĢĎňâĕĆ÷ĜĠĈÿĜþň Ċł ąĢüĆēýý CEWVG UVTQMG HCUV VTCEM ąĕĈēĈĕąĈėħĄğĈĚĐ÷ğĐèģ÷ňĠĈňĊ

ÐāòãĘāċèăèÖāèíĀáèāÖāèċÓòĆüÑŚāñ

âĕĆâĬĕĎü÷ĠüĊúĕèčŇèøŇĐĆĔýâĈĔýÿŇĕüĆēýý

J Thai Stroke Soc: Volume 14, 2015

HCUV VTCEM Ćā ġ÷ąâĕĆĊĕèĠüĊúĕèĠĈēéĔ÷þĆēëěĄ Ćā ğåĆĚĐãŇĕąğāĚħĐčĚħĐčĕĆĠüĊúĕèâĕĆ ÷ĬĕğüėüèĕüĠĈâ ğþĈĘħąüåĊĕĄåė÷ğĎĦüğāĚħĐĢĎňģ÷ňĐèåŋþĆēâĐýúĘħğĎĄĕēčĄ ĠĈēčĚħĐčĕĆøĆèâĔü÷÷ąğêāĕēğĆĚħĐèâĕĆâĬĕĎü÷ğĊĈĕĢü âĕĆğãňĕùęèýĆėâĕĆúĘħåĊĆĄĘğĊĈĕ÷ĬĕğüėüâĕĆúĘħġĆèāąĕýĕĈ þĈĕąúĕèĐąŇĕèøĬĕħ üĕúĘ âĕĆ÷ĬĕğüėüâĕĆúĕè÷ňĕüĊėëĕâĕĆğāĚħĐğþŎü âĕĆāĔõüĕýěåĈĕâĆğåĆĚĐãŇĕą ģ÷ňĠâŇéĔ÷ĐýĆĄåĊĕĄĆĜňúĕè Ċė ë ĕâĕĆþĆēéĬ ĕ þĿ Ć ĊĄùę è âĕĆģþğþŎ ü Ċė ú ąĕâĆĢĎň âĔ ý Ćā ğåĆĚ Đ ãŇ ĕ ą ĠĈēčŇ è ğčĆė Ą čüĔ ý čüě ü čĚħ Đ âĕĆčĐü þĆēëĕčĔ Ą āĔ ü ûŋ Ġ âŇ Ćā ĈĜ â ãŇ ĕ ą ĐýĆĄåĊĕĄĆĜ ň Ġ Ĉē þĆēëĕčĔ Ą āĔ ü ûŋ čĔ î îĕöĐĔ ü øĆĕąĠâŇ þ ĆēëĕëüĠĈē ýěåĈĕâĆĢüğåĆĚĐãŇĕą éĔ÷èĕü UVTQMG RTGXGPVKQP FC[ ğāĚĐħ ğÿąĠāĆŇåĊĕĄĆĜĠň ĈēøĆĊéĎĕâĈěĄŇ ğčĘąħ èĠâŇýåě åĈúĔĊħ ģþ âĆēøě ň ü ĢĎň Ć ā ğåĆĚ Đ ãŇ ĕ ąéĔ ÷ úĬ ĕ ġåĆèâĕĆ āĔõüĕâĕĆ÷ĜĠĈÿĜňþłĊą UVTQMG øĕĄċĔâąăĕāâĕĆ÷ĜĠĈ ĢüĆēąēøŇĕèĥ øĔĨèĠøŇâŇĐüğâė÷ġĆå ãöēğþŎü ĠĈēâĕĆ÷ĜĠĈ ĎĈĔèéĬĕĎüŇĕą ğüňüøĔĨèåöēâĆĆĄâĕĆĆĔýÿė÷ëĐý éĔ÷úĬĕ (NQY âĕĆ÷ĬĕğüėüèĕüþĆēčĕüøŇĐĢüĆē÷ĔýĐĬĕğăĐ éĔèĎĊĔ÷ úěâġĆèāąĕýĕĈġ÷ąģ÷ňĆĔýúěüčüĔýčüěüéĕâčþčë ĆĔýþĆęâČĕĠĈēþĆēčĕüĠâňģãþŌîĎĕâĕĆĆĔý čŇè øŇĐ ğĄĚħĐğåĆĚĐãŇĕąāýþŌîĎĕ÷ňĕüâĕĆ TGHGT øė÷øĕĄÿĈâĕĆ÷ĬĕğüėüèĕüĠĈēøĔĊëĘĨĊĔ÷ãĐè ğåĆĚĐãŇĕą ĠĈēĆĕąèĕüøŇĐ čþčë úěâ ğ÷ĚĐü ĆēąēúĘħ âĕĆþĆēëĕčĔĄāĔüûŋ ġ÷ąâĕĆčĚħĐãňĐĄĜĈãŇĕĊčĕĆåĊĕĄĆĜňğâĘħąĊâĔýåĊĕĄ ğãňĕĢéğĆĚĐħ èġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè åĊĕĄčĬĕåĔîĐĕâĕĆğøĚĐü ĠĈēâĕĆĆĔâČĕĆĊĄùęè ĠüĊúĕèâĕĆğãňĕùęèýĆėâĕĆĠĈē ĠüēüĬĕýĆėâĕĆ ECNN EGPVGT ÿŇĕüčĚħĐġ÷ąĊėûĘâĕĆøŇĕèĥúĔĨè âĕĆéĔ÷èĕüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèğþŎüþĆēéĬĕúěâþĿ âĕĆúĬĕ þĆēëĕčĔĄāĔüûŋÿŇĕüčĚħĐġúĆúĔċüŋ ĊėúąěĠĈēĎüĔèčĚĐāėĄāŋ ĆēąēúĘħ âĕĆåňüĎĕ ğĀŃĕĆēĊĔèĠĈēĂŁŐüĂĜčăĕā ġ÷ąâĕĆéĔ÷øĔĨèåĈėüėâåĔ÷âĆĐèÿĜňþłĊąúĘħĄĘåĊĕĄ ğčĘąħ èøŇĐâĕĆğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèčĜèğāĚĐħ ĢĎňåĊĕĄĆĜĢň ü âĕĆþŃĐèâĔü éĔ÷øĔĨèåĈėüėâġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèğāĚħĐĢĎň ýĆėâĕĆÿĜÿň þłĊąğêāĕēġĆåğāĚĐħ ĢĎňâĕĆĆĔâČĕøŇĐğüĚĐħ èĢüâĈěĄŇ ÿĜþň Ċł ąúĘüħ ÷Ĕ Ąĕøė÷øĕĄĆĔâČĕĎĈĔèéĕâĐĐâġĆèāąĕýĕĈĎĆĚĐ ÿĜňþłĊąĢĎĄŇúĘħøňĐèâĕĆĆĔýåĬĕþĆęâČĕ

J Thai Stroke Soc: Volume 14, 2015

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÷ňĕüâĕĆĢĎňâĕĆĆĔâČĕÿĜňþłĊą #EWVG UVTQMG ÿĜþň Ċł ąĄĕĆĔýýĆėâĕĆģ÷ňĆýĔ ąĕĈēĈĕąĈėĄħ ğĈĚĐ÷ TV2# ăĕąĢü ëĄ ĄĕâãęüĨ ĠĈēğĆĦĊãęüĨ úěâþĿ÷èĔ Ġč÷èĢüøĕĆĕèúĘħ ĠĈēÿĈĈĔāûŋãĐèâĕĆĆĔâČĕĢüĆĜþúĘħ ÷ňĕüâĕĆþŃĐèâĔüĠĈēğĀŃĕĆēĊĔèġĆå éĔ ÷ ĢĎň å ĊĕĄĆĜ ň Ġ âŇ þ ĆēëĕëüúĔĨ è ĢüġĆè āąĕýĕĈ 5VTQMG RTGXGPVKQP FC[ ğþŎüþĆēéĬĕúěâþĿúĬĕ ĢĎňåüň āýþĆēëĕâĆâĈěĄŇ ğčĘąħ èğāėĄħ ãęüĨ ĠĈēğþŎüâĕĆğÿąĠāĆŇ åĊĕĄĆĜňĠâŇýěååĈĕâĆĢüġĆèāąĕýĕĈĠĈēýěååĈúĔħĊģþ âĕĆéĔ÷čĚħĐþĆēëĕčĔĄāĔüûŋĠéâøĕĄ Ćā ëěĄëüĠĈēčùĕüĘĐüĕĄĔąúĬĕĢĎňğãňĕùęèþĆēëĕëüĠĈēé÷éĬĕ ģ÷ňèŇĕąãęĨü ĆŇĊĄâĔýġĆèāąĕýĕĈĈĜâãŇĕąĢüâĕĆāĔõüĕ ĆēýýâĕĆ÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèčĜŇëěĄëüğāĚħĐ ğøĆĘ ą ĄāĆň Đ ĄčĜ Ň â ĕĆāĔ õ üĕâĕĆĢĎň ą ĕģ÷ň ÷ ň Ċ ąøüğĐèĢü Đüĕåø ĆĜþ Ġč÷èÿĈâŇĐü ĎĈĔèâĕĆāĔõüĕğåĆĚĐãŇĕą øĔĊĐąŇĕèġåĆèâĕĆãĐèĆā ğåĆĚĐãŇĕą Ć ā čēğĄėè ÁčĆňĕèğåĆĚĐãŇĕąâĕĆğĀŃĕĆēĊĔèĢü ëěĄëüÂ åĔ÷âĆĐèĠĈēøė÷øĕĄøŇĐ éĔ÷âėéâĆĆĄ Á5VTQMG RTGXGPVKQP FC[ āå Â Ć ā üåĆāėèåŋ ÁâĕĆāĔõüĕâĕĆ÷ĜĠĈÿĜňþłĊąġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèčĬĕĎĆĔý ECTGIKXGTÂ þŌééěýüĔ čĕĄĕĆùĢĎň ąĕĈēĈĕąĈėħĄğĈĚĐ÷ğĐèģ÷ň Ć ā āĆňĕĊ ÁğĀŃĕĆēĊĔèâĈěĄŇ ğčĘąħ èčĜèĠĈēğÿąĠāĆŇ åĊĕĄĆĜňğĆĚħĐèġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèčĜŇëěĄëüġ÷ąĊėúąěëěĄëü ĐýĆĄåĊĕĄĆĜň è÷čĜýýěĎĆĘħ è÷čěĆĕÂ Ć ā ĠĄŇĐĐü ÁâĕĆ÷ĜĠĈĆĔâČĕġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèĠýýåĆýĊèéĆÂ åĔ÷âĆĐèğĀŃĕĆēĊĔèğëėèþŃĐèâĔü ÷ĜĠĈ åĊĕĄğčĘħąèĎĈĔèğâė÷ġĆå ĂŁŐüĂĜ÷ĜĠĈøŇĐğüĚħĐèúĘħýňĕüĠĈē éĔ÷ĆēýýğâĦýãňĐĄĜĈ Ć ā ÷ĐąĎĈŇĐ ÁéĔ÷øĔèĨ åöēâĆĆĄâĕĆ åĔ÷âĆĐè âĈěŇĄğčĘħąè ĐýĆĄ ĐčĄ Ć ā ĠāĆŇ ÁĐýĆĄåĊĕĄĆĜňýěåĈĕâĆ éĔ÷Ćēýý (CUV VTCEM ĢüĆā þŌééěýĔüčĕĄĕĆùĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷ ğĐèģ÷ň Ć ā čĔüâĬĕĠāè ÁåĔ÷âĆĐèâĈěŇĄğčĘħąè ĐýĆĄ ĢĎňåĊĕĄĆĜňĎüŇĊąâĜňëĘā ğąĘħąĄýňĕü ĠĈēğÿąĠāĆŇåĊĕĄĆĜň åĊĕĄĆĜňğĆĚħĐèġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèčĜŇëěĄëü ġĆèğĆĘąüÂ

øĔĊëĘĨĊĔ÷ ĆňĐąĈē Stroke fast track (rtPA) ĆňĐąĈēãĐèÿĜňþłĊąúĘħĄĕăĕąĢü ëĄ ģ÷ňĆĔýąĕ TV 2# &QQT VQ PGGFNG VKOG ĐĕâĕĆÿĜňþłĊąĎĈĔèĢĎňąĕ TV2# ğþŎüþâøė ĄĘ DNGGFKPI 5[ORVQOCVKE +%* #U[ORVQOCVKE +%* ĎĈèğĎĈĚĐåĊĕĄāėâĕĆ øĕąĢü Ćā

ğþŃĕĎĄĕą

2551 2552 2553 2554 2555 2556

ğāėħĄãęĨü úěâþĿ

103

100

97.9

üĕúĘ

57.2

>30%

72.5

10 11 30 22

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5 27.5 0

1.1

øĕĆĕèúĘħ Ġč÷èÿĈĈĔāûŋãĐèâĕĆĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷ Ć ā ÷ĐąčēğâĦ÷ ġåĆèâĕĆğąĘħąĄýňĕüÿĜňþłĊą éĔ÷åŇĕąåĊĕĄĆĜňĢĎň ĐčĄ Ć ā ÷ĐąğøŇĕ øĔĨèúĘĄ UVTQMG éĔ÷úĬĕ RTKOCT[ RTGXGPVKQP Ć ā ĐĄâŊĐą åĔ÷âĆĐè ğąĘħąĄýňĕüĠĈēéĔ÷úĬĕ čĚħĐ UVTQMG CNGTV ăĕČĕâĆēğĎĆĘħąè Ć ā ĈĬĕāĜü ÁġåĆèâĕĆĐýĆĄåĊĕĄĆĜğň éňĕĎüňĕúĘħ āąĕýĕĈĠĈēâĕąăĕāýĬĕýĔ÷ ğąĘħąĄ ýňĕüÿĜňþłĊą ĠĈē éĔ÷ğâĦýøĔĊëĘĨĊĔ÷ Ć ā ĠĄŇĊĕè åĔ÷âĆĐèâĈěĄŇ ğčĘąħ è ĠĈēéĔ÷ĐýĆĄ ĢĎňåĊĕĄĆĜň

ÓöāðïāÓïĈðĎă × ÐāòċëñČíòŚëôÖāèÑüÖæĄðÖāè

üĬĕğčüĐ QTCN RTGUGPVCVKQP ÿĈèĕüĊėéĔą OKPK TGUGCTEJ ãĐèċĜüąŋåĊĕĄĆŇĊĄĄĚĐāĔõüĕåěöăĕā ġĆèāąĕýĕĈ *#%% ğëĘąèĢĎĄŇ ā ċ ĠĈē ā ċ ëĄĆĄāąĕýĕĈ UVTQMG čĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèþĆēğúċģúą Ąå Ģüèĕü 0CVKQPCN HQTWO ãĐèčùĕýĔüĆĔýĆĐèåěöăĕā Ćā ĄĘå ĠĈēĢüèĕü 6JG VJ 4GIKQPCN (QTWO 3WCNKV[ +ORTQXGOGPV CPF *QURKVCN #EETGFKVCVKQP Ąėùěüĕąü ÿŇĕüâĕĆåĔ÷ğĈĚĐâğþŎüğåĆĚĐãŇĕąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐè÷Ęğ÷ŇüãĐèčþčë ğãø ā ċ ĠĈē

ĆĕèĊĔĈüĔâþĆē÷ėČòŋëĄĆĄċĔĈąċĕčøĆŋþĆēčĕú ëėèëňĕ÷ĬĕĆè

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ġ÷ąéĔ÷úĬĕ OKPK TGUGCTEJ ăĕąĢü UVTQMG WPKV 4 4 âĕĆāąĕýĕĈÿĜňþłĊąúĘħĄĘăĕĊēčĄĐèýĊĄ /KPK TGUGCTEJ âĕĆĎąŇĕğåĆĚħĐèëŇĊąĎĕąĢéĢüĎĐÿĜňþłĊą UVTQMG Ąė ą Ąė ą ġþĆĠâĆĄåĐĄāėĊğøĐĆŋĀâŀ āĜ÷ĢüÿĜþň Ċł ą #RJCUKC 4 4 âĕĆĢëňĠýýþĆēğĄėü %*# &5 8#5E UEQTG CPF TKUM QH UVTQMG CPF /CLQT DNGGFKPI CV [GCT WUKPI *#5 ¼ $.'& ĢüÿĜ ň þ ł Ċ ąúĘħ Ģ ëň ą ĕ warfarin

ÐāòêòÿãăøßŞöùĀ ãćĎÐôśäöĀ ċíĆüē èĘāðāĎÙśĎèÐāòîŔèŤ îĈ ëĈśêŕöñ

ğëŇü üĊĔøâĆĆĄĐĐââĬĕĈĔèâĕąëėèëňĕ÷ĬĕĆè üĊĔøâĆĆĄ ğåĆĚħ Đ èëŇ Ċ ąĀŀ â ğ÷ė ü ĠĈēğåĈĚħ Đ üģĎĊčĎčĕãĕĊė ë ĕëĘ ā üĊĔøâĆĆĄĐěþâĆöŋâĆēøěüň ÌPG OQVQT OQXGOGPV ĠĈē ġþĆĠâĆĄâĕĆâĆēøěüň âĕĆčĚĐħ čĕĆĢüÿĜþň Ċł ą CRJCUKC ĆĜþúĘ ħ

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÷ňĕüĆēýý HCUV VTCEM čŇèğčĆėĄĠĈēčüĔýčüěü ğåĆĚ Đ ãŇ ĕ ąúĘħ ĄĘ å ĊĕĄāĆň Đ ĄĢĎň č ĕĄĕĆùāĔ õ üĕąģþğþŎ ü ġĆèāąĕýĕĈúĘčħ ĕĄĕĆùĢĎňýĆėâĕĆÿĜþň Ċł ą HCUV VTCEM ģ÷ň÷Ċň ą

J Thai Stroke Soc: Volume 14, 2015

øĔĊğĐèĆĊĄùęèüĬĕčĚĐħ KPVGTPGV ğāĚĐħ üĬĕĢëňāõ Ĕ üĕġĆèāąĕýĕĈ ĢüğåĆĚĐãŇĕąúĘĐħ ĕéąĔèģĄŇĄåĘ ĊĕĄāĆňĐĄøĕĄĘĆēąēúĕèüĬĕčŇè ģâĈĢĎňčĕĄĕĆùĢĎňąĕâŇĐüâĕĆüĬĕčŇèģ÷ň ğāėħĄéĬĕüĊüğøĘąèĢüâĕĆ÷ĜĠĈÿěňþłĊąĢü UVTQMG WPKV éĕâ ğøĘąèğþŎü ğøĘąè þĆēčĕüâĔýčĕûĕĆöčěãéĔèĎĊĔ÷ğëĘąèĢĎĄŇ éĔ÷ĐýĆĄāąĕýĕĈëěĄëü÷ĜĠĈÿĜňþłĊąčĄĐèğčĚħĐĄ ğāĆĕē ÿĜ ň þ ł Ċ ą UVTQMG ğčĘħ ą èøŇ Đ âĕĆğâė ÷ ăĕĊē RQUV UVTQMG FGOGPVKC éęèĄĘĠüĊåė÷ĢĎň Ćā ëěĄëü ëŇĊąþĆēğĄėüčŇèøŇĐ ĠĈēéĔ÷âėéâĆĆĄ÷ĜĠĈÿĜňþłĊąģ÷ň ġ÷ąčĆěþýúýĕúãĐèġĆèāąĕýĕĈĢüğåĆĚĐãŇĕą âĕĆĢĎňýĆėâĕĆĄĘ÷èĔ üĘġĨ ÷ąğüňüåĈĐýåĈěĄâĕĆ÷ĜĠĈÿĜþň Ċł ąúĔèĨ čĕĄĆēąē ĆĜþúĘħ

ÑüéċÑäúèś ā æĄē Ó öāðòĀ é ëă ã ÙüéÑüÖČðŚ Ñ Ś ā ñ òí ðúāòāÙþ

ĢĎňýĆėâĕĆâĕĆ÷ĜĠĈĆĔâČĕĢüĆē÷ĔýøøėąăĜĄėĠâŇ ÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĎĆĚĐĐě÷øĔüĢüğãøăĕå ğĎüĚĐøĐüýüĠĈēÿĜňþłĊąýĔøĆúĐèĠýŇèğãøøĕĄğåĆĚĐãŇĕą þĆēğĄėüĠĈēāĔõüĕċĔâąăĕāĎüŇĊąýĆėâĕĆĈĜâ ãŇĕąĢüâĕĆ÷ĜĠĈÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĎĆĚĐĐě÷øĔü ğāĚĐħ ĢĎňĄåĘ ĊĕĄĆĜĢň üâĕĆþĆēğĄėüÿĜþň Ċł ąĠĈēâĕĆĊėüéė êĔąġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĎĆĚĐĐě÷øĔüĢüĆēąēğĆėħĄøňü ğëŇü âĕĆĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷ âĕĆčŇèøŇĐ âĕĆĆĔýâĈĔý āĔõüĕĆēýýâĕĆčŇèøŇĐ ĆĔýâĈĔý ġ÷ąâĕĆĊĕè ĆēýýâĕĆ 4GHGT úĘħĄĘþĆēčėúûėăĕāĆŇĊĄâĔüĢüğåĆĚĐãŇĕą āĔõüĕĆēýýĠĈēëŇĐèúĕèâĕĆčĚĐħ čĕĆ ğāĚĐħ âĕĆ ĠĈâğþĈĘħąüúĕèĊėëĕâĕĆĠĈēâĕĆğÿąĠāĆŇþĆēëĕčĔĄāĔüûě āĔõüĕĆēýýâĕĆğâĦýãňĐĄĜĈÿĜňþłĊąġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèøĘýĎĆĚĐĐě÷øĔüĢĎňåĆĐýåĈěĄúĔĨèğåĆĚĐãŇĕą øĆĊéğąĘħąĄ øė÷øĕĄþĆēğĄėüÿĈ âĕĆ÷Ĭĕğüėü èĕüãĐèġĆèāąĕýĕĈĈĜâãŇĕą ĠĈē øė÷øĕĄøĔĊëĘĊĨ ÷Ĕ ÿĈâĕĆ ÷ĬĕğüėüèĕüãĐèġĆèāąĕýĕĈĈĜâãŇĕą

ÑüéċÑäúèśāæĄē ÓöāðòĀéëăãÙüéÑüÖôĈÐÑŚāñ

ĢĎňýĆėâĕĆâĕĆ÷ĜĠĈĆĔâČĕÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèøĘýĎĆĚĐĐě÷øĔüøĔèĨ ĠøŇ âĕĆþĆēğĄėüĊėüéė êĔą ĠĈēĢĎňâĕĆ ĆĔâČĕğýĚĨĐèøňü ĢĎňâĕĆĆĔâČĕġ÷ąĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷ ĢüġĆè āąĕýĕĈëěĄëüúĘħčĕĄĕĆùĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷

J Thai Stroke Soc: Volume 14, 2015

øė÷øŇĐþĆēčŇĕüèĕüâĔýĠĄŇãŇĕą ğāĚħĐþĆęâČĕ ĠĈēčŇèøŇĐÿĜňþłĊą čŇèøŇĐÿĜňþłĊąģþąĔèġĆèāąĕýĕĈĠĄŇãŇĕą ĆĔýâĈĔýÿĜňþłĊąúĘħġĆèāąĕýĕĈĠĄŇãŇĕąčŇèâĈĔý ğāĚħĐâĕĆ÷ĜĠĈøŇĐğüĚħĐè ğâĦýĠĈēčŇèãňĐĄĜĈ øĔĊëĘĨĊĔ÷ úĘħğþŎüĄĕøĆòĕü ğāĚħ Đ čĕĄĕĆùüĬ ĕ ĄĕğþĆĘ ą ýğúĘ ą ýâĔ ü ģ÷ň å ĊĆĢëň ğ âöôŋ ğ÷ĘąĊâĔü āĔõüĕĆēýýâĕĆ÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèøĘýĎĆĚĐĐě÷øĔü čě÷úňĕąøňĐèãĐãĐýåěöúĘĄèĕüĠĈēğéňĕĎüňĕúĘħ úěâåüúĔĨèĢüġĆèāąĕýĕĈĄĎĕĆĕëĠĈēġĆèāąĕýĕĈğåĆĚĐ ãŇĕąúĘħĆŇĊĄĄĚĐĆŇĊĄĢéĢüâĕĆāĔõüĕĆēýýâĕĆ÷ĜĠĈÿĜňþłĊą úĘħ ĄĘ þ Ćēčė ú ûė ă ĕā ãĐãĐýåě ö čþčëúĘħ úĬ ĕ ĢĎň ÿĜ ň þ ł Ċ ąĄĘ ġĐâĕčģ÷ňğãňĕùęèąĕĠĈēĄĘġĐâĕčģ÷ňĆĔýâĕĆ÷ĜĠĈĐąŇĕèğúŇĕ ğúĘąĄ ãĐýåěöúĘĄĐĕéĕĆąŋéĕâčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèģúąĠĈēčùĕýĔüþĆēčĕúĊėúąĕúĘĢħ ĎňåĊĕĄĐüěğåĆĕēĎŋ ĢüâĕĆëŇĊąğĎĈĚĐĢüâĕĆ÷ĬĕğüėüâĕĆéĔ÷øĔĨèĠĈēčüĔýčüěü úĕè÷ňĕüĊėëĕâĕĆ ãĐýåěöÿĜňýĆėĎĕĆåöēĠāúąċĕčøĆŋ úĘğħ ĈĦèğĎĦüùęèåĊĕĄčĬĕåĔîãĐèâĕĆéĔ÷øĔèĨ âĕĆĢĎňýĆėâĕĆ÷ĜĠĈ ÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ãĐýåěöúĘĄèĕüUVTQMG WPKV Ćā ĄĎĕĆĕëúĘúħ ĄŇě ğúúĬĕèĕüĐąŇĕèģĄŇąĐŇ úňĐĠĈēúĘãħ ĕ÷ģĄŇģ÷ň Ć ċ āî ċėĊĕāĆ éĔüúĆŋâĆēéŇĕè ÿĜňâŇĐøĔĨèċĜüąŋġĆåčĄĐè ăĕåğĎüĚĐĠĈēğþŎüĠĆèÿĈĔâ÷ĔüčĬĕåĔîĢüâĕĆúĬĕĢĎňğâė÷ âĕĆ÷ĜĠĈÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèġ÷ąâĕĆĢĎňąĕĈēĈĕą ĈėħĄğĈĚĐ÷ĠĈēâĕĆéĔ÷øĔĨèĎĐÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĠĎŇèĠĆâĢüăĕåğĎüĚĐ

ĆĜþúĘħ ĠÿüúĘħĠč÷èāĚĨüúĘħĐĬĕğăĐøŇĕèĥĠĈēéĔèĎĊĔ÷ĢâĈňğåĘąèāĚĨüúĘħĢĎňýĆėâĕĆãĐèġĆèāąĕýĕĈĄĎĕĆĕëüåĆğëĘąèĢĎĄŇ

