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Advances in the diagnosis and treatment of symptomatic intracranial atherosclerotic disease |
| Hongrui Ma1, Xunming Ji2* |
1.Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
2.Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China |
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Abstract Intracranial atherosclerotic disease (ICAD) manifests systemic atherosclerosis in the intracranial arterial bed. It is the most common risk factor for ischemic stroke in Chinese population, with symptomatic ICAD (sICAD) patients at higher stroke risk. Continuous cerebral hypoperfusion and hemodynamic decompensation caused by arterial stenosis or occlusion are the main pathological mechanisms for stroke recurrence and cognitive impairment in sICAD patients. Despite receiving reinforced medical therapy, about 10% of sICAD patients still suffer stroke recurrence. Blood flow reconstruction techniques are not yet established as routine stroke prevention for sICAD due to complex perioperative complications. Limb remote ischemic conditioning (LRIC) can effectively reduce the incidence of ischemic stroke, and composite cerebrovascular diseases, and improve cerebral perfusion, brain metabolism, and cerebrovascular reserve (CVR) in sICAD patients, serving as a novel therapeutic strategy. However, the protective mechanisms of LRIC and the optimal treatment regimen for sICAD still require further exploration. Exploring imaging biomarkers with high sensitivity and specificity for diagnosis is of great significance in evaluating and predicting stroke risk in sICAD patients.
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| Keywords
intracranial atherosclerotic disease
stroke
diagnosis
treatment
hemodynamics
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Issue Date: 25 December 2024
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