, Volume 35, Issue 8, pp 1311-1312
Date: 19 Mar 2014

Evidence-based optimization of the management of intracranial atherosclerotic disease

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Dear Editor,

The recently published article in Neurological Sciences by Mattioni et al. [1] titled ‘Prevalence of intracranial large artery stenosis and occlusion in patients with acute ischaemic stroke or TIA’ was very interesting. The authors retrospectively evaluated all consecutive patients who presented with an ischemic stroke or transient ischemic attack (TIA) and also underwent computed tomography angiography (CTA) in the emergency room of a single institution in The Netherlands over a 2-year span. Of the 220 patients included for analysis, 39 % were found to have intracranial atherosclerotic disease (ICAD) including 35 % with intracranial arterial occlusion, 6 % with stenosis, and 2 % with both. Multivariate analysis identified only extracranial carotid disease and partial or total anterior circulation syndromes as predictors of symptomatic ICAD.

Given the contribution of ICAD to ischemic cerebrovascular disease, optimizing its management has been the source of significant debate ...