ĆĜþúĘħ Ġč÷èÿĈĈĔāûŋãĐèâĕĆ÷ĬĕğüėüĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷

J Thai Stroke Soc: Volume 14, 2015

'MPX DIBSU 4USPLF 'BTU 5SBDL $.6 )PTQJUBM Ġãüãĕ ĐŇĐüĠĆè ãňĕèĢ÷ãňĕèĎüęèħ āĜ÷ģĄŇëĔ÷ āĜ÷ģĄŇģ÷ň ĎĆĚĐĂŌè ģĄŇğãňĕĢé ğ÷ėüğì ğĊĘąüċĘĆČē øĕĄĐèğĎĦüăĕāìňĐü ĎĆĚĐøĕĄĔĊãňĕèĢ÷ãňĕèĎüęħè

ĄĕúĘħ '4 ăĕąĢü ëĄ ĠāúąŋğĊĆþĆēğĄėü +8 NKPG .#$ '-)

čŇèúĬĕ %6 ģĄŇāýğĈĚĐ÷ĐĐâĢüčĄĐè

0GWTQ /'&

'MPX DIBSU 4USPLF 'BTU 5SBDL ĢüĎĐÿĜňþłĊą ĄĘĐĕâĕĆĢüĎĐÿĜňþłĊą ăĕąĢü ëĄ ĠāúąŋğĊĆþĆēğĄėü

+8 NKPG .#$ '-)

āýğĈĚĐ÷ĐĐâ ĢüčĄĐè

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Ġãüãĕ ĐŇĐüĠĆè ãňĕèĢ÷ãňĕèĎüęèħ āĜ÷ģĄŇëĔ÷ āĜ÷ģĄŇģ÷ň ĎĆĚĐĂŌè ģĄŇğãňĕĢé ğ÷ėüğì ğĊĘąüċĘĆČē øĕĄĐèğĎĦüăĕāìňĐü ĎĆĚĐøĕĄĔĊãňĕèĢ÷ãňĕèĎüęħè

0GWTQ /'&

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ĢĎňąĕúĘħ '4

øĆĊéčĐýãňĐýŇèëĘĨ ãňĐĎňĕĄ ãĐåĊĕĄąėüąĐĄéĕâîĕøė

ãĐąĚĄąĕ TV 2# éĕâĎňĐèąĕ

øĆĊéčĐýãňĐýŇèëĘĨ ãňĐĎňĕĄ ãĐåĊĕĄąėüąĐĄéĕâîĕøė

ãĐąĚĄąĕ TV 2# éĕâĎňĐèąĕ

þĆęâČĕ 0GWTQ574)

Tranfer to stroke unit

þĆęâČĕ 0GWTQ574)

Tranfer to stroke unit

ĆĜþúĘħ Ġč÷è (NQY EJCTV ĢüâĕĆ÷ĜĠĈÿĜňþłĊą CEWVG UVTQMG úĔĨèúĘħĄĕéĕâüĐâĠĈēăĕąĢüġĆèāąĕýĕĈ âĕĆþĆēčĕüčŇèøŇĐÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ġĆèāąĕýĕĈëěĄëü ġúĆþĆēčĕüĠāúąŋğĊĆ ĐĕąěĆċĕčøĆŋĆēýý þĆēčĕú ğüňüĠāúąŋ ġúĆåěąâĔýĠāúąŋ ğĄĚħĐĠāúąŋğĊĆĐĕąěĆċĕčøĆŋĆēýýþĆēčĕúąėüąĐĄ 1- ĢĎň ğãňĕčĜŇĆēýý (CUV VTCEM ĢĎňĆĘýčŇèÿĜňþłĊąĢĎňùęèĎňĐèêěâğêėüãĐè ġĆèāąĕýĕĈĄĎĕĆĕë ĐąŇĕèĆĊ÷ğĆĦĊĠĈēþĈĐ÷ăĔą ăĕąĢü âĆĐýğĊĈĕúĘâħ ĕĬ Ďü÷ ġ÷ąģĄŇĈēğĈąâĕĆĆĔâČĕãĔüĨ āĚüĨ òĕüãĐè ÿĜňþłĊąêěâğêėü ğëŇü 5VCTV +8 QP '6 VWDG EQPVTQNNGF $2

ġúĆþĆēčĕü %CNN EGPVGT ĠéňèāąĕýĕĈúĘħ %CNN EGPVGT ĊŇĕÿĜňþłĊąğþŎü ÿĜňþłĊąúĘħĄĘĐĕâĕĆ čèčĔąĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħĄĕğĆĦĊ HCUV VTCEM UVTQMG ăĕąĢü âĆĐýğĊĈĕúĘħâĬĕĎü÷ āąĕýĕĈ %CNN EGPVGT þĆēčĕüĢĎňğýĐĆŋġúĆĠāúąŋğĊĆ ĐĕąěĆċĕčøĆŋĆēýýþĆēčĕú

ùòćêÐāòêòÿùāèùŚÖäŚüëĈśêŕöñčòÓúôüãċôĆüãùðüÖ ġĆèāąĕýĕĈëěĄëü ġĆèāąĕýĕĈúĔħĊģþ ġĆèāąĕýĕĈéĔèĎĊĔ÷ %CNN EGPVGT ĠāúąŋğĊĆĐĕąěĆċĕčøĆŋĆēýýþĆēčĕú

ĆĜþúĘħ Ġč÷èĠüĊúĕèâĕĆþĆēčĕüčŇèøŇĐÿĜňþłĊą 32

J Thai Stroke Soc: Volume 14, 2015

ĆĜþúĘħ ÿĈâĕĆāĔõüĕãĐèğåĆĚĐãŇĕąâŇĐüĠĈēĎĈĔèâĕĆ÷ĬĕğüėüâĕĆ

ĆĜþúĘħ Ġč÷èüĊĔøâĆĆĄĢüâĕĆëŇĊąĂŁŐüĂĜÿĜňþłĊą

J Thai Stroke Soc: Volume 14, 2015

ÐāòãĈČôòĀÐøāčòÓúôüãċôĆüãùðüÖċÓòĆüÑŚāñ ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè

ĆēąēâŇĐüğâė÷ġĆå

Ćēąēğâė÷ġĆå

5VTQMG CYCTGPGUU RTKOCT[ RTGXGPVKQP 5VTQMG CNGTV åĔ÷âĆĐèĠĈēþĆēğĄėüåĊĕĄğčĘħąèĢü âĈěŇĄ &/ *6 #( &.2 éĔ÷âĕĆĢĎňåĊĕĄĆĜň ĠĈēğĀŃĕĆēĊĔèĢü âĈěŇĄğčĘħąèĆē÷ĔýøŇĕèĥ âĈěŇĄğčĘħąèøĬħĕ ĢĎňåĊĕĄĆĜňĢüâĕĆğĀŃĕ ĆēĊĔèĠĈēþĆĔýğþĈĘħąüāćøėâĆĆĄ âĈěŇĄğčĘħąèčĜèþĕüâĈĕè ğüňüâĕĆ þĆĔýğþĈĘħąüāćøėâĆĆĄ ğāĚħĐĈ÷åĊĕĄ ğčĘħąè âĈěŇĄğčĘħąèčĜèĄĕâ ğüňüčĔîîĕö ğøĚĐüăĔąĐĔüøĆĕąúĘħÿĜňþłĊąĠĈēîĕøė øňĐèúĆĕý ĠĈēĆĘý÷ŇĊüĢüâĕĆþĆĔý ğþĈĘħąüāćøėâĆĆĄğāĚħĐĈ÷åĊĕĄğčĘħąè âėéâĆĆĄ åĊĕĄĆĜňčĜŇþĆēëĕëü 5VTQMG RTGXGPVKQP FC[ ĐĐâëěĄëü ğąĘħąĄýňĕü

2TGJQURKVCN ECTG UVTQMG HCUV VTCEM Ćā ëěĄëü '4 #$% 8KVCN UKIP þĆēğĄėü (#56 ùňĕĠüŇĢé 4GHGT Ćā ĄĎĕĆĕãĒ øĕĄĠüĊúĕè

ĆēąēĎĈĔèğâė÷ġĆå Ćā ëěĄëü ğąĘħąĄýňĕü UGNH ECTG âĕąăĕāýĬĕýĔ÷ þĆēğĄėü EQORNKECVKQP (7 þŃĐèâĔü nd RTGXGPVKQP

#EWVG ECTG UVTQMG WPKV +%7 ward) þŃĐèâĔü PGWTG FGÍGKV DTCKP GFGOC RQUV TV2# DNGGFKPI KPHGEVKQP

RPGWOGPKC 76+ - early rehab - 2nd RTGXGPVKQP - education 3. Intermediate care to YCTF Ćā ğåĆĚĐãŇĕą

ĆĜþúĘħ ãĐýğãøâĕĆ÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè

J Thai Stroke Soc: Volume 14, 2015

÷ĈèñŞčòÓúôüãċôĆüãùðüÖÓòéöÖ×ò $PNQSFIFOTJWF 4USPLF $FOUFS

íÜ üòüćðā Ùćäăċèäò ùāÑāöăÙāêòÿùāæöăæñā ïāÓöăÙāüāñćò÷āùäòŞ ÓâÿČíæñ÷āùäòŞ ×ćûāôÖÐòâŞðúāöăæñāôĀñ čòÖíñāéāô×ćûāôÖÐòâŞ ùïāÐāÙāãďæñ E-mail address: aurauma@yahoo.com "VSBVNB $IVUJOFU . % Division of Neurology, Department of Medicine Faculty of Medicine, Chulalongkorn University King Chulalongkorn Memorial Hospital, Thai Red Cross E-mail address: aurauma@yahoo.com $PSSFTQPOEJOH "VUIPS "VSBVNB $IVUJOFU . % Division of Neurology, Department of Medicine Faculty of Medicine, Chulalongkorn University King Chulalongkorn Memorial Hospital, Thai Red Cross Bangkok 10330, Thailand E-mail address: aurauma@yahoo.com

Abstract

/PXBEBZT TUSPLF TZTUFNT PG DBSF BSF EJWJEFE JOUP DSVDJBM MFWFMT QSJNBSZ TUSPLF DFOUFS 14$ BOE DPNQSFIFOTJWF TUSPLF DFOUFS $4$ #PUI MFWFMT QMBZ JOUFHSBM SPMFT JO FNFSHFODZ NFEJDBM TZTUFNT BDVUF TUSPLF DBSF BOE QSJNBSZ TFDPOEBSZ TUSPLF QSFWFOUJPO BOE SFIBCJMJUBUJPO )PXFWFS B DPNQSFIFOTJWF TUSPLF DFOUFS PȼFST NPSF DPNQSFIFOTJWF DBSF UIBU JT BWBJMBCMF IPVST FWFSZ EBZ UP QBUJFOUT XJUI NPSF DPNQMFY BOE NPSF TFWFSF TUSPLF DPOEJUJPOT FTQFDJBMMZ UIPTF XIP OFFE PG TVSHFSZ BOE FOEPWBTDVMBS QSPDFEVSFT 4FWFSBM TUVEJFT IBWF GPVOE UIBU DPNQSFIFOTJWF TUSPLF DFOUFST JODSFBTFE USFBUNFOU FȼFDUJWFOFTT CZ MPXFSJOH TUSPLF NPSUBMJUZ DPNQBSFE XJUI QSJNBSZ TUSPLF DFOUFST PS PUIFS TUSPLF TZTUFNT PG DBSF (J Thai Stroke Soc 2015; 14: 35-43.) ,FZXPSET 1SJNBSZ TUSPLF DFOUFS DPNQSFIFOTJWF TUSPLF DFOUFS

éæèĘā

ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèğþŎüþŌîĎĕčĬĕåĔîúĔĨèĢüþĆēğúċģúąĠĈē úĔĊħ ġĈâ ġ÷ąāýĊŇĕġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèğþŎüčĕğĎøěãĐèâĕĆğčĘąëĘĊøė ĐĔü÷Ĕý ĠĈēĄĘâĕĆčĜîğčĘąþĿčãě ăĕĊē &KUCDKNKV[ #FLWUVGF .KHG ;GCTU &#.;U ğþŎüĐĔü÷ĔýúĘ ħ ãĐèþĆēëĕâĆġĈâĢüþĿā ċ 1 ĠĄňĊĕŇ þĆēğúċúĘĄħ ĆĘ ĕąģ÷ň čĜèéēĄĘĐěýĔøėâĕĆöŋãĐèġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĈ÷ĈèĢüëŇĊè þĿúĘħÿŇĕüĄĕ ĠøŇĐýě øĔ âė ĕĆöŋãĐèġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèąĔèåèğāėĄħ ãęüĨ ĢüþĆēğúċúĘĄħ ĆĘ ĕąģ÷ň øĬħĕĠĈēþĆēğúċúĘħĄĘĆĕąģ÷ňþĕüâĈĕè ìęħèĆĊĄúĔĨèþĆēğúċģúą÷ňĊą2 ÷ĔèüĔĨü âĕĆāĔõüĕâĕĆ÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĢüĆēąēğêĘąýāĈĔüéęèĄĘ åĊĕĄčĬĕåĔîĄĕâ ğāĚĐħ Ĉ÷ăĕĊēĠúĆâìňĐü Ĉ÷åĊĕĄāėâĕĆĠĈēĈ÷ĐĔøĆĕâĕĆ ğčĘąëĘĊøė ãĐèÿĜþň Ċł ą âĕĆéĔ÷øĔèĨ ċĜüąŋâĕĆ÷ĜĠĈĠĈēĆĔâČĕÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐè éęèğþŎüĊėûĘâĕĆĎüęħèúĘħéēúĬĕĢĎňâĕĆ÷ĜĠĈĆĔâČĕÿĜňþłĊąğþŎüģþøĕĄ ĄĕøĆòĕüčĕâĈĠĈēĄĘâĕĆāĔõüĕþĆĔýþĆěèĢĎň÷ãĘ üęĨ ğþŎüĈĬĕ÷Ĕý ġ÷ąĠýŇèċĜüąŋ âĕĆ÷ĜĠĈĠĈēĆĔâČĕÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèğþŎü Ćē÷Ĕý ģ÷ňĠâŇ ċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĄĕøĆòĕü 2TKOCT[ UVTQMG EGPVGT 25% ĢĎňâĕĆ÷ĜĠĈĆĔâČĕÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĆēąēğêĘąýāĈĔüģ÷ň ğâĚĐýúěâåü ġ÷ąčĕĄĕĆùĆĔýÿĜňþłĊąğãňĕ÷ĜĠĈĢüĎĐÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷

J Thai Stroke Soc: Volume 14, 2015

čĄĐè 5VTQMG 7PKV čĬĕĎĆĔýĢüþĆēğúċģúą čĄĕåĄ ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúąĆŇĊĄâĔýčùĕýĔüĆĔýĆĐèåěöăĕā čùĕüāąĕýĕĈ ĐèåŋâĕĆĄĎĕëü čĆā éĔ÷úĬĕğâöôŋ þĆēğĄėüĠĈēĆĔýĆĐèċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĄĕøĆòĕü ĠĈēĄĘ ġ ĆèāąĕýĕĈúĘħ ģ ÷ň ÿ Ň ĕ üâĕĆþĆēğĄė ü éĕâåöē ÿĜňğëĘħąĊëĕîĢüĆēąēúĘħ ģþĠĈňĊ éĬĕüĊü ġĆèāąĕýĕĈ ÷ĔèøŇĐģþüĘĨ ġĆèāąĕýĕĈûĆĆĄċĕčøĆŋğêĈėĄāĆēğâĘąĆøė ġĆèāąĕýĕĈĆĕĄĕûė ý ÷Ę ġĆèāąĕýĕĈéě ď ĕĈèâĆöŋ ġĆèāąĕýĕĈċė Ćė Ć ĕë ġĆèāąĕýĕĈāĆēĄèâě ð ğâĈň ĕ ġĆèāąĕýĕĈĎĕ÷ĢĎîŇ ġĆèāąĕýĕĈĄĎĕĆĕëğëĘąèĢĎĄŇ čùĕýĔüþĆēčĕúĊėúąĕ ĠĈēġĆèāąĕýĕĈâĆěèğúā úĔĨèüĘĨ ġĆèāąĕýĕĈĐĚħüĥúĘħčüĢé čĕĄĕĆùčĄĔåĆğāĚħĐãĐĆĔýĆĐè ģ÷ňúĘħčùĕýĔüĆĔýĆĐèåěöăĕāčùĕüāąĕýĕĈ ĐèåŋâĕĆ ĄĎĕëü čĆā ġ÷ą÷ĜĆĕąĈēğĐĘą÷ğāėħĄğøėĄģ÷ňúĘħ JVVR YYY JC QT VJ ċĜ ü ąŋ ġ ĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèåĆýĊèéĆ

%QORTGJGPUKXG UVTQMG EGPVGT %5% üĐâéĕâ čĕĄĕĆùĢĎňâĕĆ÷ĜĠĈĆĔâČĕÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĆēąēğêĘąýāĈĔü ĠĈēĆĔýÿĜňþłĊąğãňĕ÷ĜĠĈĢüĎĐÿĜňþłĊąġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐè UVTQMG WPKV øĕĄĎĈĔâğâöôŋãĐè ċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĄĕøĆòĕüĠĈňĊ ąĔèčĕĄĕĆù ĢĎňâĕĆĆĔâČĕÿĜňþłĊąýĕèĆĕąúĘħéĬĕğþŎüøňĐèģ÷ňĆĔýâĕĆÿŇĕøĔ÷ ĎĆĚĐâĕĆĆĔâČĕġ÷ą GPFQXCUEWNCT VTGCVOGPV ģ÷ňøĈĐ÷ ëĔħĊġĄè÷ňĊą ìęħèéēģ÷ňâĈŇĕĊùęèĆĕąĈēğĐĘą÷ĢýýúåĊĕĄ üĘĨøŇĐģþ

üÖÓŞêòÿÐüéÑüÖ÷ĈèñŞčòÓúôüãċôĆüãùðüÖ ÓòéöÖ×ò øĕĆĕèúĘħ

þĆēâĐý÷ňĊąĐèåŋþĆēâĐýĎĈĔâ čŇĊü ģ÷ňĠâŇ ýěåĈĕâĆúĘħĄĘåĊĕĄğëĘąĊëĕîğêāĕē÷ňĕü âĕĆĢĎňýĆėâĕĆøĆĊéĊėüėéêĔąãĔĨüčĜè âĕĆĆĔâČĕúĕèċĔĈąâĆĆĄĠĈēâĕĆĆĔâČĕġ÷ą GPFQXCUEWNCT þŌééĔąāĚĨüòĕüğêāĕē÷ňĕüøŇĕèĥ

éćÓôāÐòæĄēðĄÓöāðċÙĄēñöÙāÜċØíāÿãśāè ĊèéĆ

åĊĆþĆēâĐýģþ÷ňĊąýěåĈĕâĆøŇĐģþüĘĨ ÿĜňĐĬĕüĊąâĕĆċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆý

J Thai Stroke Soc: Volume 14, 2015

þĆēčĕúĠāúąŋĠĈēþĆēčĕúċĔĈąĠāúąŋ ċĔĈąĠāúąŋÿĜňğëĘħąĊëĕîĢüâĕĆÿŇĕøĔ÷ ECTQVKF GPFCTVGTGEVQO[ %'# ĆĔèčĘĠāúąŋÿĜňğëĘħąĊëĕî÷ňĕüĆĔèčĘĊėüėéêĔą Ġāúąŋ ÿĜ ň ğ ëĘħ ą Ċëĕî÷ň ĕ ü KPVGTXGPVKQPCN GPFQXCUEWNCT PGWTQTCFKQNQI[ Ġāúąŋ āąĕýĕĈ ĠĈēýěåĈĕâĆĢüĠÿüâêěâğêėü āĆňĐĄúĔĨèúĘĄýĆėâĕĆúĕèâĕĆĠāúąŋêěâğêėü üĔâĆĔèčĘğúåüėå āąĕýĕĈÿĜňğëĘħąĊëĕîĢüâĕĆ÷ĜĠĈÿĜňþłĊąġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐè ĠāúąŋÿĜňğëĘħąĊëĕîĢü÷ňĕüøŇĕèĥ ğëŇü ÷ĜĠĈ ÿĜňþłĊąăĕĊēĊėâćø ĎĆĚĐ÷ĜĠĈÿĜňþłĊą÷ňĕüĆēýýþĆēčĕúĢü ăĕĊēĊėâćø øĆĊé GEJQECTFKQITCRJ[ øĆĊéĎĈĐ÷ğĈĚĐ÷ čĄĐè÷ňĊąåĈĚħüğčĘąèåĊĕĄùĘħčĜè ģ÷ňĠâŇ ECTQVKF FWRNGZ WNVTCUQWPF ĠĈē VTCPUETCPKCN &QRRNGT WNVTCUQWPF Ġ ā ú ą ŋ ğ Ċ ë ċ ĕ č ø Ć ŋ Ă Ł Ő ü ĂĜ Ġ Ĉ ē üĔ â âĕąăĕāýĬĕýĔ÷ ÿĜ÷ň ĠĜ Ĉ÷ňĕüýĆėâĕĆøŇĕèĥ ãĐèÿĜþň Ċł ąġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐè ECUG OCPCIGT ĠĈēüĔâčĔèåĄčèğåĆĕēĎŋ

ÐāòĎúśéòăÐāòäòö×öăèă×ØĀñÑĀĔèùĈÖ

ċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆ åĊĆĄĘåĊĕĄ čĕĄĕĆùĢüâĕĆøĆĊéĊėüėéêĔąğāėħĄğøėĄ÷ĔèøŇĐģþüĘĨ âĕĆøĆĊéčĄĐè÷ňĊąåĈĚħüčēúňĐüĢüčüĕĄ ĠĄŇğĎĈĦâ /CIPGVKE TGUQPCPEG KOCIKPI /4+ ìęħè éēøň Đ èčĕĄĕĆùøĆĊé FKHHWUKQP YGKIJVGF KOCIG

&9+ øĆĊéĎĈĐ÷ğĈĚĐ÷Ġ÷è /CIPGVKE TGUQPCPEG CPIKQITCRJ[ /4# øĆĊéĎĈĐ÷ğĈĚĐ÷÷Ĭĕ /CIPGVKE TGUQPCPEG XGPQITCRJ[ /48 ģ÷ňøĈĐ÷ ëĔħĊġĄèùňĕ éĬĕğþŎüøňĐèúĬĕ ĠĈēĐĕéøĆĊé OCIPGVKE TGUQPCPEG RGTHWUKQP /42 ģ÷ň÷ňĊą âĕĆøĆĊéĎĈĐ÷ğĈĚĐ÷čĄĐèġ÷ąĢëň EQORWVGF VQOQITCRJ[ CPIKQITCRJ[ %6# ĠĈēĐĕéøĆĊé EQORWVGF VQOQITCRJ[ RGTHWUKQP %62 ģ÷ň÷ňĊą âĕĆøĆĊéĎĈĐ÷ğĈĚĐ÷čĄĐèġ÷ąĢëňčĕąčĊü ÿŇ ĕ üúĕèĎĈĐ÷ğĈĚ Đ ÷ EGTGDTCN CPIKQITCRJ[ ìęħ è ùĚĐĊŇĕğþŎüĊėûĘĄĕøĆòĕü IQNF UVCPFCTF ĢüâĕĆĊėüėéêĔą ĎĈĐ÷ğĈĚ Đ÷čĄĐèġþłè āĐè EGTGDTCN CPGWT[UOU CTVGTKQXGPQWU OCNHQTOCVKQPU #8/U CTVGTKQXGPQWU

ÌUVWNC #8(U ĠĈēâĕĆøĘýãĐèĎĈĐ÷ğĈĚĐ÷čĄĐèúĔĨèčŇĊü üĐâĠĈēčŇĊüĢüġāĆèâēġĎĈâċĘĆČē ìęħèåĊĆéēúĬĕâĕĆ øĆĊéģ÷ňøĈĐ÷ ëĔħĊġĄè úĔĨè ĊĔü ġ÷ąğâė÷ġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèĆēĎĊŇĕèâĕĆúĬĕĎĔøùâĕĆĠĈēĄĘĐĔøĆĕâĕĆøĕą üňĐąâĊŇĕ ĠĈēĄĘăĕĊēĠúĆâìňĐüúĘħĆěüĠĆèüňĐąâĊŇĕ ĎĆĚĐğúŇĕâĔý 7 âĕĆøĆĊéĎĈĐ÷ğĈĚĐ÷čĄĐèġ÷ąĢëňåĈĚħüğčĘąè åĊĕĄùĘħčĜè ģ÷ňĠâŇ %CTQVKF FWRNGZ WNVTCUQWPF ğāĚħĐøĆĊé ĎĈĐ÷ğĈĚĐ÷čŇĊüüĐâġāĆèâēġĎĈâċĘĆČēýĆėğĊöåĐ ğëŇü ĎĈĐ÷ğĈĚĐ÷Ġ÷èĠåġĆúė÷ĠĈēĎĈĐ÷ğĈĚĐ÷Ġ÷è XGTVGDTCN 6TCPUETCPKCN &QRRNGT 7NVTCUQWPF ğāĚĐħ øĆĊéĎĈĐ÷ğĈĚĐ÷ ãüĕ÷ĢĎîŇúĘħĐąĜŇýĆėğĊöòĕüãĐèâēġĎĈâċĘĆČē ĢëňøĆĊé÷Ĝ âĕĆøĘýĎĆĚĐĐě÷øĔüãĐèĎĈĐ÷ğĈĚĐ÷ ĠĈēąĔèĢëňøĆĊé÷ĜâĕĆ Ď÷ĆĔ÷øĔĊãĐèĎĈĐ÷ğĈĚĐ÷ĢüÿĜþň Ċł ąúĘĄħ ğĘ ĈĚĐ÷ĐĐâĢüëĔüĨ ğąĚĐħ ĎěňĄčĄĐè UWDCTCEJPQKF JGOQTTJCIG ÷ňĊą âĕĆøĆĊéăĕāĎĔĊĢé÷ňĊą GEJQECTFKQITCRJ[ üĐâéĕââĕĆøĆĊéăĕāĎĔ Ċ Ģéġ÷ą VTCPUVJQTCEKE GEJQECTFKQITCRJ[ 66' ğþŎüāĚĨüòĕüĠĈňĊ ċĜüąŋġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆøňĐèčĕĄĕĆùøĆĊéăĕāĎĔĊĢé ġ÷ą VTCPUGUQRJCIGCN GEJQECTFKQITCRJ[ 6'' Ģü âĆöĘúĘħéĬĕğþŎüģ÷ň÷ňĊą ğāĆĕē 6'' éēĄĘåĊĕĄģĊčĜèĢüâĕĆ øĆĊéāýĆĐąġĆåúĘħĎĔĊĢéĠĈē CQTVKE CTEJ ğëŇü ĈėħĄğĈĚĐ÷ ĢüĎĔĊĢéĎňĐèýüìňĕą NGHV CVTKWO âňĐüúĘýħ ĆėğĊöĈėüĨ ĎĔĊĢé RCVGPV HQTCOGP QXCNG ĈĔâČöēãĐèĎĈĐ÷ğĈĚĐ÷ĠãĦè ýĆėğĊö CQTVKE CTEJ

