Abstract:
:Our goal in this review is to discuss the pathophysiology, diagnosis, and treatment of stroke caused by atherosclerosis of the major intracranial arteries. References for the review were identified by searching PubMed for related studies published from 1955 to June 2016 using search terms intracranial stenosis and intracranial atherosclerosis. Reference sections of published randomized clinical trials and previously published reviews were searched for additional references. Intracranial atherosclerotic disease is a highly prevalent cause of stroke that is associated with a high risk of recurrent stroke. It is more prevalent among blacks, Hispanics, and Asians compared with whites. Diabetes mellitus, hypertension, metabolic syndrome, smoking, hyperlipidemia, and a sedentary lifestyle are the major modifiable risk factors associated with intracranial atherosclerotic disease. Randomized clinical trials comparing aggressive management (dual antiplatelet treatment for 90 days followed by aspirin monotherapy and intensive management of vascular risk factors) with intracranial stenting plus aggressive medical management have shown medical management alone to be safer and more effective for preventing stroke. As such, aggressive medical management has become the standard of care for symptomatic patients with intracranial atherosclerotic disease. Nevertheless, there are subgroups of patients who are still at high risk of stroke despite being treated with aggressive medical management. Future research should aim to establish clinical, serological, and imaging biomarkers to identify high-risk patients, and clinical trials evaluating novel therapies should be focused on these patients.
journal_name
Circ Resjournal_title
Circulation researchauthors
Banerjee C,Chimowitz MIdoi
10.1161/CIRCRESAHA.116.308441subject
Has Abstractpub_date
2017-02-03 00:00:00pages
502-513issue
3eissn
0009-7330issn
1524-4571pii
CIRCRESAHA.116.308441journal_volume
120pub_type
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pub_type: 杂志文章
doi:10.1161/01.res.66.6.1755
更新日期:1990-06-01 00:00:00
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更新日期:1990-03-01 00:00:00
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更新日期:2010-10-15 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2015-06-05 00:00:00
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pub_type: 杂志文章
doi:10.1161/01.res.75.3.462
更新日期:1994-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:1991-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1161/01.res.39.1.106
更新日期:1976-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1161/01.res.64.3.554
更新日期:1989-03-01 00:00:00
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journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.36.4.547
更新日期:1975-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1161/01.res.71.5.1200
更新日期:1992-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-02-03 00:00:00
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pub_type: 杂志文章
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更新日期:1982-04-01 00:00:00
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更新日期:1996-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:1995-10-01 00:00:00
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更新日期:1995-09-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2014-05-23 00:00:00
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pub_type: 杂志文章
doi:10.1161/01.res.66.4.1133
更新日期:1990-04-01 00:00:00
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journal_title:Circulation research
pub_type: 杂志文章
doi:10.1161/01.res.71.6.1324
更新日期:1992-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2013-09-13 00:00:00
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pub_type: 杂志文章
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更新日期:2003-02-07 00:00:00
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pub_type: 杂志文章
doi:10.1161/01.res.45.6.764
更新日期:1979-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2002-08-23 00:00:00