Intracranial Arterial Stenosis

• Type: Another Publication in an International Scientific Journal
• Date: 2014

Authors

Carvalho, M (Author) Other; Oliveira, A (Author) Other; Elsa Azevedo (Author) FMUP; Bastos-Leite AJ (Author) FMUP

Journal

Title: Journal of Stroke and Cerebrovascular Diseases

Vol. 23

Pages: 599-609

ISSN: 1052-3057

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 36 Citations

Scopus - 42 Citations

Other information

Authenticus ID: P-009-9QQ

DOI: 10.1016/j.jstrokecerebrovasdis.2013.06.006

Abstract (EN): Intracranial arterial stenosis (IAS) is usually attributable to atherosclerosis and corresponds to the most common cause of stroke worldwide. It is very prevalent among African, Asian, and Hispanic populations. Advancing age, systolic hypertension, diabetes mellitus, high levels of low-density lipoprotein cholesterol, and metabolic syndrome are some of its major risk factors. IAS may be associated with transient or definite neurological symptoms or can be clinically asymptomatic. Transcranial Doppler and magnetic resonance angiography are the most frequently used ancillary examinations for screening and follow-up. Computed tomography angiography can either serve as a screening tool for the detection of IAS or increasingly as a confirmatory test approaching the diagnostic accuracy of catheter digital subtraction angiography, which is still considered the gold (confirmation) standard. The risk of stroke in patients with asymptomatic atherosclerotic IAS is low (up to 6% over a mean follow-up period of approximately 2 years), but the annual risk of stroke recurrence in the presence of a symptomatic stenosis may exceed 20% when the degree of luminal narrowing is 70% or more, recently after an ischemic event, and in women. It is a matter of controversy whether there is a specific type of treatment other than medical management (including aggressive control of vascular risk factors and antiplatelet therapy) that may alter the high risk of stroke recurrence among patients with symptomatic IAS. Endovascular treatment has been thought to be helpful in patients who fail to respond to medical treatment alone, but recent data contradict such expectation.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 11