ÐāòòĀÐøāæāÖ÷ĀôñÐòòðČôÿÐāòòĀÐøāčãñ FOEPWBTDVMBS ÿĜ ň þ ł Ċ ąġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèýĕèĆĕąéĬ ĕ ğþŎ ü øňĐèģ÷ňĆĔýâĕĆÿŇĕøĔ÷ĎĆĚĐâĕĆĆĔâČĕġ÷ą GPFQXCUEWNCT ċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆéēøňĐèčĕĄĕĆùĢĎňâĕĆ ĆĔâČĕúĘħìĔýìňĐüĄĕâãęĨü ģ÷ňĠâŇ ENKRRKPI QH KPVTCETCPKCN CPGWT[UO âĕĆĢčŇ XGPVTKEWNQUVQO[ âĕĆÿŇĕøĔ÷ğĐĕ âň Đ üğĈĚ Đ ÷ĐĐâ JGOCVQOC TGOQXCN FTCKPKPI âĕĆĢčŇ KPVTCETCPKCN RTGUUWTG VTCPUFWEGT ECTQVKF GPFCTVGTGEVQO[ %'# GPFQXCUEWNCT CDNCUKQP ãĐè KPVTCETCPKCN CPGWT[UOU ĎĆĚĐ CTVGTKQXGPQWU OCNHQTOCVKQP âĕĆĢĎňąĕĈēĈĕąĈėĄħ ğĈĚĐ÷ġ÷ąÿŇĕüčĕąčĊü úĕèĎĈĐ÷ğĈĚĐ÷Ġ÷è KPVTCCTVGTKCN VJTQODQN[UKU ĎĆĚĐ âĕĆĢčŇĐěþâĆöŋğãňĕģþüĬĕĈėħĄğĈĚĐ÷ĐĐâĄĕġ÷ąÿŇĕüčĕą

čĊüúĕèĎĈĐ÷ğĈĚĐ÷Ġ÷è VJTQODGEVQO[ âĕĆĆĔâČĕ ĎĈĐ÷ğĈĚĐ÷Ď÷ğâĆĦè XCUQURCUO ġ÷ąĢëň GPFQXCUEWNCT VTGCVOGPV üĐâéĕâüĘąĨ èĔ ĐĕéčĕĄĕĆùĢĎňâĕĆĆĔâČĕĐĚüħ ĥģ÷ň ğëŇü âĕĆĢčŇã÷ĈĊ÷ 5VGPVKPI ĎĆĚĐ CPIKQRNCUV[ ãĐè ĎĈĐ÷ğĈĚĐ÷ăĕąĢüĠĈēăĕąüĐââēġĎĈâċĘĆČē ìęèħ âĕĆúĬĕ ĎĔøùâĕĆøŇĕèĥğĎĈŇĕüĘøĨ Đň èúĬĕġ÷ąÿĜğň ëĘąħ Ċëĕîğêāĕē÷ňĕü ğëŇü þĆēčĕúċĔĈąĠāúąŋ ċĔĈąĠāúąŋÿĜňğëĘħąĊëĕî÷ňĕü ĎĈĐ÷ğĈĚĐ÷ ĠāúąŋÿĜňğëĘħąĊëĕî÷ňĕü GPFQXCUEWNCT ĠĈē úĘĄèĕüìęħèþĆēâĐýģþ÷ňĊąāąĕýĕĈĠĈēÿĜňëŇĊąúĘħĄĘåĊĕĄ ëĬĕüĕî ġ÷ąĢüýĕèčùĕýĔüģ÷ňâĬĕĎü÷ĢĎň ċĜüąŋġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèåĆýĊèéĆéēøňĐèĄĘþĆēčĕúċĔĈąĠāúąŋĠĈēúĘĄ èĕüìęħ è þĆēâĐýģþ÷ň Ċ ąāąĕýĕĈĠĈēÿĜ ň ë Ň Ċ ąúĘħ ĄĘ å ĊĕĄ ëĬĕüĕîĢĎňýĆėâĕĆøĈĐ÷ ëĔħĊġĄè ĎĆĚĐčĕĄĕĆùğãňĕĄĕ÷Ĝ ÿĜňþłĊąĢüġĆèāąĕýĕĈģ÷ňăĕąĢü üĕúĘ éęèéēÿŇĕüâĕĆ ĆĔýĆĐèğþŎüċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆ

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ğüĚħĐèéĕâċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆ øňĐè÷ĜĠĈÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħĄĘåĊĕĄìĔýìňĐü ğāĚħĐĢĎňâĕĆ÷ĜĠĈĆĔâČĕÿĜňþłĊąĄĘþĆēčėúûėăĕā éęèåĊĆéēĄĘ þŌééĔąāĚĨüòĕü þŌééĔąāĚĨüòĕüúĘħåĊĆéēĄĘ ĎĐÿĜ ň þ ł Ċ ąġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐè

UVTQMG WPKV ġ÷ąÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèéēģ÷ňĆýĔ âĕĆ ÷ĜĠĈġ÷ąýěåĈĕâĆčĎčĕãĕĊėëĕúĘħĄĘåĊĕĄğëĘħąĊëĕî÷ňĕü ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèġ÷ąğêāĕēğëŇü ĄĘâĕĆ÷ĜĠĈ÷ňĕü ğĊëċĕčøĆŋĂŁŐüĂĜøĔĨèĠøŇëŇĊèĠĆâúĘħğãňĕĆĔýâĕĆĆĔâČĕĢüġĆè āąĕýĕĈ ìęħèþĆēâĐýģþ÷ňĊą âĕĆúĬĕâĕąăĕāýĬĕýĔ÷ ĐĕëĘĊýĬĕýĔ÷ ĠĈēĐĆĆùýĬĕýĔ÷ ĎĐĐăėýĕĈÿĜþň Ċł ąĎüĔâ KPVGPUKXG ECTG WPKV +%7 åĊĆĄĘĎĐĐăėýĕĈÿĜňþłĊąĎüĔâĐąŇĕèğøĦĄĆĜþĠýý ğüĚħĐèéĕâÿĜňþłĊąýĕèĆĕąéĬĕğþŎüøňĐèģ÷ňĆĔýâĕĆ÷ĜĠĈĆĔâČĕ ĐąŇĕèĢâĈňë÷ė øĈĐ÷ğĊĈĕ ğëŇü ÿĜþň Ċł ąčĄĐèãĕ÷ğĈĚĐ÷ãüĕ÷ ĢĎîŇ ÿĜňþłĊąúĘħĄĘğĈĚĐ÷ĐĐâĢüëĔĨüğąĚħĐĎěňĄčĄĐèĐĕéøňĐèģ÷ň ĆĔýâĕĆĢčŇúŇĐëŇĊąĎĕąĢé øňĐèĢëňğåĆĚħĐèëŇĊąĎĕąĢé ĄĘâĕĆ ĢčŇĐěþâĆöŋøŇĕèĥÿŇĕüúĕèĎĈĐ÷ğĈĚĐ÷Ġ÷è âĕĆĢčŇúŇĐ ĆēýĕąüĬĕĨ ĎĈŇĐğĈĘąĨ èģãčĔüĎĈĔè XGPVTKEWNQUVQO[ âĕĆĊĔ÷ åĊĕĄ÷ĔüăĕąĢüčĄĐè Ďň Đ èÿŇ ĕ øĔ ÷ āĆň Đ ĄĐě þ âĆöŋ Ġ ĈēĄĘ ýěåĈĕâĆúĘħāĆňĐĄþñėýĔøėèĕüģ÷ňøĈĐ÷ ëĔħĊġĄè J Thai Stroke Soc: Volume 14, 2015

ĎňĐèúĬĕ +PVGTXGPVKQP úĕè GPFQXCUEWNCT āĆňĐĄĐěþâĆöŋĠĈēĄĘýåě ĈĕâĆúĘāħ ĆňĐĄþñėýøĔ èė ĕüģ÷ň øĈĐ÷ ëĔħĊġĄè ĆēýýĈèúēğýĘąüğâĦýãňĐĄĜĈğĐèÿĜþň Ċł ą ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè UVTQMG TGIKUVT[ úĬĕĢĎňčĕĄĕĆù úĆĕýãňĐĄĜĈúĕèčùėøėøŇĕèĥ ģ÷ň ğëŇü þŌééĔąğčĘħąèãĐèâĕĆ ğâė÷ăĕĊēĠúĆâìňĐü ÿĈĈĔāûŋâĕĆĆĔâČĕÿĜþň Ċł ą QWVEQOG ğāĚħĐčĕĄĕĆùüĬĕģþāĔõüĕâĕĆ÷ĜĠĈÿĜňþłĊąøŇĐģþúĔĨèĢü÷ňĕü âĕĆĆĔâČĕ âĕĆþŃĐèâĔüģĄŇĢĎňğþŎüġĆå þŃĐèâĔüâĕĆğâė÷ġĆå ìĬĨĕ ĠĈēþŃĐèâĔüăĕĊēĠúĆâìňĐüøŇĕèĥ þŌééĔąāĚĨüòĕüúĘħĐĕéĄĘ åĈėüėâġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĆēýýâĕĆğåĈĚĐħ üąňĕąÿĜþň Ċł ąúĕèĐĕâĕċ ĎĐĐăėýĕĈÿĜþň Ċł ąĎüĔâ÷ňĕü PGWTQUEKGPEG PGWTQUEKGPEG +%7 âĕĆĢĎňåĊĕĄĆĜňĠĈēâĕĆĊėéĔą âĕĆĢĎňåĊĕĄĆĜňğþŎüĎüňĕúĘħúĘħčĬĕåĔîãĐèċĜüąŋġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆìęħèåĊĆĄĘâĕĆĢĎňåĊĕĄĆĜňâĔý ýěåĈĕâĆúĕèâĕĆĠāúąŋúĔĨèăĕąĢüĠĈēăĕąüĐâċĜüąŋġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèĐąŇĕèüňĐąþĿĈē åĆĔèĨ ĠĈēĢĎňåĊĕĄĆĜâň ýĔ þĆēëĕëü ġ÷ąğêāĕēĐąŇ ĕ èąėħ è âĕĆĠüēüĬ ĕ ĢĎň Ą ĕġĆè āąĕýĕĈġ÷ąúĔüúĘùĕň čèčĔąĊŇĕĄĘġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèğâė÷ ãęüĨ ĠüēüĬĕâĕĆþŃĐèâĔü âĕĆåĊýåěĄĠĈēĆĔâČĕþŌééĔąğčĘąħ è âĕĆ÷ĜĠĈøĔĊğĐèĎĈĔèéĕâğþŎüġĆå ĠĈēâĕĆþŃĐèâĔüģĄŇĢĎňğâė÷ ġĆåìĬĕĨ

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ĢüþŌ é éě ýĔ ü ąĔ è ģĄŇ ĄĘ Ď ĈĔ â òĕüúĘħ Ġ č÷èùę è âĕĆ ĊėğåĆĕēĎŋøňüúěüþĆēčėúûėÿĈãĐèċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèåĆýĊèéĆúĘëħ ÷Ĕ ğéü ĠøŇâĄĦ ĎĘ ĈĕąþĆēğúċúĘģħ ÷ňúĕĬ âĕĆ ċęâČĕþĆēčėúûėÿĈãĐèċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆý ĊèéĆĠĈēāýĊŇĕâĕĆğãňĕĆĔýâĕĆĆĔâČĕĢüċĜüąŋġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèåĆýĊèéĆ ĄĘþĆēčėúûėÿĈĄĕââĊŇĕâĕĆğãňĕĆĔý âĕĆĆĔ â ČĕúĘħ ċĜü ąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĄĕøĆòĕüĎĆĚĐ čùĕüāąĕýĕĈúĘħģĄŇģ÷ňĄĘċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè âĕĆċę â ČĕĠýýčĔ è ğâøâĕĆöŋ Ģ üþĆēğúċ ĂľüĠĈü÷ŋ ĆēĎĊŇĕèþĿ ā ċ ĢüÿĜňþłĊąġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐè Ćĕą úĘğħ ãňĕĆĔýâĕĆĆĔâČĕĢüčùĕü āąĕýĕĈ ĠĎŇè ġ÷ąĠýŇèčùĕüāąĕýĕĈğþŎü Ćē÷Ĕý ģ÷ňĠâŇ ċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆ ċĜüąŋġĆåĎĈĐ÷

J Thai Stroke Soc: Volume 14, 2015

ğĈĚĐ÷čĄĐèĄĕøĆòĕüĠĈēġĆèāąĕýĕĈúĔħĊģþøĕĄğâöôŋ ãĐè $TCKP #VVCEM %QCNKVKQP āýĊŇĕâĕĆ÷ĜĠĈÿĜþň Ċł ąĢüċĜüąŋ ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĄĘâĕĆğčĘąëĘĊėøúĘħ þĿ ĠĈēâĕĆøňĐè ĐąĜĆŇ âĔ ČĕøŇĐĢüčùĕüāąĕýĕĈúĘ ħ þĿ øĬĕħ âĊŇĕâĕĆģ÷ňĆýĔ âĕĆ ÷ĜĠĈĢüčùĕüāąĕýĕĈĆē÷ĔýĐĚħüĥĐąŇĕèĄĘüĔąčĬĕåĔîúĕè čùėøė ġ÷ąĄĘĐĔøĆĕâĕĆğčĘąëĘĊėøúĘħ þĿ WPCFLWUVGF CNN ECWUG [GCT ECUG HCVCNKV[ ğúŇĕâĔý ĠĈē čĬĕĎĆĔý %5% 25% ĠĈēġĆèāąĕýĕĈúĔħĊģþøĕĄ ĈĬĕ÷Ĕý åĊĕĄğčĘħąèãĐèâĕĆğčĘąëĘĊėøúĘħ þĿ CFLWUVGF HQT DCUGNKPG EJCTCEVGTKUVKE ğúŇĕâĔý ĠĈē čĬĕĎĆĔý %5% 25% ĠĈēġĆèāąĕýĕĈúĔħĊģþøĕĄ ĈĬ ĕ ÷Ĕ ý åĊĕĄğčĘħ ą èãĐèâĕĆøň Đ èĐąĜ Ň ĆĔ â ČĕøŇ Đ Ģüčùĕü āąĕýĕĈúĘħâ þĿ CFLWUVGF TKUMU QH KPUVKVWVKQPCN ECTG ğúŇĕâĔý ĠĈē čĬĕĎĆĔý %5% 25% ĠĈēġĆèāąĕýĕĈúĔħĊģþøĕĄĈĬĕ÷Ĕý éĬĕüĊüÿĜňþłĊąúĘħéēøňĐè ĆĔâČĕ PWODGT ¼ PGGFGF ¼ VQ ¼ VTGCV 006 ğāĚħĐúĘħéē úĬĕĢĎňÿþňĜ Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèčĕĄĕĆùĐąĜúŇ ýĘħ ĕň üúĘ ħ þĿ ğāėħĄãęĨüĐĘâ Ćĕą ğúŇĕâĔý čĬĕĎĆĔý %5% ĠĈē čĬĕĎĆĔý 25% ċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèčĕĄĕĆùĈ÷ĐĔøĆĕ âĕĆčĘąëĘĊøė øĈĐ÷ĆēąēğĊĈĕâĕĆøė÷øĕĄÿĜþň Ċł ąģþ þĿ ĠĈē ğāėħĄåŇĕĄĔûąòĕüãĐèâĕĆĄĘëĘĊėøĐąĜŇĄĕâãęĨüĐĘâ þĿ ğĄĚħĐ ğúĘąýâĔýġĆèāąĕýĕĈúĔħĊģþ âĕĆċęâČĕĠýýģþãňĕèĎüňĕúĘħþĆēğúċğâĕĎĈĘ9 ğâĦýãňĐĄĜĈéĕâ ġĆèāąĕýĕĈ øĔĨèĠøŇ ā ċ ¼ ĢüÿĜňþłĊąčĄĐèãĕ÷ğĈĚĐ÷ĆēąēğêĘąýāĈĔüéĬĕüĊü Ćĕą āýĊŇĕĐĔøĆĕâĕĆğčĘąëĘĊėøúĘħ ĊĔü ĎĈĔèéĕâúĘħĄĘâĕĆ éĔ÷øĔèĨ ċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆøĬĕħ âĊŇĕâŇĐüâĕĆ éĔ ÷ øĔĨ è ċĜ ü ąŋ ġ ĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèåĆýĊèéĆĐąŇ ĕ èĄĘ üĔ ą čĬĕåĔîúĕèčùėøė 14 %+ ¼ âĕĆċęâČĕúĘħþĆēğúċîĘħþěłü10 ĢüÿĜňþłĊąġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐè Ćĕą éĕâčùĕüāąĕýĕĈ ĠĎŇè āýĊŇĕċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆĄĘåĊĕĄčĔĄāĔüûŋ âĔýâĕĆĈ÷ĈèãĐèĐĔøĆĕâĕĆğčĘąëĘĊėøĢüġĆèāąĕýĕĈ âĕĆċęâČĕúĘčħ ĎĆĔòĐğĄĆėâĕ11 ğāĚĐħ ÷ĜĐøĔ ĆĕâĕĆğčĘą ëĘĊėøúĘħ ĊĔü ĎĈĔèéĕâğãňĕĆĔýâĕĆĆĔâČĕĢüġĆèāąĕýĕĈ āýĊŇĕÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘğħ ãňĕĆĔýâĕĆĆĔâČĕĢüġĆè āąĕýĕĈúĔħĊģþĢüëŇĊèĊĔüĎąě÷čě÷čĔþ÷ĕĎŋéēĄĘĐĔøĆĕâĕĆ ğčĘąëĘĊėøúĘħ ĊĔü ĄĕââĊŇĕÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħ ğãň ĕ ĆĔ ý âĕĆĆĔ â ČĕĢüġĆèāąĕýĕĈúĔħ Ċ ĥģþ ĢüëŇ Ċ èĊĔ ü

ûĆĆĄ÷ĕĐąŇĕèĄĘüĔąčĬĕåĔîúĕèčùėøė ĠøŇģĄŇāýåĊĕĄĠøâ øŇ ĕ èãĐèâĕĆĆĔ â ČĕĆēĎĊŇ ĕ èĊĔ ü Ďąě ÷ čě ÷ čĔ þ ÷ĕĎŋ âĔ ý ĊĔ ü ûĆĆĄ÷ĕ ùňĕÿĜþň Ċł ąğãňĕĆĔýâĕĆĆĔâČĕĢüċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèåĆýĊèéĆ éēğĎĦüģ÷ňĊĕŇ ÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘğħ ãňĕĆĔý âĕĆĆĔ â ČĕúĘħ ċĜ ü ąŋ ġ ĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèåĆýĊèéĆ ĄĘ þĆēčėúûėÿĈãĐèâĕĆĆĔâČĕúĘħ÷ĘâĊŇĕċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèĄĕøĆòĕüĠĈēġĆèāąĕýĕĈúĘħģĄŇģ÷ňĄĘċĜüąŋġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐè ìęħèĢüĐüĕåøåèéēĄĘâĕĆċęâČĕĊėğåĆĕēĎŋ øňüúěüþĆēčėúûėÿĈøŇĐģþ

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J Thai Stroke Soc: Volume 14, 2015

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þĆēčĕúĠāúąŋ þĆēčĕúĠāúąŋĐąĜŇğĊĆĠĈēğãňĕĄĕ÷ĜÿĜňþłĊąúĘħġĆè āąĕýĕĈģ÷ňăĕąĢü üĕúĘ ĠāúąŋÿĜňğëĘħąĊëĕîĢüâĕĆøĆĊéĎĈĐ÷ğĈĚĐ÷ čĄĐè÷ňĊąåĈĚħüğčĘąèåĊĕĄùĘħčĜè ĠāúąŋÿĜňğëĘħąĊëĕîĢüâĕĆøĆĊé GEJQECTFKQITCRJ[ ĆĔèčĘĠāúąŋĐąĜŇğĊĆ þĆēčĕúċĔĈąĠāúąŋĐąĜŇğĊĆĠĈēğãňĕĄĕ÷ĜÿĜňþłĊąúĘħ ġĆèāąĕýĕĈģ÷ňăĕąĢü üĕúĘ ċĔĈąĠāúąŋ÷ĕň üĎĈĐ÷ğĈĚĐ÷úĘĄħ åĘ ĊĕĄğëĘąħ Ċëĕî ĢüâĕĆúĬĕ %CTQVKF GPFCTVGTGEVQO[ ĠāúąŋğĊëċĕčøĆŋĂŁŐüĂĜ üĔâĐĆĆùýĬĕýĔ÷ čĕĄĕĆùğĆėħĄâĕĆĀŀâāĜ÷ăĕąĢü ĊĔü üĔââĕąăĕāýĬĕýĔ÷ ğĆėħĄâĕĆĀŀâăĕąĢü ĊĔü üĔâčĔèåĄčèğåĆĕēĎŋ āąĕýĕĈÿĜňğëĘħąĊëĕîġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè

J Thai Stroke Soc: Volume 14, 2015

øĕĆĕèúĘħ øŇĐ ĐèåŋþĆēâĐý

25%

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ĄĘĠüĊúĕèâĕĆĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷úĕèĎĈĐ÷ ğĈĚĐ÷÷Ĭĕ ġ÷ąĆēąēğĊĈĕøĔĨèĠøŇĄĕùęè Ćā éü ģ÷ňĆĔýąĕĈēĈĕąĈėħĄğĈĚĐ÷ FQQT VQ PGGFNG VKOG ăĕąĢü üĕúĘ ëĔħĊġĄè ĊĔü čĕĄĕĆùĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷úĕèĎĈĐ÷ğĈĚĐ÷ Ġ÷èģ÷ň ëĔħĊġĄè ĊĔü ĄĘâĕĆ÷ĜĠĈëŇĊąĆēýýâĕĆĎĕąĢé ĄĘâĕĆÿŇĕøĔ÷ĎĈĐ÷ğĈĚĐ÷ġþłèāĐè CPGWT[UOU ĄĕââĊŇĕ ĆĕąøŇĐþĿĠĈē CPGWT[UOU ENKRRKPI ĄĕââĊŇĕ ĆĕąøŇĐþĿ

J Thai Stroke Soc: Volume 14, 2015

øĕĆĕèúĘħ øŇĐ ĐèåŋþĆēâĐý

25%

%5% ÿŇĕøĔ÷ *GOKETCPKGEVQO[ âĕĆĢčŇ XGPVTKEWNCT FTCKPCIG ÿŇĕøĔ÷ğĐĕâňĐüğĈĚĐ÷ĐĐâ âĕĆĢčŇúĘħĊĔ÷åĊĕĄ÷ĔüĢüġāĆèâēġĎĈâċĘĆČē 'PFQXCUEWNCT CDNCVKQP QH CPGWT[UOU ĠĈē CTVGTKQXGPQWU OCNHQTOCVKQPU #8/ âĕĆĆĔâČĕĎĈĐ÷ğĈĚĐ÷Ď÷ğâĆĦèġ÷ąĢëň 'PFQXCUEWNCT /KETQXCUEWNCT '% +% D[RCUU

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ĎĐÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèāĆňĐĄ÷ňĊą ýěåĈĕâĆÿĜňğëĘħąĊëĕî ĠÿüâğĊëċĕčøĆŋêěâğêėü ĎĐĐăėýĕĈÿĜňþłĊąĎüĔâ ġ÷ąģ÷ňĆĔýâĕĆ÷ĜĠĈ éĕâčĎčĕãĕĊėëĕ

ĠüĊúĕèâĕĆ÷ĜĠĈ ĄĘĠüĊúĕèâĕĆĢĎňąĕĈēĈĕąĈėħĄğĈĚĐ÷úĕè ĆĔâČĕÿĜňþłĊą ĎĈĐ÷ğĈĚĐ÷÷Ĭĕ ĄĘĠüĊúĕèâĕĆ÷ĜĠĈĆĔâČĕÿĜňþłĊąġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐè ĄĘĠüĊúĕèâĕĆ÷ĜĠĈĆĔâČĕÿĜňþłĊąġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèúĘğħ ãňĕĆĔýâĕĆĆĔâČĕĢüġĆèāąĕýĕĈ ĄĘâĕĆĆöĆèåŋĢĎňþĆēëĕëüĄĘåĊĕĄøĆēĎüĔâ ùęèġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĄĘĆēýýâĕĆğâĦýãňĐĄĜĈãĐèÿĜňþłĊąġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐè ĄĘĆēýýâĕĆĢĎňåĊĕĄĆĜňğĆĚħĐèġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐè

J Thai Stroke Soc: Volume 14, 2015

ÿĜňþłĊąĢüģ÷ňĆĔýâĕĆĆĔâČĕúĕèğĊëċĕčøĆŋĂŁŐüĂĜ ĎĆĚĐĄĘĠüĊúĕèâĕĆčŇèøŇĐÿĜňþłĊąģþĆĔýâĕĆ ĆĔâČĕúĘħčùĕüāąĕýĕĈĐĚħüúĘħĄĘâĕĆĆĔâČĕúĕè ğĊëċĕčøĆŋĂŁŐüĂĜ

