Diagnosis and Treatment of Intracranial Stenoses

Clinical Neuroradiology
W ReithO Jansen

Abstract

Stroke is one of the most frequent and most significant vascular diseases. According to estimates, 16.9 million people suffered a stroke in 2010, and over one-third of the incidents were lethal. The risk of suffering a stroke due to intracranial stenosis is between 7 and 24%. As opposed to extracranial stenoses of the internal carotid artery, there is no standardized treatment concept for intracranial stenoses. At present, treatment with a low daily dose of 100 mg aspirin is recommended by the guidelines for intracranial stenoses to additionally prevent dose-dependent gastrointestinal side effects and bleeding complications. The WINGSPAN study showed stroke rates and mortality rates amounting to 4.5% after 30 days and 7.0% after 6 months. The Stenting versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis study is a randomized, multicenter study that compared endovascular stent treatment in patients with symptomatic arteriosclerotic intracranial stenoses with intensified drug therapy. After the inclusion of 451 of 764 study patients planned initially, study recruitment was terminated prematurely because the stroke rate or mortality rate within 30 days was 14.7% in the endovascular treatmen...Continue Reading

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