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Surgical Therapy

Chang Wan Oh, Gary K Steinberg

    Frontiers of Neurology and Neuroscience
    |December 14, 2016
    PubMed

    Insights

    Surgical treatments for intracranial atherosclerosis, including angioplasty, stenting, and decompressive craniectomy, are reviewed. Their controversial benefits for stroke prevention in severe cases are discussed.

    Area of Science:

    • Neurology
    • Neurosurgery
    • Vascular Surgery

    Background:

    • Intracranial atherosclerosis is a significant cause of stroke.
    • Medical management is primary, but surgical interventions are sometimes considered.
    • The efficacy of surgical options for intracranial atherosclerosis remains debated.

    Purpose of the Study:

    • To review surgical therapies for intracranial atherosclerosis.
    • To discuss the role and controversy of surgical interventions in managing stroke risk.

    Main Methods:

    • Literature review of surgical treatments for intracranial atherosclerosis.
    • Focus on angioplasty, stenting, extracranial-intracranial (EC-IC) bypass, and decompressive craniectomy.
    • Exclusion of EC-IC bypass for moyamoya disease.

    Main Results:

    • Angioplasty and stenting are used, but benefits can be limited.
    • EC-IC bypass is considered for severe hemodynamic impairment.
    • Decompressive craniectomy may reduce mortality in massive middle cerebral artery occlusions.

    Conclusions:

    • Surgical interventions for intracranial atherosclerosis present a complex treatment landscape.
    • The benefits of surgical procedures, particularly EC-IC bypass, are controversial and require careful patient selection.
    • Further research is needed to clarify the role of surgery in stroke prevention for this condition.

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