éæÓĀãñŚü

þŌééěýĔüċĜüąŋâĕĆ÷ĜĠĈĠĈēĆĔâČĕġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèčĕĄĕĆùĠýŇèģ÷ňğþŎü Ćē÷Ĕý ģ÷ňĠâŇ ċĜüąŋ ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĄĕøĆòĕü ĠĈēċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆìęħèéēĄĘåĊĕĄåĆĐýåĈěĄúĔĨèâĕĆ÷ĜĠĈ ÿĜňþłĊąĢüăĕĊēêěâğêėü âĕĆĆĔâČĕĢüĆēąēğêĘąýāĈĔü âĕĆþŃĐèâĔüģĄŇĢĎňğþŎüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè âĕĆþŃĐèâĔü ģĄŇĢĎňğþŎüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèìĬĕĨ ĠĈēâĕĆ÷ĜĠĈúĕèğĊëċĕčøĆŋĂŁŐüĂĜ ġ÷ąċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆ éēčĕĄĕĆùĢĎňâĕĆ÷ĜĠĈĆĔâČĕÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘĄħ åĘ ĊĕĄìĔýìňĐüĎĆĚĐĄĘåĊĕĄĆěüĠĆèĄĕâãęüĨ čĕĄĕĆù ÿŇĕøĔ÷ĠĈēĢĎňâĕĆĆĔâČĕġ÷ąâĕĆĢčŇĐěþâĆöŋğãňĕģþúĕèĎĈĐ÷ğĈĚĐ÷ģ÷ňøĈĐ÷ ëĔħĊġĄè éĕâÿĈâĕĆċęâČĕāýĊŇĕ ċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèåĆýĊèéĆčĕĄĕĆùğāėĄħ þĆēčėúûėÿĈâĕĆĆĔâČĕÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèġ÷ąĈ÷ĐĔøĆĕ âĕĆğčĘąëĘĊėøğĄĚħĐğúĘąýâĔýċĜüąŋġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĄĕøĆòĕüĎĆĚĐâĕĆĆĔâČĕĢüčùĕüāąĕýĕĈĐĚħüĥ

J Thai Stroke Soc: Volume 14, 2015

)ZQFSIPNPDZTUFJOF JO TUSPLF QBUJFOUT 5BTBOFF 5BOUJSJUUJTBL . % Department of neurology, Prasat Neurological Institute

Abstract

)PNPDZTUFJOF BO BNJOP BDJE IBT BUIFSPHFOJD BOE QSPUISPNCPUJD QSPQFSUJFT CZ JOEVDJOH WBTDVMBS JOKVSZ WJB TFWFSBM NFDIBOJTNT )JHI IPNPDZTUFJOF MFWFMT XFSF GPVOE JO JTDIFNJD TUSPLF QBUJFOUT BOE XBT BTTPDJBUFE XJUI FBSMZ EFBUI JO UIF BDVUF QFSJPE CVU OPU JO UIF PVUDPNF PG TUSPLF QBUJFOUT )ZQFSIPNPDZTUFJOFNJB JT BTTPDJBUFE XJUI MBSHF WFTTFMT TUSPLF TVCUZQF BOE NBZ CF B SJTL GBDUPS PG TUSPLF 7JUBNJO UIFSBQZ FTQFDJBMMZ WJUBNJO # BOE GPMBUF NBZ SFEVDF UIF SJTL PG SFDVSSFOU TUSPLF (J Thai Stroke Soc 2015; 14: 44-49.) )PNPDZTUFJOF JT BO BNJOP BDJE GPSNFE CZ UIF DPOWFSTJPO PG NFUIJPOJOF UP DZTUFJOF *U JT NFUBCPMJ[FE CZ EJWFSHFOU QBUIXBZT USBOTTVMGVSBUJPO BOE SFNFUIZMBUJPO 5IF USBOTTVMGVSBUJPO PG IPNPDZTUFJOF UP DZTUFJOF JT DBUBMZ[FE CZ DZTUBUIJPOJOF É&#x2020; TZOUIBTF 5IJT QSPDFTT SFRVJSFT QZSJEPYBM QIPTQIBUF WJUBNJO # BT B DPGBDUPS 3FNFUIZMBUJPO PG IPNPDZTUFJOF QSPEVDFT NFUIJPOJOF 5IJT SFBDUJPO JT DBUBMZ[FE CZ NFUIJPOJOF TZOUIBTF PS CFUBJOF IPNPDZTUFJOF NFUIZMUSBOTGFSBTF 7JUBNJO #12 JT UIF DPGBDUPS GPS NFUIJPOJOF TZOUIBTF &MFWBUJPO PG QMBTNB IPNPDZTUFJOF PDDVSSFE JO QFSDFOU PG HFOFSBM QPQVMBUJPO1 BOE NBZ CF BO JOEFQFOEFOU SJTL GBDUPS GPS BUIFSPTDMFSPUJD WBTDVMBS EJTFBTF BOE PS UISPNCPFNCPMJTN )JHI QMBTNB IPNPDZTUFJOF DPODFOUSBUJPO DBO CF GPVOE JO UIPTF XIP IBWF HFOFUJD EFGFDUT JO UIF FO[ZNF JOWPMWFE JO IPNPDZTUFJOF NFUBCPMJTN2 OVUSJUJPOBM EFÈ½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uH EBZ 4VCPQUJNBM WJUBNJO # JOUBLF XJUI QPPS BCTPSQUJPO NJHIU DBVTF FMFWBUJPO PG QMBTNB IPNPDZTUFJOF DPODFOUSBUJPO .

J Thai Stroke Soc: Volume 14, 2015

)PNPDZTUFJOF IBT BUIFSPHFOJD BOE QSPUISPNCPUJD QSPQFSUJFT )PNPDZTUFJOF NBZ JOEVDF WBTDVMBS JOKVSZ WJB TFWFSBM NFDIBOJTNT11 )PNPDZTUFJOF QSPNPUFT MFVLPDZUF SFDSVJUNFOU CZ VQSFHVMBUJOH NPOPDZUF DIFNPBUUSBDUBOU QSPUFJO BOE JOUFSMFVLJO FYQSFTTJPO BOE TFDSFUJPO 5IF UIJPMBDUPOF NFUBCPMJUF PG IPNPDZTUFJOF DBO DPNCJOF XJUI -%- DIPMFTUFSPM UP QSPEVDF BHHSFHBUFT UIBU BSF UBLFO VQ CZ WBTDVMBS NBDSPQIBHFT JO BSUFSJBM JOUJNBM 5IFTF GPBN DFMMT NBZ SFMFBTF UIF MJQJE JOUP BUIFSPTDMFSPUJD QMBRVFT )PNPDZTUFJOF JODSFBTFT TNPPUI NVTDMF DFMM QSPMJGFSBUJPO BOE FOIBODFT DPMMBHFO QSPEVDUJPO 1SPUIPNCPUJD FÈ¼FDUT JODMVEF BUUFOVBUJPO PG FOEPUIFMJBM DFMM UJTTVF QMBTNJOPHFO BDUJWBUPS CJOEJOH TJUFT BDUJWBUJPO PG GBDUPS 7 BOE 7**B JOIJCJUJPO PG QSPUFJO BOE IFQBSJO TVMGBUF JODSFBTFE È½CSJOPQFQUJEF " BOE QSPUISPNCJO GSBHNFOU BOE CMPPE WJTDPTJUZ BOE EFDSFBTFE FOEPUIFMJBM BOUJUISPNCPUJD BDUJWJUZ EVF UP DIBOHFT JO UISPNCPNPEVMJO GVODUJPO 0YJEBUJWF TUSFTT CZ GSFF SBEJDBMT GPSNFE EVSJOH UIF PYJEBUJPO PG SFEVDFE IPNPDZTUFJOF NBZ EJSFDU JOKVSF FOEPUIFMJBM DFMMT .BSLFE QMBUFMFU BDDVNVMBUJPO NBZ CF EVF UP EJSFDU QSPBHHSFHBUPSZ FÈ¼FDU PG IPNPDZTUFJOF PS JNQBJSNFOU JO FOEPUIFMJVN NFEJBUFE QMBUFMFU JOIJCJUJPO 1SPMPOH FYQPTVSF PG FOEPUIFMJBM DFMMT UP IPNPDZTUFJOF SFEVDFT UIF BDUJWJUZ PG EJNFUIZMBSHJOJOF EJNFUIZMBNJOPIZESPMBTF 5IJT FO[ZNF EFHSBEFT BTZNNFUSJD EFNFUIZMBSHJOJOF BO FOEPHFOPVT JOIJCJUPS PG OJUSJD PYJEF TZOUIBTF XIJDI JNQBJST UIF QSPEVDUJPO PG OJUSJD PYJEF BOE DPOUSJCVUFT UP JNQBJSFE FOEPUIFMJVN EFQFOEFOU WBTPEJMBUJPO

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J Thai Stroke Soc: Volume 14, 2015

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J Thai Stroke Soc: Volume 14, 2015

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J Thai Stroke Soc: Volume 14, 2015

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J Thai Stroke Soc: Volume 14, 2015

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J Thai Stroke Soc: Volume 14, 2015

čòÓúñćãúāñĎ×ÑâÿúôĀé×āÐÐāòüćãÐĀĔèÐĀéčòÓúôüãċôĆüãùðüÖ 0CTUSVDUJWF 4MFFQ "QOFB BOE 4USPLF

íÜ ïĀæòăè ïăòðñŞíāèăÙ úèŚöñčòÓòÿééÐāòúāñĎ×ČôÿċöÙéĘāéĀãöăÐóä ïāÓöăÙāüāñćò÷āùäòŞ ÓâÿČíæñ÷āùäòŞ ðúāöăæñāôĀñçòòð÷āùäòŞ 1BUUBSJO 1JSPNQBOJDI . % Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Thammasat University $PSSFTQPOEJOH BVUIPS 1BUUBSJO 1JSPNQBOJDI . % Instructor in Pulmonary and Critical Care Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Klong 1, Klong Luang, Pathumthani 12120, Thailand, Email: pirompanichp@gmail.com, Tel: 02-926-9794

J Thai Stroke Soc: Volume 14, 2015

Abstract

0CTUSVDUJWF TMFFQ BQOFB 04" XIJDI JODSFBTFT UIF SJTL PG TUSPLF BOE EFBUI CZ UJNFT DPNQBSFE UP UIPTF XJUIPVU 04" JT B DPNNPO EJTFBTF JO HFOFSBM QSBDUJDF 4VDI SJTLT DBO BSJTF GSPN TFWFSBM GBDUPST TVDI BT IZQFSUFOTJPO BSSIZUINJBT BOE BUIFSPTDMFSPTJT XIJDI BSF QSFWBMFOU JO 04" 5SFBUNFOU XJUI DPOUJOVPVT QPTJUJWF BJSXBZ QSFTTVSF XIJMF TMFFQJOH OPU POMZ IFMQT UP SFEVDF UIF SJTL PG TUSPLF CVU BMTP JNQSPWFT RVBMJUZ PG MJGF BOE UIF BCJMJUZ UP EP EBJMZ BDUJWJUJFT PG QBUJFOUT XJUI TUSPLF (J Thai Stroke Soc 2015; 14: 50-55.) ,FZXPSET PCTUSVDUJWF TMFFQ BQOFB TUSPLF IZQPQOFB IZQPYFNJB

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ġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü QDUVTWEVKXG UNGGR CRPGC ĎĆĚĐ 15# ğþŎüġĆåúĘħāýģ÷ňýŇĐąĢüğĊëþñėýĔøėúĔħĊģþ ğâė÷éĕââĕĆ Đě÷âĔĨüãĐèúĕèğ÷ėüĎĕąĢéčŇĊüýü ğüĚħĐèéĕââĈěŇĄâĈňĕĄğüĚĨĐúĘħúĬĕĎüňĕúĘħ ãąĕąúĕèğ÷ėüĎĕąĢéčŇĊüýü WRRGT CKTYC[ FKNCVQT OWUENGU ğâė÷åĈĕą øĔĊãöēüĐüĎĈĔý úĬĕĢĎňĄĘâĕĆĎĕąĢéĠÿŇĊ J[RQRPGC ĎĆĚĐĎąě÷ĎĕąĢé

CRPGC éüčŇèÿĈĢĎňğâė÷ăĕĊēāĆŇĐèĐĐâìėğéüĢüğĈĚĐ÷ J[RQZGOKC ĆŇĕèâĕąéēĄĘâĕĆøĚħüøĔĊãĐèčĄĐè CTQWUCN ğāĚħĐĢĎňâĈňĕĄğüĚĨĐýĆėğĊöúĕè ğ÷ėüĎĕąĢéčŇĊüýüâĈĔýĄĕúĬĕèĕüøęèøĔĊ ğāĚħĐğþľ÷úĕèğ÷ėüĎĕąĢéčŇĊüýü ğĄĚħĐÿĜňþłĊąğãňĕčĜŇĆēąēĎĈĔýĐĘâåĆĔĨèâĦéēğâė÷âĕĆĐě÷âĔĨüìĬĨĕ âĕĆğâė÷ăĕĊē÷Ĕè âĈŇ ĕ ĊýŇ Đ ąĥ éēâĆēøě ň ü âĕĆúĬ ĕèĕüãĐèĆēýýþĆēčĕúĐĔ ø ġüĄĔ øė ë üė ÷ U[ORCVJGVKE úĬĕĢĎňğâė÷ÿĈğčĘąøŇĐĆēýýĎĔĊĢéĠĈēĎĈĐ÷ğĈĚĐ÷ ğëŇü ğâė÷ġĆå åĊĕĄ÷ĔüġĈĎėøčĜè ăĕĊēĎĔĊĢéĊĕą ĎĔĊĢéğøňüÿė÷éĔèĎĊē ĠĈēġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐè ğþŎüøňü ĢüýúåĊĕĄüĘéĨ ēâĈŇĕĊùęèåĊĕĄčĔĄāĔüûŋãĐèġĆåĎąě÷ĎĕąĢé ãöēĎĈĔýéĕââĕĆĐě÷âĔĨüâĔýġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè

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þĆēğúċģúąāýåĊĕĄëěâãĐèġĆåĎąě÷ĎĕąĢé ãöēĎĈĔýéĕââĕĆĐě÷âĔüĨ ĢüþĆēëĕâĆúĔĊħ ģþĆňĐąĈē Ģü ÿĜňëĕąĆňĐąĈē ĠĈēĢüÿĜňĎîėèĆňĐąĈē ìęħèĢâĈňğåĘąèâĔý ëĕĊøēĊĔüøâ1 ĢüãöēúĘåħ ĊĕĄëěâãĐèġĆåĎąě÷ĎĕąĢéãöē âĈĔýéĕââĕĆĐě÷âĔĨüĢüÿĜňþłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèāýģ÷ň čĜèùęèĄĕââĊŇĕĆňĐąĈē 2 åĊĕĄğčĘħąèĢüâĕĆğâė÷ġĆå čĔĄāĔüûŋâĔýĐĕąěĠĈē÷ĔëüĘĄĊĈâĕąúĘħğāėħĄãęĨü ĠøŇĐąŇĕèģĆ âĦøĕĄÿĜňþłĊąëĕĊğĐğëĘąĄĔâāýĊŇĕĄĘ÷ĔëüĘĄĊĈâĕąøĬħĕâĊŇĕ ëĕĊøēĊĔüøâ ğüĚĐħ èéĕâĄĘġåĆèĎüňĕúĘğħ čĘąħ èøŇĐâĕĆğâė÷ġĆå ğëŇü ĄĘåĕèúĘħčĔĨüâĊŇĕëĕĊøēĊĔüøâ ğþŎüøňü3 ÿĜňúĘħüĐüâĆü éēğāėħĄåĊĕĄğčĘħąèĢüâĕĆğþŎüġĆå ğúŇĕğĄĚħĐğúĘąýâĔýÿĜňúĘħ ģĄŇüĐüâĆü ġ÷ąÿĜþň Ċł ąġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆ Đě÷âĔĨü ĄĘġĐâĕčğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĠĈēğčĘąëĘĊėøčĜè ğþŎü ùęè ğúŇĕğĄĚħĐğúĘąýâĔýÿĜňģĄŇğþŎüġĆå

Ðāòöăèă×ØĀñčòÓúñćãúāñĎ×ÑâÿúôĀé ×āÐÐāòüćãÐĀĔè

âĕĆĊėüéė êĔąġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷ âĔĨü ĐĕċĔąøĕĄğâöôŋãĐè +PVGTPCVKQPCN %NCUUKÌECVKQP QH 5NGGR &KUQTFGTU +%5& ìęħèâĈŇĕĊġ÷ąčĔèğãþåĚĐ ÿĜňþłĊąéēøňĐèĄĘãňĐĢ÷ãňĐĎüęħè÷ĔèøŇĐģþüĘ7Ĩ 1 ÿĜ ň þ ł Ċ ąĄĘ Đ ĕâĕĆãĐèġĆåĎąě ÷ ĎĕąĢéãöē ĎĈĔýéĕââĕĆĐě÷âĔĨüĐąŇĕèĢ÷ĐąŇĕèĎüęħè ğëŇü ĐĕâĕĆèŇĊè Ąĕâÿė÷þâøėĢüëŇĊèğĊĈĕâĈĕèĊĔü ĆĜňčęâĐŇĐüğāĈĘą üĐü âĆü ĄĘâĕĆĎĕąĢéğđĚĐâĎĆĚĐčĬĕĈĔâãöēĎĈĔý ĄĘÿĜňğĎĦüĊŇĕ ÿĜþň Ċł ąĎąě÷ĎĕąĢéãöēĎĈĔý ĎĆĚĐÿĜþň Ċł ąģ÷ňĆýĔ âĕĆĊėüéė êĔą ĊŇĕğþŎüġĆååĊĕĄ÷ĔüġĈĎėøčĜè ġĆåğýĕĎĊĕü ġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐè ĎĆĚĐġĆåĎĈĐ÷ğĈĚĐ÷ĎĔĊĢé ğþŎüøňü ĆŇĊĄâĔý ÿĈøĆĊéâĕĆüĐüĎĈĔý RQN[UQOPQITCRJ[ āýĊŇĕĄĘ âĕĆĎąě÷ĎĕąĢéĎĆĚĐĎĕąĢéĠÿŇĊúĘğħ âė÷éĕââĕĆĐě÷âĔüĨ ĎĆĚĐ âĕĆøĚħüøĔĊéĕââĕĆĐĐâĠĆèĎĕąĢé TGURKTCVQT[ GHHQTV TGNCVGF CTQWUCNU ĎĆĚĐ 4'4#U øĔĨèĠøŇ 5 åĆĔĨèøŇĐëĔħĊġĄè ãęĨüģþ ÿĜþň Ċł ąģĄŇĄĐĘ ĕâĕĆĎĆĚĐġĆåĆŇĊĄ÷ĔèâĈŇĕĊãňĕèøňü ĠøŇ ĄĘ ÿ ĈøĆĊéâĕĆüĐüĎĈĔ ý āýĊŇ ĕ ĄĘ â ĕĆĎąě ÷ ĎĕąĢé ĎĆĚĐĎĕąĢéĠÿŇĊúĘħğâė÷éĕââĕĆĐě÷âĔĨü ĎĆĚĐâĕĆøĚħüøĔĊéĕâ âĕĆĐĐâĠĆèĎĕąĢéøĔĨèĠøŇ åĆĔĨèøŇĐëĔħĊġĄèãęĨüģþ

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åĊĕĄĆěüĠĆèãĐèġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕâ âĕĆĐě÷âĔĨü ĄĘåĊĕĄčĔĄāĔüûŋâĔýâĕĆāýåĊĕĄÿė÷þâøėãĐè EGTGDTCN YJKVG OCVVGT ğüĚĐħ èéĕâĄĘâĕĆğþĈĘąħ üĠþĈèĆē÷Ĕý åĊĕĄ÷ĔüġĈĎėø ĠĈēăĕĊēāĆŇĐèĐĐâìėğéüĢüğĈĚĐ÷ ãöē ĎĈĔý3 ĠĈēéĕââĕĆċęâČĕġ÷ąĢëň OCIPGVKE TGUQPCPEG URGEVTQUEQR[ ğāĚħĐ÷ĜâĕĆğĄøĕýĐĈėìęĄãĐèčĄĐè āýĊŇĕ ÿĜňþłĊąġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü ĄĘâĕĆĈ÷ ĈèãĐèğĄøĕýĐĈėìęĄýĆėğĊöčĄĐèčŇĊüĎüňĕğĄĚħĐğúĘąýâĔý åüþâøė ìęèħ čĕĄĕĆùĐûėýĕąâĕĆčĜîğčĘąåĊĕĄčĕĄĕĆù÷ňĕü åĊĕĄĆĜåň ĊĕĄğãňĕĢéøŇĕèĥ EQIPKVKXG HWPEVKQP ġ÷ąğêāĕē ÷ňĕü÷ňĕüâĕĆéĔ÷âĕĆ GZGEWVKXG HWPEVKQP ĢüÿĜňþłĊąġĆå Ďąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨüģ÷ň

êŠ××ĀñæĄæē āĘ ĎúśëêśĈ öŕ ñčòÓúñćãúāñĎ×ÑâÿúôĀé×āÐ ÐāòüćãÐĀĔè ðĄÓöāðċùĄēñÖäŚüÐāòċÐăãčòÓúôüã ċôĆüãùðüÖ

āąĕûėâĕĬ ğüė÷ãĐèġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĢüÿĜþň Ċł ą ġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔüĨ ğâė÷ģ÷ňéĕâĎĈĕą âĈģâ ĆĜþúĘħ 1) ġĆååĊĕĄ÷ĔüġĈĎėøčĜè åĊĕĄĆěüĠĆèãĐè ġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕâ âĕĆĐě÷âĔüĨ čĔĄāĔüûŋâýĔ ĐěýøĔ âė ĕĆöŋãĐèġĆååĊĕĄ÷ĔüġĈĎėø čĜèúĘħğāėħĄãęĨü ġ÷ąāýĊŇĕâĕĆĎąě÷ĎĕąĢéúĘħğāėħĄãęĨü 1 åĆĔĨè øŇĐëĔĊħ ġĄèğāėĄħ åĊĕĄğčĘąħ èøŇĐġĆååĊĕĄ÷ĔüġĈĎėøčĜèĆňĐąĈē 19 ĠĈēÿĜňþłĊąġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü ĄĕââĊŇĕĆňĐąĈē 50 ĄĘġĆååĊĕĄ÷ĔüġĈĎėøčĜèĆŇĊĄ÷ňĊą ĢüãöēúĘÿħ þňĜ Ċł ąġĆååĊĕĄ÷ĔüġĈĎėøčĜèúĘģħ ĄŇčĕĄĕĆùåĊýåěĄ åĊĕĄ÷ĔüġĈĎėøģ÷ňĠĄňéēĢëňąĕĈ÷åĊĕĄ÷Ĕüãüĕ÷čĜèčě÷ 3 øĔĊĠĈňĊ TGUKUVCPV J[RGTVGPUKQP āýĄĘăĕĊē ġĆåĎąě÷ ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü ĆŇĊĄ÷ňĊąùęèĆňĐąĈē 11 üĐâéĕâüĔüĨ ąĔèāýĊŇĕÿĜúň âĘħ ĆüĠĈēĎąě÷ĎĕąĢéãöēĎĈĔý ĄĘ åĊĕĄčĔĄāĔüûŋâĔýåĊĕĄ÷ĔüúĘħģĄŇĈ÷ĈèĢüëŇĊèúĘħĎĈĔý PQP FKRRGT EQPFKVKQP 12 ìęħèğāėħĄåĊĕĄğčĘħąèĢüâĕĆğâė÷ġĆå ĎĔĊĢéĠĈēĎĈĐ÷ğĈĚĐ÷ĐĘâ÷ňĊą ăĕĊēĎĔĊĢéğøňüÿė÷éĔèĎĊē ÿĜňþłĊąġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü āýĎĔĊĢéğøňüÿė÷éĔèĎĊēģ÷ňúèĔĨ Ġýýëňĕ DTCF[CTTJ[VJOKCU ĠĈēĠýýğĆĦĊ VCEJ[CTTJ[VJOKCU ġ÷ąāý RTGOCVWTG J Thai Stroke Soc: Volume 14, 2015

XGPVTKEWNCT EQORNGZ ĠĈē XGPVTKEWNCT VCEJ[ECTFKC ģ÷ňýŇĐąĢüÿĜňþłĊąúĘħĄĘăĕĊēĎĔĊĢéĈňĄğĎĈĊĆŇĊĄ÷ňĊą āý UKPWU RCWUGU ĠĈē CVTKQXGPVTKEWNCT DNQEMU ğāėħĄĄĕâãęĨü øĕĄĆē÷ĔýåĊĕĄĆěüĠĆèãĐèġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕâ âĕĆĐě ÷ âĔĨ ü ĠĈēĈ÷ĈèğĄĚħ Đ ĆĔ â Čĕ÷ň Ċ ąâĕĆĢëň ğ åĆĚħ Đ èĐĔ ÷ ĐĕâĕċĠĆè÷ĔüýĊâëüė÷øŇĐğüĚħĐè EQPVKPWQWU RQUKVKXG CKTYC[ RTGUUWTG ĎĆĚĐ %2#2 13 üĐâéĕâüĘĨąĔèāýåĊĕĄ ëěâãĐèġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨüĢüÿĜňþłĊą ĎĔĊĢéğøňüÿė÷éĔèĎĊēëüė÷ CVTKCN ÌDTKNNCVKQP ùęèĆňĐąĈē ùęè 50 ġ÷ąÿĜňþłĊąĄĔâĄĘĠüĊġüňĄ÷ĚĨĐøŇĐąĕĆĔâČĕăĕĊē ĎĔĊĢéğøňüÿė÷éĔèĎĊē ĠĈēĄĘġĐâĕčğâė÷ìĬĨĕĎĈĔèâĕĆúĬĕâĕĆ ĠâňģãăĕĊēĎĔĊĢéğøňüÿė÷éĔèĎĊēĠĈňĊģ÷ňĄĕââĊŇĕÿĜňþłĊą úĔĊħ ģþ ìęèħ ăĕĊēĎĔĊĢéğøňüÿė÷éĔèĎĊē÷ĔèâĈŇĕĊğāėĄħ åĊĕĄ ğčĘħąèĢüâĕĆğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèëüė÷ãĕ÷ğĈĚĐ÷éĕâ ĈėħĄğĈĚĐ÷Đě÷øĔü 3 ăĕĊēĎĈĐ÷ğĈĚĐ÷Ġ÷èĠãĦè CVJGTQUENGTQUKU ġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü ğþŎü þŌééĔąğčĘħąèĢüâĕĆğâė÷ĎĈĐ÷ğĈĚĐ÷Ġ÷èĠãĦè éĕâăĕĊē EJTQPKE KPVGTOKVVGPV J[RQZGOKC ĠĈēâĕĆÿĔüÿĊüãĐè åĊĕĄ÷ĔüĢüëŇĐèĐâ KPVTCVJQTCEKE RTGUUWTG čŇèÿĈĢĎň ğâė÷âĕĆâĆēøěüň ĆēýýþĆēčĕúĐĔøġüĄĔøëė üė÷ U[ORCVJGVKE ĠĈēĄĘâĕĆğāėħĄãęĨüãĐè QZKFCVKXG UVTGUU üĬĕģþčĜŇăĕĊē XCUEWNCT GPFQVJGNKCN F[UHWPEVKQP17-19 čŇèÿĈĢĎňÿüĔè ĎĈĐ÷ğĈĚĐ÷Ġ÷è ECTQVKF ĠĈē CQTVC ĎüĕøĔĊãęĨü20 úĬĕĢĎň ğāėħĄåĊĕĄğčĘħąèĢüâĕĆğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĢü ĆēąēąĕĊ âĕĆĆĔâČĕ÷ňĊąğåĆĚĐħ èĐĔ÷ĐĕâĕċĠĆè÷ĔüýĊâëüė÷ øŇĐğüĚħĐè čŇèÿĈĢĎňåĊĕĄĎüĕãĐèÿüĔèĎĈĐ÷ğĈĚĐ÷ ECTQVKF Ĉ÷ĈèĐąŇĕèĄĘüĔąčĬĕåĔî21 üĐâéĕâüĔĨüăĕĊēĐĚħüĥúĘħĄĔâāý ĆŇĊĄâĔýġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü ğëŇü ġĆåğýĕĎĊĕü ġĆåĐňĊü ġĆååĊĕĄ÷ĔüġĈĎėøčĜè ğþŎüøňü ĈňĊüğþŎüþŌééĔąčŇèğčĆėĄĢĎňğâė÷ăĕĊēĎĈĐ÷ğĈĚĐ÷Ġ÷èĠãĦè ĄĕâãęĨü 4 âĆēýĊüâĕĆâĕĆĐĔâğčý KPÍCOOCVQT[ FKUVWTDCPEGU âĕĆĎĈĔħèčĕĆĐĔâğčýĠĈēčĕĆúĘħğâĘħąĊâĔýâĕĆĠãĦè øĔĊãĐèğĈĚĐ÷ čŇèÿĈĢĎňğâė÷âĕĆýĕ÷ğéĦýøŇĐĎĈĐ÷ğĈĚĐ÷ éĕââĕĆċęâČĕāýĊŇĕÿĜþň Ċł ąġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕâ âĕĆĐě÷âĔüĨ ĄĘĆē÷Ĕý ÌDTKPQIGP ĠĈēåĊĕĄğãňĄãňüãĐèğĈĚĐ÷ ğāėħ Ą čĜ è ãęĨ ü ĢüëŇ Ċ èğëň ĕ 22 üĐâéĕâüĔĨ ü ąĔ è āýĊŇ ĕ Ćē÷Ĕ ý

