Intracranial Stenosis

Sharma, Vijay K.; Wong, Ka Sing

doi:10.1002/9781444327373.ch14

Cited by 4 publications

(4 citation statements)

References 59 publications

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“…PI value between .6 and 1.2 was considered normal and a value exceeding 1.2 represented high‐resistance flow pattern. Intracranial stenosis was defined according to the published criteria, validated in our neurovascular laboratory . Patients with insufficient temporal acoustic windows were evaluated after injecting ultrasound contrast agent.…”

Section: Methodsmentioning

confidence: 99%

Poststroke Cognitive Decline is Independent of Longitudinal Changes in Cerebral Hemodynamics Parameters

Suministrado

Shuang

et al. 2016

Journal of Neuroimaging

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Section: Methodsmentioning

confidence: 99%

Poststroke Cognitive Decline is Independent of Longitudinal Changes in Cerebral Hemodynamics Parameters

Suministrado

Shuang

et al. 2016

Journal of Neuroimaging

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“…Intracranial stenosis was diagnosed according to the established criteria. 31 Patients in whom a long stenotic segment involved both the terminal ICA and proximal MCA were classified as having a stenoocclusive disease of the terminal ICA. Stenoocclusive disease of the ICA or MCA was considered severe (> 70%) according to the velocity criteria 38 and the presence of "blunted" flow spectra in the arterial segment distal to the stenosis.…”

Section: Transcranial Doppler Ultrasonographymentioning

confidence: 99%

“…20,37 Various compensatory collateral pathways in patients with severe intracranial stenosis can be evaluated noninvasively with CT angiography, 32 MR angiography, 15 or TCD ultrasonography. 31 Cerebral autoregulation helps in maintaining an adequate regional cerebral blood flow over a wide range of blood pressures by adjusting the diameter of the intracranial arterioles. 21,22 Cerebral perfusion in regions distal to the intracranial stenosis may be normal at rest due to the compensatory vasodilatation.…”

mentioning

confidence: 99%

Improvement in cerebral hemodynamic parameters and outcomes after superficial temporal artery-middle cerebral artery bypass in patients with severe stenoocclusive disease of the intracranial internal carotid or middle cerebral arteries

Low¹,

Teo²,

Lwin³

et al. 2015

JNS

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Tc HMPAO) SPECT. STA-MCA bypass surgery was offered to patients with impaired CVR on SPECT. All patients underwent TCD and SPECT at 4 ± 1 months and were followed up for cerebral ischemic events. results A total of 112 patients were included. This total included 73 men, and the mean age of the entire study population was 56 years (range 23-78 years). 99mTc HMPAO SPECT demonstrated impaired CVR in 77 patients (69%). Of these 77 patients, 46 underwent STA-MCA bypass while 31 received best medical treatment. TCD and acetazolamidechallenge 99m Tc HMPAO SPECT repeated at 4 ± 1 months showed significant improvement in the STA-MCA bypass group. During a mean follow-up of 34 months (range 18-39 months), only 6 (13%) of 46 patients in the bypass group developed cerebral ischemic events, as compared with 14 (45%) of 31 patients receiving medical therapy (absolute risk reduction 32%, p = 0.008). coNclusioNs STA-MCA bypass surgery in carefully selected patients with symptomatic severe intracranial stenoocclusive disease of the intracranial ICA or MCA results in significant improvement in hemodynamic parameters and reduction in stroke recurrence.http://thejns.org/doi/abs/10.3171/2014.11.JNS141553KeY words acute ischemic stroke; intracranial atherosclerosis; cerebral vasodilatory reserve; SPECT; external carotid-internal carotid bypass; superficial temporal artery; middle cerebral artery; bypass; vascular disorders 662©AANS, 2015 ec-ic bypass for intracranial stenosis

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“…Complete TCD evaluation would be performed with a 2 MHz pulse wave Doppler probe using the commercially available TCD machine. Intracranial stenosis would be diagnosed according to the established as well as locally validated criteria ( 47 , 48 ). ICAD would be considered severe (>70%) according to the velocity criteria and presence of “blunted” flow spectra in the arterial segment distal to the stenosis ( 49 ).…”

Section: Baseline Evaluationmentioning

confidence: 99%

Enhanced external counter pulsation therapy in patients with symptomatic and severe intracranial steno-occlusive disease: a randomized clinical trial protocol

Sharma,

Gopinathan,

Tan

et al. 2023

Front. Neurol.

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Intracranial stenosis is prevalent among Asians and constitutes a common cause of cerebral ischemia. While the best medical therapy carries stroke recurrence rates in excess of 10% per year, trials with intracranial stenting have been associated with unacceptable peri-procedural ischemic events. Cerebral ischemic events are strongly related to the severity of intracranial stenosis, which is high in patients with severe intracranial stenosis with poor vasodilatory reserve. Enhanced External Counter Pulsation (EECP) therapy is known to improve myocardial perfusion by facilitating the development of collateral blood vessels in the heart. In this randomized clinical trial, we evaluate whether EECP therapy may be useful in patients with severe stenosis of intracranial internal carotid (ICA) or middle cerebral artery (MCA). The review of literature, methods of evaluation, status of currently used therapeutic approaches, and trial protocol have been presented.Clinical trial registrationClinicalTrials.gov, Identifier: NCT03921827.

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Intracranial Stenosis

Cited by 4 publications

References 59 publications

Poststroke Cognitive Decline is Independent of Longitudinal Changes in Cerebral Hemodynamics Parameters

Poststroke Cognitive Decline is Independent of Longitudinal Changes in Cerebral Hemodynamics Parameters

Improvement in cerebral hemodynamic parameters and outcomes after superficial temporal artery-middle cerebral artery bypass in patients with severe stenoocclusive disease of the intracranial internal carotid or middle cerebral arteries

Enhanced external counter pulsation therapy in patients with symptomatic and severe intracranial steno-occlusive disease: a randomized clinical trial protocol

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