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Permanent Cerebral Vessel Occlusion via Double Ligature and Transection

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection

Published on: July 21, 2013

Intracranial arterial stenosis.

Marta Carvalho¹, Ana Oliveira¹, Elsa Azevedo¹

¹Department of Neurology, Hospital de São João, Porto, Portugal; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association

|July 16, 2013

Summary

Intracranial arterial stenosis (IAS), a leading cause of stroke, affects diverse populations. While medical management is standard, endovascular treatments show limited benefit for symptomatic cases.

Keywords:

Atherosclerosis epidemiology intracranial arterial stenosis management and treatment middle cerebral artery stenosis middle cerebral artery stroke neuroimaging pathophysiology vascular risk factors

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Permanent Cerebral Vessel Occlusion via Double Ligature and Transection

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Published on: July 21, 2013

Transient Middle Cerebral Artery Occlusion Model of Stroke

Transient Middle Cerebral Artery Occlusion Model of Stroke

Published on: August 11, 2023

Area of Science:

Neurology
Vascular Medicine
Radiology

Background:

Intracranial arterial stenosis (IAS) is a primary cause of stroke globally, particularly prevalent in specific ethnic groups.
Key risk factors include advanced age, hypertension, diabetes, high LDL cholesterol, and metabolic syndrome.
IAS can manifest with neurological symptoms or be asymptomatic.

Purpose of the Study:

To review the epidemiology, risk factors, diagnostic methods, and treatment controversies of intracranial arterial stenosis.
To evaluate the stroke risk associated with asymptomatic and symptomatic IAS.
To discuss the role of medical versus endovascular interventions.

Main Methods:

Review of existing literature on intracranial arterial stenosis.
Analysis of diagnostic modalities including Transcranial Doppler, MR Angiography, CT Angiography, and DSA.
Assessment of stroke risk based on stenosis severity, symptoms, and patient demographics.

Main Results:

Stroke risk is low for asymptomatic IAS but high for symptomatic cases, especially with severe stenosis (>70%) in women or after recent events.
Catheter digital subtraction angiography remains the gold standard for diagnosis.
Medical management (risk factor control, antiplatelets) is the mainstay; endovascular treatment efficacy is debated.

Conclusions:

IAS is a significant stroke risk factor requiring aggressive medical management.
The benefit of endovascular treatment over medical therapy for symptomatic IAS is not clearly established and may be limited.
Further research is needed to clarify optimal treatment strategies for high-risk patients.