Intracranial Atherosclerotic Disease
Intracranial atherosclerotic disease (ICAD) is the most common proximate mechanism of ischemic stroke worldwide. Approximately half of those affected are Asians. For diagnosis of ICAD, intra-arterial angiography is the gold standard to identify extent of stenosis. However, noninvasive techniques inc...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.4061/2011/282845 |
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| _version_ | 1832560791550689280 |
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| author | Maria Khan Imama Naqvi Asha Bansari Ayeesha Kamran Kamal |
| author_facet | Maria Khan Imama Naqvi Asha Bansari Ayeesha Kamran Kamal |
| author_sort | Maria Khan |
| collection | DOAJ |
| description | Intracranial atherosclerotic disease (ICAD) is the most common proximate mechanism of ischemic stroke worldwide. Approximately half of those affected are Asians. For diagnosis of ICAD, intra-arterial angiography is the gold standard to identify extent of stenosis. However, noninvasive techniques including transcranial ultrasound and MRA are now emerging as reliable modalities to exclude moderate to severe (50%–99%) stenosis. Little is known about measures for primary prevention of the disease. In terms of secondary prevention of stroke due to intracranial atherosclerotic stenosis, aspirin continues to be the preferred antiplatelet agent although clopidogrel along with aspirin has shown promise in the acute phase. Among Asians, cilostazol has shown a favorable effect on symptomatic stenosis and is of benefit in terms of fewer bleeds. Moreover, aggressive risk factor management alone and in combination with dual antiplatelets been shown to be most effective in this group of patients. Interventional trials on intracranial atherosclerotic stenosis have so far only been carried out among Caucasians and have not yielded consistent results. Since the Asian population is known to be preferentially effected, focused trials need to be performed to establish treatment modalities that are most effective in this population. |
| format | Article |
| id | doaj-art-1ef03a0b908941bea64b0cca243d881e |
| institution | Kabale University |
| issn | 2042-0056 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-1ef03a0b908941bea64b0cca243d881e2025-02-03T01:26:39ZengWileyStroke Research and Treatment2042-00562011-01-01201110.4061/2011/282845282845Intracranial Atherosclerotic DiseaseMaria Khan0Imama Naqvi1Asha Bansari2Ayeesha Kamran Kamal3Fellow International Cerebrovascular Translational Clinical Research Training Program, Stroke Service, Aga Khan University Hospital, Karachi 74800, PakistanResearch Officers, Medical College, Aga Khan University Hospital, Karachi 74800, PakistanResearch Officers, Medical College, Aga Khan University Hospital, Karachi 74800, PakistanDirector Stroke Service and Vascular Fellowship Program, Section of Neurology, Department of Medicine, Aga Khan University Hospital, Karachi 74800, PakistanIntracranial atherosclerotic disease (ICAD) is the most common proximate mechanism of ischemic stroke worldwide. Approximately half of those affected are Asians. For diagnosis of ICAD, intra-arterial angiography is the gold standard to identify extent of stenosis. However, noninvasive techniques including transcranial ultrasound and MRA are now emerging as reliable modalities to exclude moderate to severe (50%–99%) stenosis. Little is known about measures for primary prevention of the disease. In terms of secondary prevention of stroke due to intracranial atherosclerotic stenosis, aspirin continues to be the preferred antiplatelet agent although clopidogrel along with aspirin has shown promise in the acute phase. Among Asians, cilostazol has shown a favorable effect on symptomatic stenosis and is of benefit in terms of fewer bleeds. Moreover, aggressive risk factor management alone and in combination with dual antiplatelets been shown to be most effective in this group of patients. Interventional trials on intracranial atherosclerotic stenosis have so far only been carried out among Caucasians and have not yielded consistent results. Since the Asian population is known to be preferentially effected, focused trials need to be performed to establish treatment modalities that are most effective in this population.http://dx.doi.org/10.4061/2011/282845 |
| spellingShingle | Maria Khan Imama Naqvi Asha Bansari Ayeesha Kamran Kamal Intracranial Atherosclerotic Disease Stroke Research and Treatment |
| title | Intracranial Atherosclerotic Disease |
| title_full | Intracranial Atherosclerotic Disease |
| title_fullStr | Intracranial Atherosclerotic Disease |
| title_full_unstemmed | Intracranial Atherosclerotic Disease |
| title_short | Intracranial Atherosclerotic Disease |
| title_sort | intracranial atherosclerotic disease |
| url | http://dx.doi.org/10.4061/2011/282845 |
| work_keys_str_mv | AT mariakhan intracranialatheroscleroticdisease AT imamanaqvi intracranialatheroscleroticdisease AT ashabansari intracranialatheroscleroticdisease AT ayeeshakamrankamal intracranialatheroscleroticdisease |