J Thai Stroke Soc: Volume 14, 2015

JQOQE[UVGKPG ğāėħĄčĜèãęĨü RNCUOKPQIGP CEVKXCVQT KPJKDKVQT V[RG ùĜâąĔýąĔĨè ĠĈēğâĈĦ÷ğĈĚĐ÷ùĜââĆēøěňü čŇèÿĈĢĎňÿþňĜ Ċł ąĄĘåĊĕĄğčĘąħ èøŇĐâĕĆğâė÷ĎĈĐ÷ğĈĚĐ÷Đě÷øĔü čĜèãęĨü ĠĈēâĕĆâĆēøěňüĆēýýþĆēčĕúëüė÷ U[ORCVJGVKE ÷ĔèâĈŇĕĊãňĕèøňü éēčŇèÿĈĢĎňĄâĘ ĕĆĠč÷èĐĐâãĐè CFJGUKQP OQNGEWNGU ĠĈē RTQKPÍCOOCVQT[ E[VQMKPG ğāėĄħ čĜèãęüĨ 23-25 ìęħèčĕğĎøě÷ĔèâĈŇĕĊčŇèÿĈĢĎňÿĜňþłĊąğčĘħąèøŇĐâĕĆğâė÷ġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèĄĕâãęĨü 5 âĕĆğþĈĘħąüĠþĈè÷ňĕüāĈċĕčøĆŋĆēýý ģĎĈğĊĘąü JGOQF[PCOKE EJCPIGU âĕĆĈ÷ĈèãĐèåĊĕĄ÷ĔüğĈĚĐ÷úĘħģþğĈĘĨąèčĄĐè

EGTGDTCN RGTHWUKQP RTGUUWTG ĢüëŇĊèúĘħĎąě÷ĎĕąĢé ğüĚĐħ èéĕâăĕĊēāĆŇĐèĐĐâìėğéüĢüğĈĚĐ÷úĬĕĢĎňåĊĕĄ÷ĔüĢü âēġĎĈâċĘĆČē KPVTCETCPKCN RTGUUWTG čĜèãęĨü čŇèÿĈĢĎňĄĘ âĕĆğþĈĘħąüĠþĈè VGPUKQP ãĐèÿüĔèĎĈĐ÷ğĈĚĐ÷ ğþŎüğĎøě ĢĎňğâė÷âĕĆýĕ÷ğéĦýãĐèĎĈĐ÷ğĈĚĐ÷éĕâ UJGCT UVTGUU HQTEGU ģ÷ň RCVGPV HQTCOGP QXCNG āýåĊĕĄëěâãĐè RCVGPV HQTCOGP QXCNG Ģü ÿĜňþłĊą ġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü ĄĕââĊŇĕ ĢüþĆēëĕâĆúĔħĊģþ ĆňĐąĈē ĠĈē 17 øĕĄĈĬĕ÷Ĕý ğüĚħĐèéĕâåĊĕĄ÷ĔüĠĈēþĆėĄĕøĆãĐèĎĔĊĢéĎňĐèãĊĕĄĘâĕĆ ğāėħĄčĜèãęĨüğþŎüåĆĔĨèåĆĕĊ éĕââĕĆĐě÷âĔĨüúĕèğ÷ėüĎĕąĢé čŇĊüýüãöēĎĈĔýúĬĕĢĎňĄĘåĊĕĄÿĔüÿĊüãĐèåĊĕĄ÷ĔüĢü ëŇĐèĐâģ÷ňĄĕââĊŇĕþâøė üĐâéĕâüĔüĨ ăĕĊēāĆŇĐèĐĐâìėğéü ĢüğĈĚĐ÷ãöēĎąě÷ĎĕąĢéčŇèÿĈĢĎňĎĈĐ÷ğĈĚĐ÷ĢüþĐ÷ Ď÷øĔĊ J[RQZKE RWNOQPCT[ XCUQEQPUVTKEVKQP ğþŎüþŌééĔą ğčĆėĄĢĎňåĊĕĄ÷ĔüãĐèĎĔĊĢéĎňĐèãĊĕğāėħĄčĜèãęĨü čŇèÿĈĢĎň HQTCOGP QXCNG ğþľ÷ ĠĈēĐĕéĄĘĈėħĄğĈĚĐ÷ÿŇĕüĆĜğþľ÷üĘĨģþčĜŇ ĎĔĊĢéĎňĐèìňĕąĠĈēģþčĜŇĎĈĐ÷ğĈĚĐ÷čĄĐèģ÷ň

ăĕĊēĎąě÷ĎĕąĢé âĆü

ăĕĊēāĆŇĐèĐĐâìėğéüĢüğĈĚĐ÷ endothelial dysfunction ğĈĚĐ÷ĠãĦèøĔĊèŇĕą

åĊĕĄ÷ĔüĢüâēġĎĈâċĘĆČēčĜè

åĊĕĄ÷ĔüğĈĚĐ÷úĘħģþğĈĘĨąèčĄĐèĈ÷Ĉè

âĆēøěňüĆēýýþĆēčĕúĐĔøġüĄĔøė U[ORCVJGVKE

åĊĕĄ÷ĔüãĐèĎĔĊĢéĎňĐèãĊĕčĜèãęĨü

ĎĔĊĢéğøňüÿė÷éĔèĎĊē

HQTCOGP QXCNG ğþľ÷

åĊĕĄ÷ĔüġĈĎėøčĜè

ĎĈĐ÷ğĈĚĐ÷Ġ÷èĠãĦè

ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè

ĆĜþúĘħ Ġč÷èāąĕûėâĕĬ ğüė÷ãĐèġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĢüÿĜňþłĊąġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü

ÐāòòĀÐøāčòÓúñćãúāñĎ×ÑâÿúôĀé ×āÐÐāòüćãÐĀĔè ĎèëĈśêŕöñčòÓúôüãċôĆüãùðüÖ

ÿĜňþłĊąġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü ýĕèĆĕąĐĕéĄĘĐĕâĕĆ÷ĘãęĨüģ÷ňğĐèĎĈĔèğþŎüġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐè ìęħèĐĕéĐûėýĕąģ÷ňéĕââĕĆúĘħÿĜňþłĊąüĐüĎĈĔýĢüúŇĕ üĐüĎèĕąĈ÷ĈèéęèúĬĕĢĎňâĕĆĐě÷âĔĨüĈ÷Ĉè ĠøŇâĕĆĆĔâČĕ ĎĈĔâãĐèġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔüĨ åĚĐâĕĆ ĢčŇğåĆĚħĐèĐĔ÷ĐĕâĕċĠĆè÷ĔüýĊâëüė÷øŇĐğüĚħĐèãöēüĐü ĎĈĔýìęèħ üĐâéĕâéēëŇĊąĈ÷åĊĕĄğčĘąħ èĢüâĕĆğâė÷ġĆåĎĔĊĢé ĠĈēĎĈĐ÷ğĈĚĐ÷ øĕĆĕèúĘħ 1 ĠĈňĊąĔèëŇĊąğāėħĄåěöăĕā ëĘĊėø ĠĈēåĊĕĄčĕĄĕĆùĢüâĕĆúĬĕâėéĊĔøĆþĆēéĬĕĊĔüãĐèÿĜň þłĊąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĐĘâ÷ňĊą üĐâéĕâüĔĨüâĕĆ ĎĈĘâğĈĘħąèâĕĆĢëňąĕüĐüĎĈĔý è÷âĕĆ÷ĚħĄĠĐĈâĐđĐĈŋ ĠĈē âĕĆåĊýåěĄüĬĨĕĎüĔâ éēëŇĊąĈ÷åĊĕĄĆěüĠĆèãĐèġĆåģ÷ň

ÐāòãĘāċèăèčòÓČôÿÐāòíñāÐòâŞčòÓúôĀÖÐāòċÐăã čòÓúôüãċôĆüãùðüÖĎèëĈśêŕöñčòÓúñćãúāñĎ× ÑâÿúôĀé×āÐÐāòüćãÐĀĔè

ÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘģħ ÷ňĆýĔ âĕĆĆĔâČĕĢü ġĆèāąĕýĕĈúĘħĄĘġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü éēĄĘåĊĕĄýâāĆŇĐèĢüâĕĆúĬĕâėéĊĔøĆĄĕââĊŇĕ ĄĘĆēąēğĊĈĕ âĕĆüĐüġĆèāąĕýĕĈüĕüâĊŇĕ31 ĠĈēĐĔøĆĕâĕĆğčĘąëĘĊėø ĎĈĔèéĕâğþŎüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħ ğ÷ĚĐüĠĈē 1 þĿ čĜè âĊŇĕÿĜňúĘħģĄŇĄĘġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü

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ġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔüĨ ğþŎüþŌééĔą ğčĘħąèúĘħčĬĕåĔîøŇĐġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ĠāúąŋÿĜňĢĎňâĕĆ ĆĔâČĕåĊĆøĆēĎüĔâùęèåĊĕĄčĬĕåĔîãĐèġĆå ĠĈēĢĎňâĕĆ øĆĊéåĔ÷âĆĐèĐąŇĕèğĎĄĕēčĄ ğāĚħĐčŇèøŇĐÿĜňþłĊąģþĆĔýâĕĆ øĆĊéâĕĆüĐüĎĈĔý ĠĈēĢĎňâĕĆĆĔâČĕĐąŇĕèğĎĄĕēčĄ

øĕĆĕèúĘħ 1 ÿĈ÷ĘãĐèâĕĆĆĔâČĕ÷ňĊąğåĆĚħĐèĐĔ÷ĐĕâĕċĠĆè÷ĔüýĊâëüė÷øŇĐğüĚħĐè Ĉ÷ãĐèÿĔüÿĊüãĐèåĊĕĄ÷ĔüĢüëŇĐèĐâ Ĉ÷åĊĕĄ÷ĔüġĈĎėøúĔĨèĢüëŇĊèâĈĕèĊĔüĠĈēâĈĕèåĚü Ĉ÷âĕĆâĆēøěňüâĕĆúĬĕèĕüãĐèĆēýýþĆēčĕúĐĔøġüĄĔøėëüė÷ U[ORCVJGVKE Ĉ÷åĊĕĄ÷ĔüãĐèĎĔĊĢéĎňĐèãĊĕãöēúĘħĄĘâĕĆĎąě÷ĎĕąĢé Ĉ÷åĊĕĄğčĘħąèĢüâĕĆğâė÷ġĆåĎĔĊĢéĠĈēĎĈĐ÷ğĈĚĐ÷ Ĉ÷âĕĆğâė÷ GPFQVJGNKCN F[sfunction

J Thai Stroke Soc: Volume 14, 2015

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J Thai Stroke Soc: Volume 14, 2015

13. #FDLFS ) #SBOEFOCVSH 6 1FUFS +) FU BM 3FWFSTBM PG TJOVT BSSFTU BOE BUSJPWFOUSJDVMBS DPOEVDUJPO CMPDL JO QBUJFOUT XJUI TMFFQ BQOFB EVSJOH OBTBM DPOUJOVPVT QPTJUJWF BJSXBZ QSFTTVSF "N + 3FTQJS $SJU $BSF .FE 14. )PIM . -JO[ # #PIN . FU BM 0CTUSVDUJWF TMFFQ BQOFB BOE BUSJBM BSSIZUINPHFOFTJT $VSS $BSEJPM 3FW ,BOBHBMB 3 .VSBMJ /4 'SJFENBO 1" FU BM 0CTUSVDUJWF TMFFQ BQOFB BOE UIF SFDVSSFODF PG BUSJBM ȽCSJMMBUJPO $JSDVMBUJPO 7J[[BSEJ & 4DJBUUJ & #POBEFJ * FU BM 0CTUSVDUJWF TMFFQ BQOPFB IZQPQOPFB BOE BSSIZUINJBT OFX VQEBUFT + $BSEJPWBTD .FE )BHFSTUPXO /BDIFS . 'BSSF 3 .POUTFSSBU +. FU BM #JPMPHJDBM DPOTFRVFODFT PG PYZHFO EFTBUVSBUJPO BOE SFTQJSBUPSZ FȼPSU JO BO BDVUF BOJNBM NPEFM PG PCTUSVDUJWF TMFFQ BQOFB 04" 4MFFQ .FE /JFUP '+ )FSSJOHUPO %. 3FEMJOF 4 FU BM 4MFFQ BQOFB BOE NBSLFST PG WBTDVMBS FOEPUIFMJBM GVODUJPO JO B MBSHF DPNNVOJUZ TBNQMF PG PMEFS BEVMUT "N + 3FTQJS $SJU $BSF .FE )BZBTIJ . 'VKJNPUP , 6SVTIJCBUB , FU BM )ZQPYJB TFOTJUJWF NPMFDVMFT NBZ NPEVMBUF UIF EFWFMPQNFOU PG BUIFSPTDMFSPTJT JO TMFFQ BQOPFB TZOESPNF 3FTQJSPMPHZ ,ZMJOUJSFBT * $SBJH 4 /FUIPOPOEB 3 FU BM "UIFSPTDMFSPTJT BOE BSUFSJBM TUJȼOFTT JO PCTUSVDUJWF TMFFQ BQOFB B DBSEJPWBTDVMBS NBHOFUJD SFTPOBODF TUVEZ "UIFSPTDMFSPTJT 21. %SBHFS -' #PSUPMPUUP -" 'JHVFJSFEP "$ FU BM &ȼFDUT PG DPOUJOVPVT QPTJUJWF BJSXBZ QSFTTVSF PO FBSMZ TJHOT PG BUIFSPTDMFSPTJT JO PCTUSVDUJWF TMFFQ BQOFB "N + 3FTQJS $SJU $BSF .FE 22. /PCJMJ - 4DIJBWJ ( #P[BOP & FU BM .PSOJOH JODSFBTF PG XIPMF CMPPE WJTDPTJUZ JO PCTUSVDUJWF TMFFQ BQOFB TZOESPNF $MJO )FNPSIFPM .JDSPDJSD 23. &JTFOTFIS * &ISFOCFSH #- /PBDIUBS 4 FU BM 1MBUFMFU BDUJWBUJPO FQJOFQISJOF BOE CMPPE QSFTTVSF JO PCTUSVDUJWF TMFFQ BQOFB TZOESPNF /FVSPMPHZ 24. #PLJOTLZ ( .JMMFS . "VMU , FU BM 4QPOUBOFPVT

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

TUVEZ PG UIF BTTPDJBUJPO CFUXFFO TMFFQ EJTPSEFSFE CSFBUIJOH BOE IZQFSUFOTJPO / &OHM + .FE (JMFT 5- -BTTFSTPO 5+ 4NJUI #+ FU BM $POUJOVPVT QPTJUJWF BJSXBZT QSFTTVSF GPS PCTUSVDUJWF TMFFQ BQOPFB JO BEVMUT $PDISBOF %BUBCBTF 4ZTU 3FW $% 31. ,BOFLP : )BKFL 7& ;JWBOPWJD 7 FU BM 3FMBUJPOTIJQ PG TMFFQ BQOFB UP GVODUJPOBM DBQBDJUZ BOE MFOHUI PG IPTQJUBMJ[BUJPO GPMMPXJOH TUSPLF 4MFFQ 32. 4QSJHHT %" 'SFODI +. .VSEZ +. FU BM 4OPSJOH JODSFBTFT UIF SJTL PG TUSPLF BOE BEWFSTFMZ BȼFDUT QSPHOPTJT 2 + .FE 33. (PPE %$ )FOLMF +2 (FMCFS % FU BM 4MFFQ EJTPSEFSFE CSFBUIJOH BOE QPPS GVODUJPOBM PVUDPNF BGUFS TUSPLF 4USPLF

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ġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨüğþŎüġĆåúĘħāýģ÷ňýŇĐąĢüğĊëþñėýĔøėúĔħĊģþ ìęħèğāėħĄåĊĕĄğčĘħąè ĢüâĕĆğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĠĈēğčĘąëĘĊøė čĜèğþŎü ùęè ğúŇĕğĄĚĐħ ğúĘąýâĔýÿĜģň ĄŇğþŎüġĆå åĊĕĄğčĘąħ è÷ĔèâĈŇĕĊ ğâė÷ãęüĨ ģ÷ňéĕâĎĈĕąþŌééĔą ğëŇü ġĆååĊĕĄ÷ĔüġĈĎėøčĜè ăĕĊēĎĔĊĢéğøňüÿė÷éĔèĎĊē ĠĈēăĕĊēĎĈĐ÷ğĈĚĐ÷Ġ÷èĠãĦè ğþŎüøňü ìęħèāýčĜèãęĨüĢüÿĜňþłĊąġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔĨü âĕĆĆĔâČĕġ÷ąâĕĆĢčŇğåĆĚħĐèĐĔ÷Đĕâĕċ ĠĆè÷ĔüýĊâëüė÷øŇĐğüĚħĐèãöēüĐüĎĈĔý üĐâéĕâéēëŇĊąĈ÷åĊĕĄğčĘħąèĢüâĕĆğâė÷ġĆ÷ĎĈĐ÷ğĈĚĐ÷čĄĐèĠĈňĊ ąĔèëŇĊąğāėĄħ åěöăĕāëĘĊøė ĠĈēåĊĕĄčĕĄĕĆùĢüâĕĆúĬĕâėéĊĔøĆþĆēéĬĕĊĔüãĐèÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĐĘâ÷ňĊą åĬĕčĬĕåĔî ġĆåĎąě÷ĎĕąĢéãöēĎĈĔýéĕââĕĆĐě÷âĔüĨ ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè âĕĆĎĕąĢéĠÿŇĊ ăĕĊēāĆŇĐèĐĐâìėğéü ĢüğĈĚĐ÷

J Thai Stroke Soc: Volume 14, 2015

#JPNBSLFST PG JTDIFNJD TUSPLF DVSSFOU TUBUVT "VUIPS 1FSNQIBO %IBSNBTBSPKB . % 1I % "EESFTT Department of Anatomy, Faculty of Science, Mahidol University Rama VI Road, Ratchathewi, Bangkok, 10400 Tel: 0 2201 5447 E-mail: permphan.dha@mahidol.ac.th

Abstract

.BOZ QBUJFOUT XJUI BDVUF TUSPLF BSF OPU BTTFTTFE CZ B TUSPLF TQFDJBMJTU 'PS UIPTF BTTFTTFE JO IPTQJUBM JOUFSQSFUBUJPO PG CSBJO JNBHJOH BQQFBSBODFT DBO CF EJÈ¿DVMU BT DPNQVUFSJ[FE UPNPHSBQIZ JT PGUFO OPSNBM BGUFS FBSMZ POTFU PG JTDIFNJB BOE NBZ SFNBJO OPSNBM JO QBUJFOUT XJUI NJME JTDIFNJD TUSPLFT .BHOFUJD 3FTPOBODF *NBHJOH .3* NBZ OPU CF GFBTJCMF JO BDVUFMZ JMM QBUJFOUT CFDBVTF UIFZ IBWF B DPOUSBJOEJDBUJPO UP .3* PS .3* NBZ OPU CF JNNFEJBUFMZ BWBJMBCMF " OVNCFS PG CMPPE CJPNBSLFST PG JTDIFNJD TUSPLF IBWF CFFO JEFOUJÈ½FE BOE TIPX QSPNJTF UP BJE JO JTDIFNJD TUSPLF .BOZ SFMBUF UP UIF VOEFSMZJOH QBUIPQIZTJPMPHZ PG JTDIFNJD TUSPLF JODMVEJOH JTDIFNJB PG DFOUSBM OFSWPVT TZTUFN UJTTVF BDVUF UISPNCPTJT BOE JOÈ¾BNNBUPSZ SFTQPOTF 5IPVHI NBOZ DBOEJEBUF CJPNBSLFST IBWF CFFO JEFOUJÈ½FE OPOF BSF DVSSFOUMZ VTFE JO DMJOJDBM QSBDUJDF (J Thai Stroke Soc 2015; 14: 56-61.) ,FZXPSET TUSPLF CJPNBSLFS CMPPE QSFEJDUJPO

*OUSPEVDUJPO

"U QSFTFODF UIF EJBHOPTJT PG JTDIFNJD TUSPLF SFMJFT PO DMJOJDBM FWBMVBUJPO JO DPNCJOBUJPO XJUI OFVSPJNBHJOH 1IZTJDJBOT BSF WFSZ HPPE BU EJBHOPTJOH TUSPLF UIFSFGPSF UIF VTF PG B CMPPE UFTU UP EJBHOPTF TUSPLF JT HFOFSBMMZ MJNJUFE UP TQFDJÈ½D TDFOBSJPT XIFSF UJNF BOE PS JNBHJOH SFTPVSDFT BSF MJNJUFE *O B QSF IPTQJUBM TFUUJOH XIFSF FBSMZ OFVSPJNBHJOH JT OPU BWBJMBCMF B CMPPE UFTU DPVME HVJEF UIF FWBMVBUJPO BOE EJBHOPTJT PG BDVUF JTDIFNJD TUSPLF 1 5IPVHI B DPNQVUFSJ[FE UPNPHSBQIZ $5 TDBO XJMM MJLFMZ CF SFRVJSFE QSJPS UP JOJUJBUJPO PG UISPNCPMZTJT B CMPPE UFTU UIBU SBQJEMZ JEFOUJÈ½FT JTDIFNJD TUSPLF DPVME TQFFE QBUJFOU USBOTGFS UP DFOUFST BOE QIZTJDJBOT BCMF UP QFSGPSN FWBMVBUJPO GPS UISPNCPMZTJT "EEJUJPOBMMZ JO B NJOPSJUZ PG TUSPLF QBUJFOUT UIF EJBHOPTJT PG JTDIFNJD TUSPLF SFNBJOT VODMFBS JO TQJUF PG DMJOJDBM BTTFTTNFOU BOE JNBHJOH *O TVDI B TJUVBUJPO B CMPPE UFTU DPVME BEE DPOÈ½EFODF UP B QIZTJDJBOÄ®T EJBHOPTJT PG TUSPLF 2

J Thai Stroke Soc: Volume 14, 2015

3PMF PG CJPNBSLFST JO DMJOJDBM BQQMJDBUJPO

*O JTDIFNJD TUSPLF TUVEJFT IBWF FWBMVBUFE CJPNBSLFST UP EJTUJOHVJTI JTDIFNJD TUSPLF GSPN TUSPLF NJNJDT EFUFSNJOF TUSPLF FUJPMPHZ QSFEJDU TUSPLF TFWFSJUZ BOE PVUDPNFT JODMVEJOH FBSMZ OFVSPMPHJDBM EFUFSJPSBUJPO

BOE IFNPSSIBHJD DPNQMJDBUJPOT BOE JEFOUJGZ QBUJFOUT XIP NBZ CFOFÈ½U GSPN TQFDJÈ½D UIFSBQJFT JODMVEJOH EFDPNQSFTTJWF IFNJDSBOJFDUPNZ BOE BSUFSJBM SFDBOBMJ[BUJPO 5BCMF

5BCMF Potential clinical application. #JPNBSLFST GPS UIF EJBHOPTJT PG JTDIFNJD TUSPLF #JPNBSLFST PG JTDIFNJD TUSPLF FUJPMPHZ #JPNBSLFST PG È½OBM JOGBSDU WPMVNF BOE PVUDPNF #JPNBSLFST UP QSFEJDU FBSMZ OFVSPMPHJDBM EFUFSJPSBUJPO #JPNBSLFST GPS EFDPNQSFTTJWF IFNJDSBOJFDUPNZ #JPNBSLFST PG IFNPSSIBHJD USBOTGPSNBUJPO #JPNBSLFST PG BSUFSJBM SFDBOBMJ[BUJPO #JPNBSLFST GPS TUSPLF QSFWFOUJPO UIFSBQZ #JPNBSLFST PG JTDIFNJD QFOVNCSB

#JPNBSLFST DBO CF DBUFHPSJ[FE CZ UIFJS QBUIPQIZTJPMPHJDBM SPMF JO TUSPLF 5BCMF 3 #SBJO JOKVSZ CJPNBSLFST BSF MJNJUFE CZ TFWFSBM GBDUPST 5IFZ BSF OPU TQFDJÈ½D UP JTDIFNJD TUSPLF BT NBOZ EJTFBTF QSPDFTTFT DBO EBNBHF CSBJO UJTTVF 5IF CMPPE CSBJO CBSSJFS ### SFTUSJDUT SFMFBTF PG UIFTF CJPNBSLFST JOUP TZTUFNJD DJSDVMBUJPO "T B SFTVMU CJPNBSLFS MFWFMT NBZ OPU DPSSFMBUF

XJUI JOGBSDU WPMVNF PS TUSPLF TFWFSJUZ .PMFDVMFT JOWPMWFE JO BDVUF UISPNCPTJT IBWF BMTP CFFO BTTPDJBUFE XJUI JTDIFNJD TUSPLF 5IFSF BSF B OVNCFS PG QSPUFJOT BTTPDJBUFE XJUI JTDIFNJD TUSPLF XIJDI BT ZFU EP OPU IBWF B DMFBS QBUIPQIZTJPMPHJDBM SPMF JO UIF EJTFBTF JODMVEJOH 1"3, OVDMFPUJEF EJQIPTQIBUF LJOBTF " /%," BOE # UZQF OFVSPUSPQIJD HSPXUI GBDUPS 5BCMF

5BCMF Category of biomarkers. $BUFHPSZ

.BSLFST

.BSLFST PG $/4 UJTTVF JOKVSZ

4 # ('"1 /4& /.%" 3 "C .#1

.BSLFST PG UJTTVF JOÈ¾BNNBUJPO

$31 *- 5/' É&#x2021; 7$". *$". ..1 ..1 -Q 1-" "QP$ * "QP$ ***

.BSLFST PG DPBHVMBUJPO BOE UISPNCPTJT

'JCSJOPHFO % EJNFS W8'

0UIFS NBSLFST

1MBTNB %/" 1"3, /%," # UZQF OFVSPUSPQIJD HSPXUI GBDUPS

J Thai Stroke Soc: Volume 14, 2015

5BCMF Biomarkers in application. "QQMJDBUJPO

.BSLFS

%JBHOPTJT

4 # ('"1 /4& /.%" 3 "C .#1 $31 7$". ..1 ..1 "QP$ * "QP$ *** % EJNFS W8' 1"3, /%," # UZQF OFVSPUSPQIJD HSPXUI GBDUPS

4USPLF TFWFSJUZ

4 # /4& /.%" 3 "C .#1 5/' É&#x2021; *$". ..1 ..1

*OGBSDU WPMVNF

4 # /4& .#1 *- 5/' É&#x2021; 7$". *$". ..1 ..1 QMBTNB %/"

)FNPSSIBHJD USBOTGPSNBUJPO

4 # ..1 ..1

&BSMZ OFVSPMPHJDBM EFUFSJPSBUJPO

*- 5/' É&#x2021; *$".

