nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2014-2S-50-55nnp-424Research ArticleREVIEWSОБЗОРЫIntracranial atherosclerosis: Causes of ischemic stroke, diagnosis, and treatmentАтеросклероз внутричерепных артерий: причины ишемического инсульта, диагностика и лечениеСорокоумовВ.А.SorokoumovV.Avasorokoumov@yandex.ruСавеллоА.В.SavelloA.V.

Кафедра нейрохирургии, 194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

ГБОУ ВПО «Первый Санкт-Петербургский государственный медицинский университет им. И.П. Павлова», Минздрава России, Санкт-ПетербургРоссияI.P. Pavlov Saint Petersburg State Medical University, Ministry of Health of Russia, Saint Petersburg, 6–8, Lev Tolstoy St., Saint Petersburg 197022Russian FederationФГБВОУ ВПО «Военно-медицинская академия им. С.М. Кирова» Минобороны РФ, Санкт-ПетербургРоссияS.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation, Saint Petersburg; 6, Academician Lebedev St., Saint Petersburg 194044Russian Federation20140410201462SSpecial issue "Stroke"5055Copyright © Sorokoumov V., Savello A., 20142014Сорокоумов В., Савелло А.Sorokoumov V., Savello A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/424

The paper reviews the literature on the identification of the causes of ischemic stroke and transient ischemic attacks in intracranial atherosclerosis. Symptomatic intracranial atherosclerosis is the cause of an ischemic focus in not only the cortical and subcortical structures due to hypoperfusion or arterio-arterial embolism, but also in the deep structures of the cerebral hemispheres and brainstem. Major artery dolichoectasia may make an accurate diagnosis and treatment choice difficult.

Progress in the treatment of patients with symptomatic intracranial atherosclerosis depends on the availability of current brain and vessel imaging techniques and cranial artery angioplasty and stenting methods. The efficiency of aggressive medical prevention, primarily blood pressure reduction and different combinations of antiplatelet drugs, is being intensively investigated.

Представлен обзор литературы, посвященный выявлению причин ишемического инсульта и транзиторных ишемических атак при атеросклерозе интракраниальных артерий. «Симптомный» атеросклероз внутричерепных артерий является причиной ишемического очага не только в корково-подкорковых структурах вследствие гипоперфузии или артерио-артериальной эмболии, но и в глубинных структурах больших полушарий и стволе мозга. Долихоэктазия основной артерии может затруднить установление точного диагноза и выбор лечения.

Прогресс в лечении пациентов с «симптомным» атеросклерозом интракраниальных артерий зависит от доступности современных методов визуализации мозга и сосудов, а также методов ангиопластики и стентирования артерий полости черепа.

Активно изучается эффективность «агрессивной» медикаментозной профилактики, прежде всего снижения артериального давления, и различных сочетаний антитромботических препаратов.

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The authors declare that there are no conflicts of interest present.