Zeenat Qureshi Stroke Institute and CentraCare Health, St Cloud, MN, USA.
Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Lancet. 2014 Mar 15;383(9921):984-98. doi: 10.1016/S0140-6736(13)61088-0. Epub 2013 Sep 2.
Atherosclerotic disease often involves the intracranial arteries including those encased by cranial bones and dura, and those located in the subarachnoid space. Age, hypertension, and diabetes mellitus are independent risk factors for intracranial atherosclerosis. Intracranial atherosclerosis can result in thromboembolism with or without hypoperfusion leading to transient or permanent cerebral ischaemic events. High rates of recurrent ischaemic stroke and other cardiovascular events mandate early diagnosis and treatment. Present treatment is based on a combination of antiplatelet drugs, optimisation of blood pressure and LDL cholesterol values, and intracranial angioplasty or stent placement, or both, in selected patients.
动脉粥样硬化性疾病常累及颅内动脉,包括颅骨和硬脑膜包裹的动脉,以及蛛网膜下腔的动脉。年龄、高血压和糖尿病是颅内动脉粥样硬化的独立危险因素。颅内动脉粥样硬化可导致血栓栓塞,伴有或不伴有灌注不足,导致短暂性或永久性脑缺血事件。复发性缺血性卒中和其他心血管事件的高发生率需要早期诊断和治疗。目前的治疗基于抗血小板药物的联合应用,优化血压和 LDL 胆固醇水平,并在选定的患者中进行颅内血管成形术或支架置入术,或两者兼施。