$BSEJPFNCPMJD TUSPLF

% EJNFS

4USPLF SJTL

$31 -Q 1-" È½CSJOPHFO

4USPLF PVUDPNF

1MBTNB %/"

#JPNBSLFST GPS %JBHOPTJT PG *TDIFNJD 4USPLF

4FWFSBM TUVEJFT IBWF JOWFTUJHBUFE UP EFWFMPQ B CMPPE UFTU UP EJBHOPTF TUSPLF CZ VTJOH POF PS TFWFSBM QSPUFJOT "CPVU QSPUFJOT IBWF CFFO TUVEJFE BT QPTTJCMF CJPNBSLFST GPS UIF EJBHOPTJT PG JTDIFNJD TUSPLF *O TQJUF PG UIJT BUUFNQU B CMPPE CBTFE CJPNBSLFS UP EJBHOPTF JTDIFNJD TUSPLF SFNBJOT UP CF FTUBCMJTIFE 4PNF PG UIFTF QSPUFJOT IBWF BMTP CFFO BTTPDJBUFE XJUI IZQFSUFOTJPO BUIFSPTDMFSPTJT QSJPS TUSPLF FQJMFQTZ TZTUFNJD MVQVT FSZUIFNBUPTVT BOE FODFQIBMJUJT 5IVT UIF TQFDJÈ½DJUZ PG UIFTF QSPUFJOT UP QBUJFOUT XJUI BDVUF JTDIFNJD TUSPLF SFNBJOT VODFSUBJO 5IF DMJOJDBM QSPCMFN JT OPU XIFUIFS BO JTDIFNJD TUSPLF DBO CF EJTUJOHVJTIFE GSPN B IFBMUIZ DPOUSPM CVU XIFUIFS BO JTDIFNJD TUSPLF DBO CF EJTUJOHVJTIFE GSPN EJTFBTF UIBU NJNJDT JTDIFNJD TUSPLF TVDI BT IFNPSSIBHJD TUSPLF TFJ[VSF NJHSBJOF TZODPQF PS IZQPHMZDFNJB 0G TJHOJÈ½DBOU JNQPSUBODF JT EJTUJOHVJTIJOH JTDIFNJD TUSPLF GSPN IFNPSSIBHJD TUSPLF EVF UP UIF JNQMJDBUJPOT JO BDVUF UISPNCPMZUJD UIFSBQZ *O BEEJUJPO UIPVHI JTDIFNJD TUSPLF DBO CF JEFOUJÈ½FE SFBTPOBCMZ XFMM XJUI CJPNBSLFST NBOZ OPO JTDIFNJD TUSPLF QBUJFOUT BSF BMTP JODPSSFDUMZ QSFEJDUFE UP CF JTDIFNJD TUSPLF 5IF DIBMMFOHF PG EFWFMPQJOH B CJPNBSLFS

J Thai Stroke Soc: Volume 14, 2015

XJUI TVÈ¿DJFOU TFOTJUJWJUZ BOE TQFDJÈ½DJUZ GPS DMJOJDBM BQQMJDBUJPOT JT ZFU UP CF JOWFTUJHBUFE

#JPNBSLFST PG *TDIFNJD 4USPLF &UJPMPHZ

" OVNCFS PG CJPNBSLFST IBWF CFFO GPVOE UP EJTUJOHVJTI DBSEJPFNCPMJD GSPN OPO DBSEJPFNCPMJD JTDIFNJD TUSPLF (FOF FYQSFTTJPO QSPÈ½MFT JO CMPPE IBWF BMTP CFFO TIPXO UP EJTUJOHVJTI DBSEJPFNCPMJD GSPN MBSHF WFTTFM JTDIFNJD TUSPLF )PXFWFS GVSUIFS WBMJEBUJPO PG UIFTF QSPÈ½MFT JO MBSHFS DPIPSUT JT SFRVJSFE -FTT JT LOPXO SFHBSEJOH CJPNBSLFST PG TNBMM WFTTFM JTDIFNJD TUSPLFT

#JPNBSLFST PG 'JOBM *OGBSDU 7PMVNF BOE 0VUDPNF 4FWFSBM CJPNBSLFST IBWF CFFO BTTPDJBUFE XJUI JOGBSDU WPMVNF )PXFWFS JU TIPVME CF FNQIBTJ[FE UIBU JOGBSDU TJ[F NBZ OPU DPSSFMBUF XJUI OFVSPMPHJD PVUDPNF BT FWFO TNBMM JOGBSDUT DBO DBVTF EFWBTUBUJOH OFVSPMPHJDBM PVUDPNFT XIFO UIFZ PDDVS JO DFSUBJO BOBUPNJDBM SFHJPOT TVDI BT UIF CSBJOTUFN .BSLFST UP QSFEJDU PVUDPNF XPVME CF VTFGVM JO UIF NBOBHFNFOU PG JTDIFNJD TUSPLF QBUJFOUT BT QPUFOUJBM TVSSPHBUF NFBTVSFT

#JPNBSLFST PG )FNPSSIBHJD 5SBOTGPSNBUJPO

4FWFSBM CJPNBSLFST IBWF BMTP CFFO BTTPDJBUFE XJUI BO JODSFBTFE SJTL PG IFNPSSIBHF GPMMPXJOH BENJOJTUSBUJPO PG UJTTVF QMBTNJOPHFO BDUJWBUPS U1" JODMVEJOH ..1 BOE 4 # 5IF NPTU FWJEFODF FYJTUT GPS FMFWBUFE MFWFMT PG ..1T QSFEJDUJOH IFNPSSIBHJD USBOTGPSNBUJPO GPMMPXJOH JTDIFNJD TUSPLF ..1T BSF JOWPMWFE JO EFTUSVDUJPO PG NJDSPWBTDVMBS JOUFHSJUZ CZ EFHSBEBUJPO PG UIF CBTBM MBNJOB BOE FYUSBDFMMVMBS NBUSJY -FWFMT PG ..1 QSFEJDU IFNPSSIBHJD USBOTGPSNBUJPO JO JTDIFNJD TUSPLF QBUJFOUT XIP IBWF BOE IBWF OPU CFFO USFBUFE XJUI U 1" *EFOUJÈ½DBUJPO PG IFNPSSIBHJD USBOTGPSNBUJPO XJMM CFDPNF NPSF JNQPSUBOU PODF UIFSF JT B USFBUNFOU UP QSFWFOU JU PS UFTUJOH DPVME CF QFSGPSNFE JO UJNF UP JNQBDU IFNPSSIBHJD USBOTGPSNBUJPO BTTPDJBUFE XJUI UISPNCPMZTJT

#JPNBSLFST PG *TDIFNJD 1FOVNCSB

/P QMBTNB CJPNBSLFS PG IVNBO JTDIFNJD QFOVNCSB IBT CFFO SFQPSUFE (MVDPTF UFOET UP CF IJHIFS BOE HMVUBNBUF MPXFS JO QFOVNCSBM UJTTVF $FMMT UIBU TVSWJWF GPMMPXJOH JTDIFNJB FYQSFTT B OVNCFS PG TUSFTT SFTQPOTF QSPUFJOT 4VDI QSPUFJOT TFSWF BT UJTTVF NBSLFST PG JTDIFNJD QFOVNCSB JO CSBJO 8IFUIFS B DPSSFTQPOEJOH CJPNBSLFS JO CMPPE DBO CF JEFOUJÈ½FE SFRVJSFT GVSUIFS TUVEZ

$PODMVTJPO

5IPVHI NBOZ DBOEJEBUF CMPPE CBTFE CJPNBSLFST GPS JTDIFNJD TUSPLF IBWF CFFO JEFOUJÈ½FE OPOF BSF DVSSFOUMZ VTFE JO DMJOJDBM QSBDUJDF 8JUI GVSUIFS XFMM EFTJHOFE TUVEZ BOE DBSFGVM WBMJEBUJPO UIF EFWFMPQNFOU PG CMPPE CJPNBSLFST UP JNQSPWF UIF DBSF PG QBUJFOUT XJUI JTDIFNJD TUSPLF NBZ CF BDIJFWFE

3FGFSFODFT

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J Thai Stroke Soc: Volume 14, 2015

$FSFCSPWBTD %JT Ä« 14. 4IJNJ[V ) .VSBLBNJ : *OPVF 4 FU BM )JHI QMBTNB CSBJO OBUSJVSFUJD QPMZQFQUJEF MFWFM BT B NBSLFS PG SJTL GPS UISPNCPFNCPMJTN JO QBUJFOUT XJUI OPOWBMWVMBS BUSJBM È½CSJMMBUJPO 4USPLF Ä« 9V ) 5BOH : -JV %; FU BM (FOF FYQSFTTJPO JO QFSJQIFSBM CMPPE EJÈ¼FST BGUFS DBSEJPFNCPMJD DPNQBSFE XJUI MBSHF WFTTFM BUIFSPTDMFSPUJD TUSPLF #JPNBSLFST GPS UIF FUJPMPHZ PG JTDIFNJD TUSPLF + $FSFC #MPPE 'MPX .FUBC Ä« +JDLMJOH ($ 9V ) 4UBNPWB # FU BM 4JHOBUVSFT PG DBSEJPFNCPMJD BOE MBSHF WFTTFM JTDIFNJD TUSPLF "OO /FVSPM Ä« 4VXBOXFMB /$ $IVUJOFU " 1IBOUIVNDIJOEB , *OÈ¾BNNBUPSZ NBSLFST BOE DPOWFOUJPOBM BUIFSPTDMFSPUJD SJTL GBDUPST JO BDVUF JTDIFNJD TUSPLF $PNQBSBUJWF TUVEZ CFUXFFO WBTDVMBS EJTFBTF TVCUZQFT + .FE "TTPD 5IBJ Ä« .JTTMFS 6 8JFTNBOO . 'SJFESJDI $ FU BM 4 QSPUFJO BOE OFVSPO TQFDJÈ½D FOPMBTF DPODFOUSBUJPOT JO CMPPE BT JOEJDBUPST PG JOGBSDUJPO WPMVNF BOE QSPHOPTJT JO BDVUF JTDIFNJD TUSPLF 4USPLF Ä« 'PFSDI $ 4JOHFS 0$ /FVNBOO )BFGFMJO 5 FU BM &WBMVBUJPO PG TFSVN T C BT B TVSSPHBUF NBSLFS GPS MPOH UFSN PVUDPNF BOE JOGBSDU WPMVNF JO BDVUF NJEEMF DFSFCSBM BSUFSZ JOGBSDUJPO "SDI /FVSPM Ä« 1134. $BTUJMMP + %BWBMPT " /BWFJSP + FU BM /FVSPFYDJUBUPSZ BNJOP BDJET BOE UIFJS SFMBUJPO UP JOGBSDU TJ[F BOE OFVSPMPHJDBM EFÈ½DJU JO JTDIFNJD TUSPLF 4USPLF Ä« 21. $BTUFMMBOPT . -FJSB 3 4FSFOB + FU BM 1MBTNB NFUBMMPQSPUFJOBTF DPODFOUSBUJPO QSFEJDUT IFNPSSIBHJD USBOTGPSNBUJPO JO BDVUF JTDIFNJD TUSPLF 4USPLF Ä« 22. .POUBOFS + "MWBSF[ 4BCJO + .PMJOB $" FU BM .BUSJY NFUBMMPQSPUFJOBTF FYQSFTTJPO JT SFMBUFE UP IFNPSSIBHJD USBOTGPSNBUJPO BGUFS DBSEJPFNCPMJD TUSPLF 4USPLF Ä« 23. .POUBOFS + .PMJOB $" .POBTUFSJP + FU BM .BUSJY NFUBMMPQSPUFJOBTF QSFUSFBUNFOU MFWFM QSFEJDUT JOUSBDSBOJBM IFNPSSIBHJD DPNQMJDBUJPOT BGUFS

J Thai Stroke Soc: Volume 14, 2015

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J Thai Stroke Soc: Volume 14, 2015

" XPNBO XJUI BCEPNJOBM NBTT QSFTFOUFE XJUI TVEEFO SJHIU IFNJQBSFTJT

Ă¨Ă Ă˘Ä&#x20AC;Ă&#x;ĂĂ´ ĂźÄ&#x2021;ĂťÄ Ă˛ĂˇÄ&#x192;Ă´ĂŞĹ&#x2122; Ă˛Ăˇ ĂĂ&#x153; ĂĂ˛ĂŻÄ&#x20AC;ĂŚĂ˛ Ă§Ă˛Ă˛Ă°ĂšÄ?Ă˛Ă&#x2122; ĂşĂ¨Ĺ&#x161;ĂśĂąĂŞĂ˛ĂżĂšÄ ĂŚĂśÄ&#x192;ĂŚĂąÄ ĂŻÄ Ă&#x201C;ĂśÄ&#x192;Ă&#x2122;Ä ĂźÄ ĂąÄ&#x2021;Ă˛ĂˇÄ ĂšĂ¤Ă˛Ĺ&#x17E; Ă&#x201C;Ă˘ĂżÄ&#x152;ĂĂŚĂąĂˇÄ ĂšĂ¤Ă˛Ĺ&#x17E; Ă°ĂşÄ ĂśÄ&#x192;ĂŚĂąÄ Ă´Ä&#x20AC;ĂąĂ§Ă˛Ă˛Ă°ĂˇÄ ĂšĂ¤Ă˛Ĺ&#x17E; /BUUBQIPM 6SBOTJMQ . % 1PSOQBUS %IBSNBTBSPKB . % Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Thammasat University $PSSFTQPOEJOH BVUIPS 1PSOQBUS %IBSNBTBSPKB . % Associate Professor in Neurology, Division of Neurology, Faculty of Medicine, Thammasat University, Klong 1, Klong Luang, Pathumthani 12120, Thailand Email: pornpatr1@hotmail.com

J Thai Stroke Soc: Volume 14, 2015

Abstract

" ZFBS PME XPNBO QSFTFOUFE XJUI TVEEFO POTFU PG SJHIU IFNJQBSFTJT 4IF BMTP IBE BCEPNJOBM NBTT BOE SJHIU MFH TXFMMJOH )FS $5 CSBJO TIPXFE BDVUF UP FBSMZ TVCBDVUF JOGBSDUJPO XJUI IFNPSSIBHJD USBOTGPSNBUJPO BU MFGU QBSJFUP PDJQJUBM MPCF 5IF GVSUIFS JOWFTUJHBUJPOT SFWFBMFE PWBSJBO DBODFS XJUI EFFQ WFJO UISPNCPTJT BOE QBUFOU GPSBNFO PWBMF *OGFSJPS WFOB DBWB Č˝MUFS XBT JOTFSUFE CFDBVTF TIF IBT B DPOUSBJOEJDBUJPO UP BOUJDPBHVMBOU GPS QSFWFOUJPO PG SFDVSSFOU JTDIFNJD TUSPLF (J Thai Stroke Soc 2015; 14: 62-66.) ,FZXPSE JTDIFNJD TUSPLF EFFQ WFJO UISPNCPTJT QBUFOU GPSBNFO PWBMF PWBSJBO DBODFS

ÿĜþň Ċł ąĎîėèģúąġč÷ Đĕąě þĿ ăĜĄĈė ĕĬ ğüĕéĔèĎĊĔ÷ þúěĄûĕüĘ ĐĕëĘāĆĔýéňĕè ĄĕġĆèāąĕýĕĈ÷ňĊąĠãüãĕãĊĕ ĐŇĐüĠĆè ëĔħĊġĄè üĕúĘ ģ÷ňþĆēĊĔøėéĕâāĘħčĕĊĊŇĕãöē üĔħ è ĐąĜ Ň úħĘ ýĔ ü ģ÷ĄĘ Đ ĕâĕĆğâĆĦ è ģĄŇ â Ćēøě â ģĄŇ ĄĘ Đě é éĕĆē þŌččĕĊēĆĕ÷ ĐŇĐüĠĆèìĘâãĊĕ ìęĄĈè ģĄŇāĜ÷ģĄŇúĬĕøĕĄčĔħè éęèāĕĄĕġĆèāąĕýĕĈ

#PVK *+8 PGICVKXG 26 +04 266 %6 DTCKP PQP EQPVTCUV ĆĜþúĘħ ¼ #EWVG VQ GCTN[ subacute infarction with hemorrhagic transformation CV NGHV RCTKGVQEKRKVCN NQDG GPEGRJCNQOCNCEKC CV TKIJV RCTKGVCN NQDG HGY NCEWPCT KPHCTEVKQP CV DKNCVGTCN EGPVTWO UGOKQXCNG

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TKIJV NGI āý VJTQODWU Ģü TKIJV EQOOQP HGOQTCN XGKP UWRGTÌEKCN HGOQTCN XGKP FGGR HGOQTCN XGKP RQRNKVGCN XGKP ąĚüąĔüĊŇĕĄĘăĕĊē FGGR XGKP VJTQODQUKU éĆėè čŇĊü NCTIG UWRTCRWDKE OCUU üĔüĨ ÿĜþň Ċł ąģ÷ňĆýĔ âĕĆøĆĊéăĕąĢü éĕâčĜøėüĆĘĠāúąŋğāėħĄğøėĄ āý NGHV CFPGZCN OCUU EO KP UK\G ìęħèøŇĐĄĕģ÷ňĆĔýâĕĆøĆĊé %6 YJQNG CDFQOGP āý NCTIG E[UVKE NGUKQP YKVJ GPJCPEKPI UQNKF EQORQPGPV RQUUKDN[ CTKUKPI HTQO NGHV QXCT[ NKMGN[ OCNKIPCPV QXCTKCP PGQRNCUO ĆĜþúĘ ħ ìęèħ čĐ÷åĈňĐèâĔý ÿĈ %# úĘčħ èĜ âĊŇĕåŇĕþâøė 7 ON ĠĈēāý CEWVG VJTQODQUKU YKVJKP VJG DKNCVGTCN EQOOQP HGOQTCN XGKPU ìęħèëŇĊąąĚüąĔüâĕĆĄĘăĕĊē FGGR XGKP VJTQODQUKU ĠĈēĢü ãöēğ÷ĘąĊâĔüâĦāýĊŇĕĄĘăĕĊē CEWVG RWNOQPCT[ GODQNKUO ġ÷ąýĔèğĐėî ġ÷ąāý ÌNNKPI FGHGEV KP UGIOGPVCN CPF UWDUGIOGPVCN DTCPEJGU QH NQDCT RWNOQPCT[ CTVGTKGU

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ĆĜþúĘħ %6 YJQNG CDFQOGP āý NCTIG E[UVKE OCUU YKVJ GPJCPEKPI UQNKF EQORQPGPV UWIIGUVKXG QH NGHV OCNKIPCPV QXCTKCP VWOQT

ĆĜþúĘħ %6 āý ÌNNKPI FGHGEV KP UGIOGPVCN CPF UWDUGIOGPVCN DTCPEJGU VQ RWNOQPCT[ CTVGTKGU

, 6JCK 5VTQMG 5QE 8QNWOG

ĢüÿĜňþłĊą CEWVG KUEJGOKE UVTQMG úĘħāý FGGR XGKP VJTQODQUKU åĊĆģ÷ňĆĔýâĕĆøĆĊéĎĔĊĢéĐąŇĕèĈēğĐĘą÷ ğāėħ Ą ğøė Ą ğëŇ ü VTCPUVJQTCEKE VTCPUGUQRJCIGCN GEJQECTFKQITCO YKVJ CIKVCVGF UCNKPG KPLGEVKQP ğāĚħĐĎĕ ĊŇĕĄĘăĕĊē TKIJV VQ NGHV UJWPV ĎĆĚĐģĄŇ ğüĚħĐèéĕâĈėħĄğĈĚĐ÷ éĕâ FGGR XGKP VJTQODQUKU ĐĕéĎĈě÷ĠĈēÿŇĕü TKIJV VQ NGHV UJWPV ģþĐě÷ĎĈĐ÷ğĈĚĐ÷čĄĐè ìęħèğþŎüčĕğĎøěúĬĕĢĎň ğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔüĢüÿĜþň Ċł ąĆĕąüĔüĨ ĥ ģ÷ň ĢüÿĜ ň þ ł Ċ ąĆĕąüĘĨ ģ ÷ň ĆĔ ý âĕĆøĆĊé VTCPUVJQTCEKE GEJQECTFKQITCO YKVJ CIKVCVGF UCNKPG KPLGEVKQP āý RCVGPV HQTCOGP QXCNG 2(1

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éĕâÿĈâĕĆøĆĊéúĔĨèĎĄ÷āýĊŇĕ ÿĜňþłĊąüŇĕéēĄĘ ĄēğĆĦèĆĔèģãŇìęħèúĬĕĢĎňğâė÷ăĕĊē FGGR XGKP VJTQODQUKU ĠĈēĄĘâĕĆĎĈě÷ãĐèĈėħĄğĈĚĐ÷úĘħĎĈĐ÷ğĈĚĐ÷÷ĬĕãĕãĊĕģþąĔè ĎĈĐ÷ğĈĚĐ÷÷ĬĕúĘħþĐ÷úĬĕĢĎňğâė÷ăĕĊēĈėħĄğĈĚĐ÷Đě÷âĈĔĨü ĢüþĐ÷ 2WNOQPCT[ GODQNKUO ġ÷ąĈėħĄğĈĚĐ÷čŇĊüĎüęħè ÿŇĕüéĕâĎĔĊĢéĎňĐèãĊĕģþčĜŇĎĔĊĢéĎňĐèìňĕąġ÷ąÿŇĕüúĕè 2CVGPV HQTCOGP QXCNG ĠĈēúĬĕĢĎňĈėħĄğĈĚĐ÷üĔĨüâĆēéĕą ÿŇĕüĎĈĐ÷ğĈĚĐ÷Ġ÷èģþąĔèčĄĐèúĬĕĢĎňğâė÷ CEWVG NGHV OKFFNG EGTGDTCN CTVGT[ KPHCTEVKQP ĢüÿĜňþłĊąĆĕąüĘĨ âĕĆĆĔâČĕĢüÿĜþň Ċł ąĆĕąüĘåĨ ĊĆģ÷ňĆýĔ CPVKEQCIWNCPV ğāĚħĐĆĔâČĕăĕĊē FGGR XGKP VJTQODQUKU RWNOQPCT[ GODQNKUO ĠĈēþŃĐèâĔüâĕĆğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè Đě÷øĔüìĬĨĕ ĠøŇÿĜňþłĊąĄĘ JGOQTTJCIKE VTCPUHQTOCVKQP ğþŎü ãňĐĎňĕĄĢüâĕĆĢĎň CPVKEQCIWNCPV éęèþĆęâČĕċĔĈąĠāúąŋ ğāĚĐħ ĢčŇ +8% ÌNVGT ğāĚĐħ þŃĐèâĔüâĕĆğâė÷ RWNOQPCT[ GODQNKUO ĠĈē TGEWTTGPV UVTQMG øŇĐģþ ăĕĊēĈėħĄğĈĚĐ÷Đě÷øĔüĢüĎĈĐ÷ğĈĚĐ÷÷ĬĕčŇĊüĈęâ úĘħãĕ FGGR XGKP VJTQODQUKU ğþŎüăĕĊēĠúĆâìňĐüãĐè ĄēğĆĦèúĘħčĬĕåĔî åĊĕĄčĔĄāĔüûŋãĐèġĆåĄēğĆĦèâĔýăĕĊē ĈėĄħ ğĈĚĐ÷Đě÷ĎĈĐ÷ğĈĚĐ÷÷ĬĕĄĘĆĕąèĕüĄĕøĔèĨ ĠøŇþ Ŀ å ċ ĢüÿĜňþłĊąëĕĊģúąāýĊŇĕăĕĊēĈėħĄğĈĚĐ÷Đě÷ĎĈĐ÷ğĈĚĐ÷÷Ĭĕ éēāýĆŇĊĄâĔýĄēğĆĦèúĕèüĆĘğĊëāýģ÷ňýĐŇ ąúĘčħ ÷ě þĆēĄĕö âĕĆğâė÷ĈėĄħ ğĈĚĐ÷ĢüÿĜþň Ċł ąĄēğĆĦè čĕĄĕĆùğâė÷ģ÷ňéĕâ ĎĈĕąâĈģâ ğëŇü âĕĆâĆēøěňüþŌééĔąâĕĆĠãĦèøĔĊãĐèğĈĚĐ÷ ġ÷ąâĕĆčĆňĕè VJTQODKP âĕĆâĆēøěňü OQPQPWENGCT EGNN ĢĎňčĆňĕè RTQ EQCIWNCPV UWDUVCPEG ĠĈē VKUUWG HCEVQT âĕĆúĬĕĢĎňğâė÷ XCUEWNCT KPLWT[ éĕâ XCUEWNCT KPXCUKQP

