Practical Approach to Management of Intracranial Atherosclerosis

Cerebrovascular Disease and Stroke (N Rost, Section Editor)
First Online:
Part of the following topical collections:
  1. Topical Collection on Cerebrovascular Disease and Stroke

Opinion statement

Intracranial atherosclerosis (ICAS) is one of the most frequent causes of stroke worldwide and has a high incidence of recurrent stroke. The therapeutic approaches for treating this high-risk disease have been evolving over time. The most recent, evidence-based approach is to focus on aggressive medical management of vascular risk factors and includes short-term dual antiplatelet treatment for 90 days followed by antiplatelet monotherapy. The role of endovascular therapy in the treatment of ICAS has not been established and is currently reserved only for patients who have failed aggressive medical management with recurrent ischemic events. There are no currently recommended surgical options to treat ICAS; however, investigational treatments such as encephaloduroarteriosynagiosis (EDAS) may hold promise. Despite aggressive medical management with short-term dual antiplatelet therapy, there remains a subset of patients with severe ICAS who will have recurrence of ischemic events. Further research is needed to better identify this high-risk subset and develop novel treatments to prevent further stroke and death.

Keywords

Intracranial atherosclerosis Cerebrovascular disease treatment Secondary stroke prevention Treatment intracranial atherosclerosis 
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Notes

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Jessica Hannah and Dr. Shelly Ozark each declare no potential conflicts of interest.

Dr. Tanya N. Turan reports REDUCE Trial-Clinical Events Committee with Gore & Associates, grants with NIH (SAMMPRIS Trial-Executive Committee, Director Risk Factor Management) and NIH/NINDS (CHIASM-Characterization of Intracranial Atherosclerotic Stenosis Using HR MRI), Clinical Trial Neurology Event Adjudication Committee (BI 1356/BI 10773), and serving on the event adjudication committee for NIH.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.MUSC Stroke ProgramDepartment of NeurologyCharlestonUSA

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