The natural history of intracranial carotid artery atherosclerosis

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Intracranial atherosclerosis is the cause of a significant number of strokes. Despite maximal medical therapy, this disease continues to carry a poor prognosis. The authors reviewed studies in which the outcomes after conservative management in patients with intracranial carotid artery atherosclerosis were reported. Analysis of the literature demonstrates that maximal medical therapy frequently fails with this disease, leaving patients at high risk for cerebral infarction and death. A better understanding of the pathophysiological aspects and natural history of this condition may serve to guide clinical decision making and the choice of therapeutic options in this patient population.

Abbreviations used in this paper:CA = carotid artery; ICA = internal CA; TIA = transient ischemic attack.

Intracranial atherosclerosis is the cause of a significant number of strokes. Despite maximal medical therapy, this disease continues to carry a poor prognosis. The authors reviewed studies in which the outcomes after conservative management in patients with intracranial carotid artery atherosclerosis were reported. Analysis of the literature demonstrates that maximal medical therapy frequently fails with this disease, leaving patients at high risk for cerebral infarction and death. A better understanding of the pathophysiological aspects and natural history of this condition may serve to guide clinical decision making and the choice of therapeutic options in this patient population.

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Address reprint requests to: Philip M. Meyers, M.D., Columbia University College of Physicians and Surgeons, Neurological Institute of New York, 710 West 168th Street, Room 423, New York, NY 10032. email: pmm2002@columbia.edu.

© AANS, except where prohibited by US copyright law.

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