ĎĆĚĐéĕââňĐüğüĚĨĐèĐââ÷úĔýĎĈĐ÷ğĈĚĐ÷ġ÷ąøĆè 2CVGPV HQTCOGP QXCNG 2(1 ğþŎüëŇĐèğþľ÷ ĆēĎĊŇĕè UGRVWO RTKOWO ĠĈē UGRVWO UGEWOFWO āý ģ÷ň ĢüþĆēëĕâĆ ġ÷ąéēāýĄĕâãęĨüğþŎü ğúŇĕ ĢüÿĜňþłĊąĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýúĘħąĔèģĄŇúĆĕýčĕğĎøě ġ÷ą ğëĚħĐĊŇĕâĕĆğâė÷ğčňüğĈĚĐ÷čĄĐèøĘýĢüÿĜňþłĊąúĘħĄĘ 2(1 ğâė÷ éĕâĈėĄħ ğĈĚĐ÷éĕâĎĈĐ÷ğĈĚĐ÷÷ĬĕĎĈě÷ğãňĕčĜĎŇ ĊĔ ĢéúĬĕĢĎňğâė÷ RCTCFQZKECN GODQNKUO ģþąĔèčĄĐè Đě÷ĎĈĐ÷ğĈĚĐ÷ čĄĐè úĬĕĢĎňğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĕĄĄĕ âĕĆĄĘĈėħĄ ğĈĚĐ÷ĢüĎĈĐ÷ğĈĚĐ÷÷ĬĕüĔĨüĐĕéğâė÷éĕâčĕğĎøěøŇĕèĥ ğëŇü J[RGTEQCIWNCDNG UVCIG CPVKRJQURJQNKRKF U[PFTQOG ĢüâĕĆøĆĊéĎĕ 2(1 čĕĄĕĆùøĆĊéāýéĕââĕĆøĆĊé VTCPUVJQTCEKE ĎĆĚĐ VTCPUGUQRJCIGCN GEJQECTFKQITCRJ[ ĎĆĚĐ VTCPUETCPKCN &QRRNGT KOCIKPI ĆŇĊĄâĔýâĕĆêĘ÷ CIKVCVGF UCNKPG ġ÷ąâĕĆøĆĊé VTCPUGUQRJCIGCN GEJQECTFKQITCRJ[ ùĚĐĊŇĕğþŎüâĕĆøĆĊéĄĕøĆòĕüğāĚħĐ ąĚüąĔüăĕĊē 2(1 åĊĕĄčĔĄāĔüûŋĆēĎĊŇĕè 2(1 âĔýâĕĆğâė÷ġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔüąĔèģĄŇģ÷ňãňĐčĆěþúĘħëĔ÷ğéü âĕĆċęâČĕ OGVC CPCN[UKU āýĊŇĕ åĊĕĄčĔĄāĔüûŋãĐèâĕĆ øĆĊéāý 2(1 âĔýåĊĕĄğčĘąħ èãĐèâĕĆğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷ čĄĐèāýĢüÿĜňþłĊąúĘħĄĘĐĕąěüňĐąĄĕââĊŇĕâĈěŇĄÿĜňþłĊąĐĕąě Ąĕâ ġ÷ąùňĕāý 2(1 ĢüÿĜňþłĊąĐĕąěüňĐąâĊŇĕ þĿ åĊĕĄ ğčĘħąèúĘħéēāý ET[RVQIGPKE KUEJGOKE UVTQMG ğāėħĄãęĨü ğúŇĕ ĠĈēğāėĄħ ãęüĨ ğúŇĕĢüÿĜþň Ċł ąúĘĐħ ĕąěĄĕââĊŇĕ þĿ ĠĈē ĄĘĆĕąèĕüāýåĊĕĄğčĘąħ èãĐèâĕĆğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè éēğāėħĄãęĨüĢüÿĜňþłĊąúĘħāý 2(1 ĆŇĊĄâĔý CVTKCN UGRVCN aneurysm5 ĢüÿĜňþłĊą ET[RVQIGPKE KUEJGOKE UVTQMG úĘħĄĘ 2(1 ĆŇĊĄ÷ňĊą āýĐĔøĆĕâĕĆğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèìĬĕĨ ĢüÿĜňþłĊąþĆēĄĕö øŇĐþĿ âĕĆċęâČĕ 2CVGPV (QTCOGP 1XCNG KP %T[RVQIGPKE 5VTQMG 2+%55 ìęħè ğþŎüâĕĆċęâČĕąŇĐąãĐèâĕĆċęâČĕ 9#455 ģ÷ňċęâČĕ ğþĆĘąýğúĘąýâĕĆĢĎňąĕ YCTHCTKP âĔýąĕ CURKTKP ĢüÿĜňþłĊą ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèúĘħĄĘ 2(1 ĊĔ÷ÿĈéĕâĐĔøĆĕâĕĆğâė÷ ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèìĬĕĨ āýĊŇĕģĄŇāýåĊĕĄĠøâøŇĕèĐąŇĕè ĄĘüąĔ čĬĕåĔîúĕèčùėø ė âĕĆċęâČĕğþĆĘąýğúĘąýâĕĆþľ÷ 2(1

VTCPUECVJGVGT ENQUWTG FGXKEGU ĢüÿĜňþłĊą ET[RVQIGPKE UVTQMG úĘħĄĘĐĕąěüňĐąâĊŇĕ þĿ éĕâ âĕĆċęâČĕĢĎîŇ

ģ÷ňĠâŇ %.1574' Ģëň 56#4(NGZ 5GRVCN %NQUWTG 4'52'%6 VTKCN 7 2% VTKCN âĕĆċę â ČĕĎĈĔ è Ģëň #ORNCV\GT 2(1 1EENWFGT ġ÷ąğþĆĘąýğúĘąýâĔýâĕĆ ĆĔâČĕġ÷ąĢëňąĕ ĐąŇĕèğ÷ĘąĊ ÿĈâĕĆċęâČĕúĔèĨ âĕĆċęâČĕ āýĊŇĕĐĔøĆĕâĕĆğâė÷ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèìĬĨĕĢüâĈěŇĄúĘħģ÷ň ĆĔýâĕĆþľ÷ 2(1 ĠĈēâĕĆĢĎňąĕ ģĄŇĠøâøŇĕèâĔüĐąŇĕèĄĘüĔą čĬĕåĔîúĕèčùėøė ĐĔøĆĕâĕĆğâė÷ăĕĊēĠúĆâìňĐüúĘħĆňĕąĠĆè ĆēĎĊŇĕèâĕĆúĬĕĎĔøùâĕĆþľ÷ 2(1 āý ĠĈēĢü āýĐĔøĆĕâĕĆğâė÷ CVTKCN ÌDTKNNCVKQP ùęè ĢüâĈěŇĄúĘħ Ģëň 56#4(NGZ 5GRVCN %NQUWTG ĢüâĕĆċęâČĕ %.1574' American Stroke Association9 ģ÷ňĢĎňåĕĬ ĠüēüĬĕ ÷ĔèüĘĨ þŌééěýĔüąĔèģĄŇĄĘãňĐĄĜĈâĕĆċęâČĕğāĘąèāĐúĘħéē ýĐâĊŇ ĕ âĕĆþŃ Đ èâĔ ü âĕĆğâė ÷ ġĆåĎĈĐ÷ğĈĚ Đ ÷čĄĐèìĬĨ ĕ ĢüÿĜňþłĊąúĘħĄĘ 2(1 ÷ňĊąâĕĆĢĎňąĕøňĕüğâĈĦ÷ğĈĚĐ÷ĎĆĚĐąĕ âĔüğĈĚĐ÷ğþŎüĈėħĄ ąĕâĈěŇĄģĎüģ÷ňÿĈ÷ĘâĊŇĕâĔü %NCUU ++D .GXGN QH GXKFGPEG $ ĢüâĕĆĆĔâČĕÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈē Đě÷øĔüúĘħāý 2(1 ĠĈē XGPQWU UQWTEG QH GODQNKUO åĊĆģ÷ňĆýĔ ąĕâĔüğĈĚĐ÷ğþŎüĈėĄħ %NCUU + .GXGN QH GXKFGPEG # ĢüâĆöĘúĘħģĄŇčĕĄĕĆùĢĎňąĕâĔüğĈĚĐ÷ğþŎüĈėħĄģ÷ňĐĕéĢčŇ KPHGTKQT XGPC ECXC ÌNVGT ģ÷ň %NCUU ++C .GXGN QH GXKFGPEG % ġ÷ąĆēąēğĊĈĕĢüâĕĆĢĎňąĕâĔüğĈĚĐ÷ğþŎüĈėĄħ ğ÷ĚĐü ĢüâĆöĘÿĜňþłĊą ET[RVQIGPKE KUEJGOKE UVTQMG úĘĄħ Ę 2(1 ĠøŇģĄŇāý FGGR XGKP VJTQODQUKU éĕâĎĈĔâòĕü úĕèâĕĆĠāúąŋĢüþŌééěýüĔ ģĄŇčüĔýčüěüĢĎňþ÷ľ 2(1 %NCUU +++ .GXGN QH GXKFGPEG # ĢüâĆöĘúāĘħ ý 2(1 ĠĈē FGGR XGKP VJTQODQUKU ĐĕéāėéĕĆöĕþľ÷ 2(1 ÷ňĊą VTCPUECVJGVGT FGXKEG úĔèĨ üĘĎĨ ĈĔââĕĆāėéĕĆöĕþľ÷ 2(1 ãęüĨ ĐąĜâŇ ýĔ åĊĕĄğčĘąħ èãĐè âĕĆğâė÷ FGGR XGKP VJTQODQUKU ìĬĨĕãĐèÿĜňþłĊąĆĕąüĔĨüĥ ğþŎüčĬĕåĔî %NCUU ++D .GXGN QH GXKFGPEG % âĕĆĢčŇ +8% (KNVGT ĠüēüĬĕĢüÿĜňþłĊąúĘħĄĘãňĐĎňĕĄ ãĐèâĕĆĢĎň CPVKEQCIWNCPV ğëŇü KPVTCETCPKCN DNGGFKPI CEVKXG DNGGFKPI TGEGPV DTCKP G[G ĎĆĚĐ URKPCN EQTF UWTIGT[ ĎĆĚĐğâė÷ÿĈãňĕèğåĘąèãĐèâĕĆĆĔâČĕ÷ňĊąąĕ CPVKEQCIWNCPV ĎĆĚĐğâė÷ăĕĊēĈėħĄğĈĚĐ÷Đě÷øĔüĢüþĐ÷ìĬĨĕ ĠøŇâĕĆĢëň +8% ÌNVGT ğāĚħĐþŃĐèâĔüâĕĆğâė÷ăĕĊēĈėħĄğĈĚĐ÷

J Thai Stroke Soc: Volume 14, 2015

Đě÷øĔüĢüþĐ÷ĢüÿĜþň Ċł ą FGGR XGKP VJTQODQUKU ąĔèģĄŇğþŎü úĘħąĐĄĆĔýĢüþŌééěýĔü10 čĆěþ ĢüĆĕąèĕüÿĜňþłĊąüĘĨğþŎüâĆöĘċęâČĕúĘħāýģ÷ň ģĄŇýŇĐąĢüğĊëþñėýĔøė ùęèĠĄňĊŇĕâĕĆøĆĊéāý FGGR XGKP VJTQODQUKU ĆŇĊĄĢüÿĜþň Ċł ąġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷ øĔüéēāýüňĐą ĠøŇùňĕāýÿĜňþłĊąåĊĆģ÷ňĆĔýâĕĆøĆĊéĎĔĊĢé ĐąŇĕèĈēğĐĘą÷ğāĚħĐĎĕ TKIJV VQ NGHV UJWPV ĎĆĚĐĢüúĕèâĈĔý âĔüĢüâĆöĘúĘħøĆĊéāý RCVGPV HQTCOGP QXCNG ĢüÿĜňþłĊą ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘýĠĈēĐě÷øĔü åĊĆčŇèøĆĊé &QRRNGT WNVTCUQWPF ğāėħĄğøėĄğāĚħĐĎĕĊŇĕĄĘ FGGR XGKP VJTQODQUKU ĆŇĊĄ÷ňĊąĎĆĚĐģĄŇ ĢüÿĜþň Ċł ą KUEJGOKE UVTQMG úĘĄħ Ę 2(1 ĠĈē FGGR XGKP VJTQODQUKU åĊĆģ÷ňĆĔýąĕâĔüğĈĚĐ÷ğþŎüĈėħĄ Ģü âĆöĘúĘħģĄŇĄĘãňĐĎňĕĄĢüâĕĆĢĎňąĕ

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4USPLF 8IBU 4IPVME #F %POF $VSS 0QJO )FNBUPM ī 4. %FTBJ "+ 'VMMFS $+ +FTVSVN +5 FU BM 1BUFOU GPSBNFO PWBMF BOE DFSFCSPWBTDVMBS EJTFBTFT /BU $MJO 1SBDU $BSEJPWBTD .FE "MTIFJLI "MJ "" 5IBMFS %& ,FOU %. 1BUFOU GPSBNFO PWBMF JO DSZQUPHFOJD TUSPLF JODJEFOUBM PS QBUIPHFOJD 4USPLF 'VSMBO "+ 3FJTNBO . .BTTBSP + FU BM $MPTVSF PS NFEJDBM UIFSBQZ GPS DSZQUPHFOJD TUSPLF XJUI QBUFOU GPSBNFO PWBMF / &OHM + .FE $BSSPMM +% 4BWFS +- 5IBMFS %& FU BM $MPTVSF PG QBUFOU GPSBNFO PWBMF WFSTVT NFEJDBM UIFSBQZ BGUFS DSZQUPHFOJD TUSPLF / &OHM + .FE .FJFS # ,BMFTBO # .BUMF )1 FU BM 1FSDVUBOFPVT DMPTVSF PG QBUFOU GPSBNFO PWBMF JO DSZQUPHFOJD FNCPMJTN / &OHM + .FE ,FSOBO 8/ 0WCJBHFMF # #MBDL )3 FU BM (VJEFMJOFT GPS UIF QSFWFOUJPO PG TUSPLF BOE USBOTJFOU JTDIFNJD BUUBDL " HVJEFMJOF GPS IFBMUIDBSF QSPGFTTJPOBMT GSPN UIF "NFSJDBO )FBSU "TTPDJBUJPO "NFSJDBO 4USPLF "TTPDJBUJPO 4USPLF 8FJOCFSH * ,BVGNBO + +Bȼ .3 *OGFSJPS 7FOB $BWB 'JMUFST +"$$ $BSEJPWBTD *OUFSW

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Ďîėèģúąġč÷ Đĕąě þĿ ĄĕġĆèāąĕýĕĈ÷ňĊąĐĕâĕĆĐŇĐüĠĆèìĘâãĊĕ øĆĊéĆŇĕèâĕąāýâňĐüĢüúňĐè ĠĈēãĕãĊĕýĊĄĆŇĊĄ÷ňĊą ğĐĦâìğĆąŋåĐĄāėĊğøĐĆŋčĄĐèāýĆĐąġĆåčĄĐèãĕ÷ğĈĚĐ÷ğêĘąýāĈĔüĠĈēĄĘğĈĚĐ÷ĐĐâúĘħ ýĆėğĊöčĄĐèčŇĊü RCTKGVQ QEEKRKVCN ÷ňĕüìňĕą ÿĈâĕĆøĆĊéğāėħĄğøėĄāýĄēğĆĦèĆĔèģãŇ ĎĈĐ÷ğĈĚĐ÷÷ĬĕĐě÷øĔüúĘħãĕ ãĊĕĠĈē RCVGPV HQTCOGP QXCNG ğüĚĐħ èéĕâÿĜþň Ċł ąĄĘãĐň ĎňĕĄĢüâĕĆĢëň CPVKEQCIWNCPV éęèģ÷ňĆýĔ âĕĆĆĔâČĕġ÷ąâĕĆ ĢčŇ +8% ÌNVGT ğāĚħĐþŃĐèâĔüâĕĆğâė÷ TGEWTTGPV UVTQMG øŇĐģþ åĬĕčĬĕåĔî ġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèøĘý ĄēğĆĦèĆĔèģãŇ ĎĈĐ÷ğĈĚĐ÷÷ĬĕĐě÷øĔü

J Thai Stroke Soc: Volume 14, 2015

ċôŚāċòĆēüÖ 4USPLF /FXT íÜ èïā÷òĄ ÙĀñùăèüèĀèäŞÐćô čòÖíñāéāôíÜāďæ

(J Thai Stroke Soc 2015; 14: 67-68.)

ĢüëŇĊèğ÷ĚĐüøěĈĕåĄúĘħÿŇĕüĄĕģ÷ňĄĘèĕüþĆēëěĄ YQTNF UVTQMG EQPHGTGPEG úĘħ +UVCPDWN þĆēğúċøěĆâĘ ĄĘĢåĆģ÷ňģþýňĕè ĢåĆģþąâĄĚĐãęĨüåē Ďüęħè čĐè čĕĄ ĄĕâĄĕąüĔýģĄŇùňĊüğĈąåē ĢåĆúĘħģĄŇģ÷ňģþģĄŇøňĐèğčĘąĢé üēåē ğ÷ĘĪąĊğĆĕéēģ÷ňĄĕğĈŇĕčĜŇâĔüĂŌèåē ĢüèĕüþĆēëěĄüĘĨģ÷ňĄĘâĕĆüĬĕğčüĐ èĕüĊėéąĔ ĢĎĄŇúüĘħ ĕŇ čüĢéĎĈĕąğĆĚĐħ è ĠøŇĄğĘ ĆĚĐħ èĎüęèħ úĘ ħ &T 5CXGT åěöåĆĜãĐè ÿĜğň ãĘąüåē ģ÷ňĠüēüĬĕĠĈēýĐâĊŇĕüŇĕčüĢéĄĕâùęèãüĕ÷ğþŎü PGY GTC ãĐè CEWVG UVTQMG VTGCVOGPV ğĈąúĘğ÷ĘąĊ ğĆĚħĐèüĔĨüåĚĐ Á/4 %.'#0Â åěňüĥâĔü ģĎĄåē ÁĄėčğøĐĆŋåĈĘüÂ ÿĈėøăĔöôŋúĬĕåĊĕĄčēĐĕ÷úĘħúěâúŇĕüåèĆĜňéĔâĠĈē åěňüğåąâĔüĐąŇĕè÷Ę ğĐėħĄ ģĄŇĢëŇĠĈňĊåē ĐĐâüĐâğĆĚħĐèģþģâĈĈē ğĆĕâĈĔýĄĕ ÷ĜâĔü÷ĘâĊŇĕåēĊŇĕ èĕüĊėéĔąëėĨüüĘĨüŇĕčüĢéĐąŇĕèģĆ øė÷øĕĄģ÷ň ö ýĔ÷üĘĨåē Á/4 %.'#0 C OWNVKEGPVGT TCPFQOK\GF ENKPKECN VTKCN QH GPFQXCUEWNCT VTGCVOGPV HQT CEWVG KUEJGOKE UVTQMG KP VJG 0GVJGTNCPFU UVWF[ RTQVQEQN HQT C TCPFQOK\GF EQPVTQNNGF VTKCNÂ

th 9QTNF 5VTQMG %QPITGUU +UVCPDWN 6WTMG[ èĕüĊėéĔąüĘĨċęâČĕĢüÿĜňþłĊąĐĕąěĄĕââĊŇĕĎĆĚĐğúŇĕâĔý þĿ úĘħĄĕ ÷ňĊąĐĕâĕĆġĆåčĄĐèãĕ÷ğĈĚĐ÷éĕâ CPVGTKQT EKTEWNCVKQP ăĕąĢü ëĔħĊġĄè ĎĈĔèéĕâğĆėħĄĄĘĐĕâĕĆ ġ÷ąğþĆĘąýğúĘąýÿĈĈĔāûŋĢüâĕĆĆĔâČĕ âĈěŇĄ âĈěŇĄ ĠĆâğþŎüâĈěĄŇ KPVGTXGPVKQP ìęèħ éēģ÷ňĆýĔ âĕĆĆĔâČĕĠýý GPFQXCUEWNCT ĎĆĚĐ KPVTC CTVGTKCN VTGCVOGPV +#6 åĚĐâĕĆêĘ÷čĘ÷ĜĎĈĐ÷ğĈĚĐ÷ĠĈēĢčŇã÷ĈĊ÷ ğāĚĐħ ÷ęè ğâĘąħ Ċ ĈėĄħ ğĈĚĐ÷úĘĐħ ÷ě øĔüĎĆĚĐêĘ÷ąĕĈēĈĕąĈėĄħ ğĈĚĐ÷øĆèýĆėğĊöĎĈĐ÷ ğĈĚĐ÷úĘħĐě÷øĔü ĠĈēâĈěŇĄúĘħčĐèğþŎüâĈěŇĄúĘħģĄŇģ÷ňúĕĬ KPVGTXGPVKQP PQ +#6 EQPVTQN ġ÷ąúĔèĨ čĐèâĈěĄŇ ÿĜþň Ċł ąåĊĆĄĘ 0+*55 ĄĕââĊŇĕğúŇĕâĔý %6 ĎĆĚĐ /4+ DTCKP ģĄŇāýğĈĚĐ÷ĐĐâĢüčĄĐè ĠĈēéĕââĕĆúĬĕ %6# /4# QT &5# āýĎĈĐ÷ğĈĚĐ÷Đě÷øĔüãĐè FKUVCN KPVTCETCPKCN ECTQVKF CTVGT[ OKFFNG EGTGDTCN CTVGT[ / QT / ĎĆĚĐ CPVGTKQT EGTGDTCN CTVGT[ # éĕâ üĔĨüøė÷øĕĄĠĈēþĆēğĄėüÿĈâĕĆĆĔâČĕúĘħ ĊĔü

J Thai Stroke Soc: Volume 14, 2015

$CUGNKPG %JCTCEVGTKUVKE ãĐèÿĜňþłĊąúĔĨèčĐèâĈěŇĄ ÷ĔèøĕĆĕè +PVGTXGPVKQP ITQWR P

%QPVTQN ITQWR P

#XGTCIG CIGU

/CNG

59%

#XGTCIG 0+*55

6TGCVGF YKVJ +8 CNVGRNCUG

91%

ăĕąĎĈĔèâĕĆĆĔâČĕúĘ ħ ëĔĊħ ġĄè âĈěĄŇ KPVGTXGPVKQP čĕĄĕĆùğþľ÷ĎĈĐ÷ğĈĚĐ÷ģ÷ňĆňĐąĈē ĢüãöēúĘħâĈěŇĄ EQPVTQN čĕĄĕĆùğþľ÷ĎĈĐ÷ğĈĚĐ÷ģ÷ňĆňĐąĈē CFLWUVGF 14 %+ ăĕąĎĈĔèâĕĆĆĔâČĕ ĊĔü ģ÷ňúĬĕâĕĆĊĔ÷þĆėĄĕøĆ ğüĚĨĐčĄĐèúĘħãĕ÷ğĈĚĐ÷ āýĊŇĕĢüâĈěŇĄ +#6 ĄĘãüĕ÷ O. ĠĈē O. ĢüâĈěŇĄ EQPVTQN

+PVGTXGPVKQP ITQWR

%QPVTQN ITQWR

2CTGPEJ[OCN JGOQTTJCIG V[RG

5.2%

New ischemic stroke in a different XCUEWNCT VGTTKVQT[

Hemicraniectomy

ğĄĚĐħ ğþĆĘąýğúĘąýâĔýâĕĆċęâČĕâŇĐüĎüňĕüĘ Ĩ ģĄŇĊĕŇ éēğþŎü 5;06*'5+5 'ZRCPUKQP VTKCN +/5 +++ ĠĈē /4 4'5%7' ÿĈâĕĆċęâČĕøŇĕèģĄŇāýþĆēġąëüŋĢüâĕĆĆĔâČĕ ġ÷ąĊėûĘ GPFQXCUEWNCT VJGTCR[ ĢüãöēúĘħ /4 %.'#0 āýþĆēġąëüŋĢüâĕĆĆĔâČĕ ëŇĊąĈ÷åĊĕĄúěāāĈăĕā ĠĈē úĬĕĢĎňÿĜňþłĊąĄĘÿĈĈĔāûŋúĕèåĈėüėâ÷ĘãęĨü éęèğþŎüúĘħĄĕãĐèåĬĕ

ÿĈâĕĆĆĔâČĕúĘħ ĊĔü âĈěŇĄ KPVGTXGPVKQP ĄĘ ÿĈĈĔāûŋâĕĆĆĔâČĕ÷ĘâĊŇĕ åĚĐĄĘ CFLWUVGF 14 %+ ÷ĔèâĆĕĂ ăĕĊēĠúĆâìňĐüøŇĕèâĔüğĈĦâüňĐą ġ÷ąâĕĆĆĔâČĕ ĢüâĈěĄŇ KPVGTXGPVKQP āýĆňĐąĈē ĠĈēâĈěĄŇ EQPVTQN āý ĆňĐąĈē

J Thai Stroke Soc: Volume 14, 2015

ĊŇĕ PGY GTC QH GPFQXCUEWNCT VTGCVOGPV éýĠĈňĊåē ãĐãĐýåěöåěöåĆĜ &T 5CXGT úĘâħ Ćěöĕ ĠüēüĬĕýúåĊĕĄĠĈēãňĐåė÷÷Ęĥåē úŇĕüÿĜňĐŇĕüĐąŇĕğāėħè ğåĆĘą÷âĔüüēåē úŇĕüĢ÷ĐąĕâĠč÷èåĊĕĄåė÷ğĎĦü ĊŇĕèĥ ĄĕĠĈâğþĈĘąħ üåĊĕĄğĎĦüâĔüģ÷ňüēåē čĬĕĎĆĔýêýĔýüĘãĨ ĐĈĕ ģþâŇĐüüēåē ýňĕąýĕą ĠĈňĊğéĐâĔüĢĎĄŇêýĔýĎüňĕåē -

êòÿÙāùĀðíĀèçŞ čĊĔč÷ĘåēĐĕéĕĆąŋ ğāĘħĐüĥ āĘħĥ üňĐèĥ ğĎĈŇĕčĄĕëėâčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè âĈĔýĄĕğéĐâĔüĐĘâåĆĔĨèüēåē ĢüèĕüþĆēëěĄĊėëĕâĕĆúĘÿħ ĕŇ üĄĕģ÷ňĄÿĘ ğňĜ ãňĕĆŇĊĄþĆēâĊ÷ÿĈèĕüĊėéąĔ ğþŎüéĬĕüĊüĄĕâ ĠĈēúĕèčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè ģúąģ÷ňĄĘĆĕèĊĔĈčĬĕĎĆĔýÿĜňëüēâĕĆþĆēâĊ÷èĕüĊėéĔą ÷ĔèĄĘĆĕąĈēğĐĘą÷÷ĔèøŇĐģþüĘĨåē ĆĕèĊĔĈ 1TCN RTGUGPVCVKQPĢüâĕĆþĆēâĊ÷ÿĈèĕüĊėéĔąčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúąþĿ ā ċ

