Related Experiment Video

Updated: Mar 22, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.7K

The contemporary management of intracranial atherosclerotic disease

Xinyi Leng1, Ka Sing Wong1, Thomas W Leung1

  • 1a Department of Medicine & Therapeutics , The Chinese University of Hong Kong , Hong Kong SAR , China.

Expert Review of Neurotherapeutics
|April 16, 2016
PubMed

Insights

Intracranial atherosclerotic disease is a major cause of stroke, particularly in certain ethnicities. Aggressive risk factor management and antiplatelet therapy are key for secondary prevention in symptomatic patients.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Public Health

Background:

  • Intracranial atherosclerotic disease (ICAD) is a leading cause of stroke and cerebral vasculopathy globally.
  • Prevalence is higher in Asian, Hispanic, and African populations, posing significant public health challenges.
  • Symptomatic ICAD carries a substantial risk of recurrent stroke within one year.

Purpose of the Study:

  • To review the current understanding and management strategies for intracranial atherosclerotic disease.
  • To highlight the importance of secondary stroke prevention through risk factor modification.
  • To discuss contemporary and emerging treatment options for ICAD.

Main Methods:

  • Literature review of studies on intracranial atherosclerotic disease.
  • Analysis of epidemiological data and risk factor prevalence.
  • Evaluation of current and investigational therapeutic interventions.

Main Results:

  • Aggressive control of cardiovascular risks (glycemic, blood pressure, lipids) and antiplatelet therapy are crucial for secondary prevention.
  • For high-grade symptomatic steno-occlusion, dual antiplatelet therapy followed by single antiplatelet therapy may reduce recurrence.
  • Percutaneous transluminal angioplasty and stenting are not currently recommended as initial treatment.

Conclusions:

  • Effective secondary prevention of stroke from ICAD relies on understanding stroke mechanisms and managing conventional risk factors.
  • Current evidence supports medical management, including antiplatelet therapy, over revascularization for most patients.
  • Further research is needed to identify high-risk patients and evaluate novel therapies.

Keywords:
Intracranial atherosclerotic diseaseanticoagulationantiplateletpercutaneous transluminal angioplasty and stentingrecurrencestroketreatment

More Related Videos

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations14:58

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

10.4K
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms11:58

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

Published on: August 11, 2015

16.6K

Related Concept Videos

Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
573
Atherosclerosis IV: Nursing Management01:23

Atherosclerosis IV: Nursing Management

Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
559
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
431
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
441
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
395
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
543