êòÿċïææĄē ČíæñŞ Čôÿ éćÓÓôāÐòüĆēèđ ĆĕèĊĔĈúĘħ ğèėüĆĕèĊĔĈ ýĕú ģ÷ňĠâŇ ÿĈèĕüğĆĚħĐè Á%QORCTKUQP QH #URKTKP 4GURQPUG /GCUWTGF D[ 7TKPCT[ &GJ[FTQVJTQODQZCPG $ CPF 8GTKH[0QY #URKTKP #UUC[ KP 2CVKGPVU YKVJ +UEJGOKE 5VTQMGÂ ġ÷ą Ćċ āî āĆăĔúĆ ûĆĆĄčġĆë åöēĠāúąċĕčøĆŋ ĄĎĕĊėúąĕĈĔąûĆĆĄċĕčøĆŋ ĆĕèĊĔĈúĘħ ğèėüĆĕèĊĔĈ ýĕú ģ÷ňĠâŇ ģ÷ňĠâŇ ÿĈèĕüğĆĚħĐè Á%QORCTCVKXG #PVKRNCVGNGV #IITGICVKQP 'HHGEV QH 6YQ %NQRKFQITGN 2TQFWEVU WPFGT 5VGCF[ 5VCVG %QPFKVKQP KP *GCNVJ[ 8QNWPVGGTUÂ ġ÷ą ăî üüúîĕ üĕååĬĕ -JQP -CGP 7PKXGTUKV[

êòÿċïææĄē íñāéāô ĆĕèĊĔĈúĘħ ğèėüĆĕèĊĔĈ ýĕú ģ÷ňĠâŇ ÿĈèĕüğĆĚħĐè ÁÿĈâĕĆāĔõüĕâĕĆĆĔýĆĜňĠĈēâĕĆéĔ÷âĕĆĐĕâĕĆğøĚĐüãĐèÿĜňþłĊąăĕĊēčĄĐèãĕ÷ğĈĚĐ÷ëĔħĊåĆĕĊĠĈēÿĜň÷ĜĠĈ øŇĐāćøėâĆĆĄ âĕĆåĊýåěĄġĆåĠĈēâĕĆéĔ÷âĕĆĐĕâĕĆğøĚĐüÂ ġ÷ą ĊėĆĕĊĆĆö éĔüúĄĜĈ āą Ą ġĆèāąĕýĕĈāĆēüåĆċĆĘĐąěûąĕ ĆĕèĊĔĈúĘħ ğèėüĆĕèĊĔĈ ýĕú ģ÷ňĠâŇ ÿĈèĕüğĆĚħĐè Á'HHGEVU QH *QOG 8KUKVKPI 2TQITCO QP 3WCNKV[ QH .KHG QH -KPI %JWNQPIMQTP /GOQTKCN *QURQVCN 5VTQMG 2CVKGPVUÂ ġ÷ą &WVUCPGG 9KPKVEJCK Ćā éěďĕ

êòÿċïææĄē 3FTJEFOU 'FMMPX ĆĕèĊĔĈúĘħ ğèėüĆĕèĊĔĈ ýĕú ģ÷ňĠâŇ ÿĈèĕüğĆĚħĐè Á2TGXCNGPEG QH EGTGDTCN OKETQDNGGFU %/$ QP /4+ KP RCVKGPVU YKVJ #N\JGKOGT¿U FKUGCUG #& Â ġ÷ą 6JKVK %JKPCLKVRJCP Ćā āĆēĄèâěðğâĈňĕ ĆĕèĊĔĈúĘħ ğèėüĆĕèĊĔĈ ýĕú ģ÷ňĠâŇ ÿĈèĕüğĆĚħĐè Á6JG CUUQEKCVKQPU DGVYGGP TKUM HCEVQTU ENKPKECN QWVEQOG CPF VJG KUEJGOKE UVTQMG UWDV[RGU 2TCUCV 0GWTQNQIKECN +PUVKVWVG UVTQMG TGIKUVT[Â ġ÷ą üā âć÷ĕ ö čèãĈĕ 2TCUCV 0GWTQNQIKECN +PUVKVWVG úĕèÿĜňğãĘąüéęèãĐĠč÷èåĊĕĄąėü÷ĘâĔýÿĜňëüēâĕĆþĆēâĊ÷úěâúŇĕüüēåē ĎĈĔèéĕâèĕüþĆēëěĄĊėëĕâĕĆþĆēéĬĕþĿ ğčĆĦéčėĨüģþ ÿĜňğãĘąüĎĊĔèğþŎüĐąŇĕèąėħèĊŇĕúěâúŇĕüúĘħğãňĕĆŇĊĄþĆēëěĄåèģ÷ňğâĆĦ÷åĊĕĄĆĜňĢĎĄŇĥìęħèğþŎüþĆēġąëüŋĠĈēčĕĄĕĆù üĬĕģþþĆēąěâøŋĢëňĢüâĕĆĆĔâČĕåüģãňãĐèğĆĕâĔüüēåē

J Thai Stroke Soc: Volume 14, 2015

ÓĘāČèÿèĘāùĘāúòĀéëĈśċÑĄñèéæÓöāð ĊĕĆčĕĆčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúąĄĘé÷ě ĄěèŇ ĎĄĕąúĘéħ ēøĘāĄė āŋýúåĊĕĄĊėéąĔ ĠĈēýúåĊĕĄĊėëĕâĕĆ úĘĄħ ğĘ üĚĐĨ Ďĕ ğâĘħąĊâĔýġĆåĎĈĐ÷ğĈĚĐ÷čĄĐè úĔĨèġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèãĕ÷ğĈĚĐ÷ĠĈēġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĠøâ ìęħèéēåĆĐýåĈěĄ÷ňĕü Ćēýĕ÷Ċėúąĕ âĕĆĆĔâČĕ âĕĆþŃĐèâĔüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĆē÷ĔýþòĄăĜĄėĠĈēúěøėąăĜĄė âĕąăĕāýĬĕýĔ÷ ġ÷ąýúåĊĕĄúĘħĈè øĘāėĄāŋĢüĊĕĆčĕĆčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúąéēÿŇĕüâĕĆåĔ÷ğĈĚĐâ ĐŇĕüĠĈēĢĎňåĬĕĠüēüĬĕéĕâþĆēčĕúĠāúąŋĎĆĚĐ ýěååĈĕâĆúĕèâĕĆĠāúąŋìęħèğþŎüÿĜňğëĘħąĊëĕî÷ňĕüġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèĐąŇĕèüňĐą åüâŇĐüâĕĆøĘāėĄāŋ RGGT TGXKGY RTQEGUU ýúåĊĕĄúĘħøĘāėĄāŋĢüĊĕĆčĕĆčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúą ģ÷ňĠâŇ • ýúåĊĕĄĊėéĔą QTKIKPCN CTVKENG ğþŎüĆĕąèĕüÿĈâĕĆĊėéĔąãĐèÿĜňğãĘąü ĢüâĆöĘúĘħúĬĕĊėéĔąĢüåü ÿĈèĕüĊėéĔąéĬĕğþŎüøňĐè ÿŇĕüâĕĆāėéĕĆöĕéĕâåöēâĆĆĄâĆĆĄéĆėąûĆĆĄâĕĆĊėéĔąĢüĄüěČąŋ • ýúåĊĕĄúĕèĊėëĕâĕĆ TGXKGY CTVKENG ğþŎüýúåĊĕĄúĘħğãĘąüéĕââĕĆĆĊýĆĊĄ čĔèğåĆĕēĎŋ ĊėğåĆĕēĎŋ åĊĕĄĆĜňğĆĚħĐèĢ÷ ğĆĚħĐèĎüęħèéĕâýúåĊĕĄĊėéĔąĠĈē ĎĆĚĐýúåĊĕĄĊėëĕâĕĆéĕâĊĕĆčĕĆøŇĕèĥúĔĨèĢüþĆēğúċĠĈēøŇĕèþĆēğúċ ĠĈēĄĘýú čĆěþĊėéĕĆöŋ • ĆĕąèĕüÿĜňþłĊą ECUG TGRQTV ğþŎüĆĕąèĕüÿĜňþłĊąúĘħüŇĕčüĢé ĐăėþĆĕąþĆēğ÷ĦüúĘħüŇĕčüĢéġ÷ąĐňĕèĐėèéĕâĎĈĔâòĕü ãňĐĄĜĈúĕèâĕĆĠāúąŋúĘħĄĘâĕĆċęâČĕĎĆĚĐĆĕąèĕüģĊň ğčüĐãňĐåė÷ğĎĦüĠĈēĄĘýúčĆěþ • ýúåĊĕĄĐĚħüĥ ğëŇü ýúåĊĕĄğâĘħąĊâĔýâėéâĆĆĄãĐèčĄĕåĄþĆēčĕúĊėúąĕ åöēâĆĆĄâĕĆ ĎĆĚĐčĄĕëėâ øĕĆĕèâĕĆ þĆēëěĄĊėëĕâĕĆ ğþŎüøňü âĕĆğøĆĘąĄøňüêýĔý âĕĆčŇèøňüêýĔýĢĎňčŇè QPNKPG ģþúĘħ GOCKN VJCKUVTQMG"IOCKN EQO čĕĄĕĆùčŇèøňüêýĔýģ÷ňúĔĨèăĕČĕģúąĎĆĚĐ ăĕČĕĐĔèâćČ ĢüâĕĆčŇèøňüêýĔýéēþĆēâĐý÷ňĊąé÷ĎĄĕąþēĎüňĕ EQXGT NGVVGT ĠĈēøňüêýĔýýúåĊĕĄ OCPWUETKRV é÷ĎĄĕąþēĎüňĕ %QXGT NGVVGT ğþŎüé÷ĎĄĕąğāĚĐħ üĬĕčŇèøňüêýĔýýúåĊĕĄğāĚĐħ ĢĎňâĐèýĆĆöĕûėâĕĆāėéĕĆöĕĈèøĘāĄė āŋĢüĊĕĆčĕĆčĄĕåĄġĆåĎĈĐ÷ ğĈĚĐ÷čĄĐèģúą øňĐèĄĘĆĕąĈēğĐĘą÷ğâĘħąĊâĔýĎĔĊãňĐýúåĊĕĄ þĆēğăúúĘħøňĐèâĕĆéēĈèøĘāėĄāŋ ğëŇü ýúåĊĕĄĊėéĔą ĎĆĚĐ ĆĕąèĕüÿĜňþłĊą ğþŎüøňü ëĚħĐ øĬĕĠĎüŇè ĠĈēúĘħĐąĜŇãĐèÿĜňğãĘąüĎĈĔâ %QTTGURQPFKPI CWVJQT øňüêýĔýýúåĊĕĄĊėéĔą 1TKIKPCN CTVKENG éēøňĐèþĆēâĐý÷ňĊąĎüňĕĎĔĊğĆĚĐħ è VKVNG RCIG ýúåĔ÷ąŇĐ CDUVTCEV ĠĈēýúåĊĕĄĊėéąĔ úĘĄħ ğĘ üĚĐĨ ĎĕĢüčŇĊüýúüĬĕ

KPVTQFWEVKQP ĊėûĘĊėéĔą OGVJQFU ÿĈâĕĆĊėéĔą TGUWNVU ĐăėþĆĕą FKUEWUUKQP ýúčĆěþ EQPENWUKQP ĠĈēğĐâčĕĆ ĐňĕèĐėè âĕĆğøĆĘąĄýúåĊĕĄĢëňġþĆĠâĆĄ /KETQUQHV 9QTF øĔĊĐĔâČĆ $TQYCNNKC 0GY ãüĕ÷ ĎüňĕĠĆâ 6KVNG RCIG þĆēâĐý÷ňĊąëĚħĐýúåĊĕĄĊėéĔą ëĚħĐĠĈēüĕĄčâěĈ øĬĕĠĎüŇè úĘħúĕĬ èĕüĎĆĚĐøňüčĔèâĔ÷ãĐè ÿĜňğãĘąüúěâåü ĠĎĈŇèúěüĊėéĔą ĠĈēëĚħĐüĕĄčâěĈ úĘħĐąĜŇ úĘħøė÷øŇĐ ğýĐĆŋġúĆċĔāúŋ GOCKN CFFTGUU ãĐèÿĜňğãĘąüĎĈĔâ

EQTTGURQPFKPI CWVJQT ýúåĔ÷ąŇĐ #DUVTCEV ğþŎüýúčĆěþğüĚĨĐĎĕãĐèýúåĊĕĄĊėéĔą éĬĕâĔ÷éĬĕüĊüģĄŇğâėü åĬĕ þĆēâĐý÷ňĊą ĊĔøùěþĆēčèåŋâĕĆĊėéĔą ĊėûĘĊėéĔą ÿĈâĕĆĊėéĔą ĠĈēčĆěþ ĢĎňĢčŇåĬĕčĬĕåĔî MG[ YQTFU åĬĕ ĢøňýúåĔ÷ąŇĐ÷ňĊą ġ÷ą ãĐýúåĔ÷ąŇĐúĔĨèăĕČĕģúąĠĈēăĕČĕĐĔèâćČ

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ýúåĊĕĄĊėéĔą ĄĘğüĚĨĐĎĕĢüčŇĊüýúüĬĕ KPVTQFWEVKQP ĊėûĘĊėéĔą OGVJQFU ÿĈâĕĆĊėéĔą TGUWNVU ĐăėþĆĕą

FKUEWUUKQP ĠĈēýúčĆěþ EQPENWUKQP ğĐâčĕĆĐňĕèĐėè ĢüâĆöĘúĘħĐňĕèĐėèéĕâýúåĊĕĄĊėéĔąĢĎňĢčŇëĚħĐÿĜňğãĘąü åü ĢüâĆöĘúĘħĄĘÿĜňğãĘąüĄĕââĊŇĕ åüĢĎň ĢčŇ GV CN ĎĈĔèëĚħĐÿĜňĠøŇèåüúĘħ øĕĄ÷ňĊąëĚħĐğĆĚħĐèĊėéĔą ĊĕĆčĕĆúĘħøĘāėĄāŋ þĿúĘħøĘāėĄāŋ êýĔý Ďüňĕ åĬĕąŇĐãĐèĊĕĆčĕĆ ĢĎňĢëňåĬĕąŇĐĊĕĆčĕĆúĘħĢëňøĕĄĎĈĔâčĕâĈ čĕĄĕĆù÷ĜøĔĊĐąŇĕèģ÷ňéĕâ JVVR YYY PEDK PNO PKJ IQX RWDOGF ÷ĔèøĔĊĐąŇĕè &JCTOCUCTQLC 2# /WGPIVCYGGRQPIUC 5 -WOOCTM 7 +ORNGOGPVCVKQP QH VGNGOGFKEKPG CPF UVTQMG PGVYQTM KP VJTQODQN[VKE CFOKPKUVTCVKQP EQORCTKUQP DGVYGGP YCNM KP CPF TGHGTTGF RCVKGPVU 0GWTQETKV %CTG ĎĕâĐňĕèĐėèéĕâýúĢüĎüĔèčĚĐĎĆĚĐøĬĕĆĕ ĢĎňĢčŇëĚħĐÿĜňğãĘąü ëĚħĐýúåĊĕĄ ëĚħĐýĆĆöĕûėâĕĆ ëĚħĐĎüĔèčĚĐ čùĕüúĘħ āėĄāŋ čĬĕüĔâāėĄāŋ þĿúĘħāėĄāŋ Ďüňĕ ÷ĔèøĔĊĐąŇĕè &JCTOCUCTQLC 2# 6GNGOGFKEKPG CPF UVTQMG PGVYQTM +P &JCTOCUCTQLC 2# GF +UEJGOKE 5VTQMG $CPIMQM ,CTWPUCPKVYQPIMCPRKO øĕĆĕèĠÿüăĜĄė ĎĆĚĐăĕāþĆēâĐý ĢĎňĠąâøŇĕèĎĕâéĕâýúåĊĕĄ ĢĎňĄĘåĊĕĄčĄýĜĆöŋĢüøĔĊĐŇĕüĠĈňĊğãňĕĢéèŇĕą ģĄŇåĊĆĢëňøĕĆĕè ĎĆĚĐĠÿüăĜĄėúĘħģĄŇĆĔ÷âěĄ ìĔýìňĐü ĎĆĚĐĄĕâğâėüåĊĕĄéĬĕğþŎü ýúåĊĕĄĊėëĕâĕĆ éēøňĐèþĆēâĐý÷ňĊą ýúåĔ÷ąŇĐ #DUVTCEV ğþŎüýúčĆěþğüĚĐĨ ĎĕãĐèýúåĊĕĄ éĬĕâĔ÷éĬĕüĊüģĄŇğâėü åĬĕ ĢĎňĢčŇåĕĬ čĬĕåĔî MG[ YQTFU åĬĕ ĢøňýúåĔ÷ąŇĐ÷ňĊą ġ÷ąãĐýúåĔ÷ąŇĐúĔĨèăĕČĕģúąĠĈēăĕČĕĐĔèâćČ ĎüňĕĠĆâ 6KVNG RCIG þĆēâĐý÷ňĊąëĚħĐýúåĊĕĄĊėéĔą ëĚħĐĠĈēüĕĄčâěĈ øĬĕĠĎüŇè úĘħúĬĕèĕüĎĆĚĐøňüčĔèâĔ÷ãĐè ÿĜňğãĘąüúěâåü ĠĈēëĚħĐüĕĄčâěĈ úĘħĐąĜŇ úĘħøė÷øŇĐ ğýĐĆŋġúĆċĔāúŋ GOCKN CFFTGUU ãĐèÿĜňğãĘąüĎĈĔâ EQTTGURQPFKPI author) ýúåĊĕĄ þĆēâĐý÷ňĊą ýúüĬĕ ğüĚĨĐĎĕúĘħøňĐèâĕĆüĬĕğčüĐ ýúčĆěþ ĠĈēğĐâčĕĆĐňĕèĐėè ĊĘûĘğãĘąüğĐâčĕĆĐňĕèĐėè ÷ĔèøĔĊĐąŇĕèãňĕèøňü âĕĆğøĆĘąĄýúåĊĕĄĢëňġþĆĠâĆĄ /KETQUQHV 9QTF øĔĊĐĔâČĆ $TQYCNNKC 0GY ãüĕ÷ ĆĕąèĕüÿĜňþłĊą éēøňĐèþĆēâĐý÷ňĊą ýúåĔ÷ąŇĐ #DUVTCEV ğþŎüýúčĆěþğüĚĐĨ ĎĕãĐèýúåĊĕĄ éĬĕâĔ÷éĬĕüĊüģĄŇğâėü åĬĕ ĢĎňĢčŇåĕĬ čĬĕåĔî MG[ YQTFU åĬĕ ĢøňýúåĔ÷ąŇĐ÷ňĊą ġ÷ąãĐýúåĔ÷ąŇĐúĔĨèăĕČĕģúąĠĈēăĕČĕĐĔèâćČ ĎüňĕĠĆâ 6KVNG RCIG þĆēâĐý÷ňĊąëĚħĐğĆĚħĐè ëĚħĐĠĈēüĕĄčâěĈ øĬĕĠĎüŇè úĘħúĕĬ èĕüĎĆĚĐøňüčĔèâĔ÷ãĐèÿĜňğãĘąüúěâ åü ĠĈēëĚħĐüĕĄčâěĈ úĘħĐąĜŇ úĘħøė÷øŇĐ ğýĐĆŋġúĆċĔāúŋ GOCKN CFFTGUU ãĐèÿĜňğãĘąüĎĈĔâ EQTTGURQPFKPI CWVJQT ýúåĊĕĄĆĕąèĕüÿĜňþłĊą ĐĕéĆĕąèĕüÿĜňþłĊąúĘħüŇĕčüĢé Ćĕą ĎĆĚĐĄĕââĊŇĕ Ćĕą ECUG UGTKGU ġ÷ąüĬĕğčüĐ þĆēĊĔø ė øĆĊéĆŇĕèâĕą ÿĈâĕĆøĆĊéğāėĄħ ğøėĄ âĕĆĊėüéė êĔą ĠĈēĐăėþĆĕąþĆēğ÷ĦüúĘüħ ĕŇ čüĢéġ÷ąĐňĕèĐėèéĕâĎĈĔâòĕü úĕèâĕĆĠāúąŋúĘħğåąĆĕąèĕüĄĕâŇĐü ĠĈēğĐâčĕĆĐňĕèĐėè âĕĆğøĆĘąĄýúåĊĕĄĢëňġþĆĠâĆĄ /KETQUQHV 9QTF øĔĊĐĔâČĆ $TQYCNNKC 0GY ãüĕ÷

ĎĄĕąğĎøě ĢüâĆöĘúĘħâĈŇĕĊùęèąĕĢüýúåĊĕĄþĆēğăúøŇĕèĥ÷ĔèâĈŇĕĊãňĕèøňü ĢĎňĢëň IGPGTKE PCOGU

J Thai Stroke Soc: Volume 14, 2015

åöēýĆĆöĕûėâĕĆčèĊüčėúûėĢī üâĕĆāėéĕĆöĕĆĔýøĘāĄė āŋýúåĊĕĄĢüĊĕĆčĕĆčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúą Ģü âĆöĘĆĔýøĘāėĄāŋÿĜňğãĘąüéēģ÷ňĆĔýé÷ĎĄĕąøĐýĆĔýéĕââĐèýĆĆöĕûėâĕĆ ĠĈēéēģ÷ňĆĔýĊĕĆčĕĆéĬĕüĊü êýĔý ġ÷ąéēéĔ÷čŇè ĢĎňÿĜňğãĘąüýúåĊĕĄëĚħĐĠĆâĎĆĚĐëĚħĐĎĈĔâøĕĄúĘħĐąĜŇúĘħĆēýěģĊň ýúåĊĕĄúĔèĨ ĎĄ÷éēĄĘâĕĆğÿąĠāĆŇúĕè YGDUKVG ãĐèčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúą JVVR VJCKUVTQMGUQEKGV[ QTI ãňĐāėéĕĆöĕ÷ňĕüĈėãčėúûėī %QR[TKIJV 0QVKEG ãňĐåĊĕĄúĘħþĆĕâðăĕąĢüýúåĊĕĄãĐèĠøŇĈēýúåĊĕĄúĘħøĘāėĄāŋĢüĊĕĆčĕĆĊėëĕâĕĆğĈŇĄüĘĨ ğþŎüãĐèÿĜňğãĘąüĠøŇĈē úŇĕü ģĄŇğâĘąħ ĊãňĐèâĔýâĐèýĆĆöĕûėâĕĆĊĕĆčĕĆčĄĕåĄġĆåĎĈĐ÷ğĈĚĐ÷čĄĐèģúąĠøŇĐąŇĕèĢ÷ åĊĕĄĆĔýÿė÷ëĐý÷ňĕüğüĚĐĨ Ďĕ ĠĈēâĕĆøĆĊéĆŇĕèýúåĊĕĄĠøŇĈēýúåĊĕĄğþŎüãĐèÿĜňğãĘąüĠøŇĈēúŇĕü ĎĕâĄĘåĊĕĄÿė÷āĈĕ÷Ģ÷ ĥ ÿĜňğãĘąüĠøŇĈēúŇĕüéē øňĐèĆĔýÿė÷ëĐýýúåĊĕĄãĐèøüğĐèĠøŇÿĜňğ÷ĘąĊ âĐèýĆĆöĕûėâĕĆãĐčèĊüčėúûėīĄėĢĎňüĕĬ ğüĚĨĐĎĕ úĔċüē ĎĆĚĐãňĐåė÷ğĎĦüĢ÷ ĥ ãĐèýúåĊĕĄĢüĊĕĆčĕĆčĄĕåĄġĆå ĎĈĐ÷ğĈĚĐ÷čĄĐèģúą ģþğÿąĠāĆŇâŇĐüģ÷ňĆĔýĐüěîĕøéĕââĐèýĆĆöĕûėâĕĆ ĐąŇĕèğþŎüĈĕąĈĔâČöŋĐĔâČĆ ÿĈèĕüúĘħģ÷ňĆĔý âĕĆøĘāėĄāŋùĚĐğþŎüĈėãčėúûėīãĐèĊĕĆčĕĆ âĕĆĈēğĄė÷ĈėãčėúûėīùĚĐğþŎüåĊĕĄĆĔýÿė÷ëĐýãĐèÿĜňčŇèýúåĊĕĄġ÷ąøĆè

J Thai Stroke Soc: Volume 14, 2015

Promising Neuroprotective Drug

In Acute Treatment

PROVED EFFICACY IN STROKE BENEFIT FOR TRAUMATIC BRAIN INJURY proved efficacy in stroke % Global Recovery at Week 12

In Chronic Treatment

IMPROVE POST-STROKE VASCULAR COGNITIVE IMPAIRMENT POSITIVE EFFECT IN CHRONIC CEREBRAL DISORDERS Can improve Post-Stroke Vascular Cognitive Impairment Six months after stroke, 44% to 74% of patients present some degree of cognitive disturbance.3

p=0.0043 ( OR = 1.38, 95% CI = 1.10-1.72)

27.9%

21.9% 15

N=1,652

Placebo

Citicoline 2000 mg/day

N=347

Rate of complete recovery according to all scales (NIHSS â&#x2030;¤ 1, MRS â&#x2030;¤ 1, BI â&#x2030;Ľ 95)

SOMAZINA : Increase the probability of complete recovery at 3 months

2,000 mg/day for 6 weeks then 1,000 mg/day up to 12 months

SOMAZINA : Improve Attention and Orientation significantly after 6 months treatment in post-stroke patient

Reference 1. Davalos A.et al. Oral Cticoline in acute ischemic stroke. An individual patient data pooling analysis of clinical trials. Stroke 2002;33:2850-2857 2. Ă lvarez-SabĂn J. et al. Citicoline in Vascular Cognitive Impairment and Vascular Dementia After Stroke. Stroke 2011; 42 (suppl 1): S 40-S43

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(cilostazol)

Cilostazol for prevention of secondary stroke (CSPS 2): an aspirin-controlled, double-blind, randomized non-inferiority trial

Cilostazol is more effective than aspirin for secondary stroke prevention based on CSPS II study

From Asia to The World ğĐâčĕĆčĖĎĆĔýÿĜňþĆēâĐýġĆåċėĈþē ĢýĐüěîĕøġçČöĕğĈãúĘħ çċ ġþĆ÷ĐŇĕüĆĕąĈēğĐĘą÷ğāėħĄğøėĄĢüğĐâčĕĆĐňĕèĐėèêýĔýčĄýĜĆöŋĠĈēğĐâčĕĆâĖâĔýąĕ

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