Türk Beyin Damar Hast Derg. 2019; 25(1): 1-10 | DOI: 10.5505/tbdhd.2019.47855

Ýntrakranial aterosklerotik hastalýða yaklaþým

Bilgehan Atýlgan Acar¹, Atilla Özcan Özdemir^2
1Sakarya Üniversitesi Týp Fakültesi, Nöroloji Anabilim Dalý, Sakarya
²Eskiþehir Osmangazi Üniversitesi Týp Fakültesi Nöroloji Anabilim Dalý, Eskiþehir

Ýntrakranial aterosklerotik hastalýk (ÝKAH), iskemik inmenin genellikle göz ardý edilen önemli bir nedenidir. Son yýllarda görüntüleme tekniklerindeki geliþmeler ve de konvansiyonel kateter anjiografi ile endovasküler giriþimsel iþlemlerin inme pratiðinde kullanýmýnýn artmasý sayesinde, günümüzde iskemik inme ve geçici iskemik atak etyolojisi ile çok daha fazla iliþkilendirilmeye baþlanmýþtýr. Asyalý'larda, Ýspanik ve Afrika kökenli Amerikalý'larda, beyaz ýrka oranla daha sýk görülmesi, inmenin bu alt grubunun ýrk-etnisite açýsýndan heterojen eðilimini göstermektedir. ÝKAH'da inme, trombotik oklüzyon, arterden artere emboli, hemodinamik iskemi ve penetran damar oklüzyonu þeklinde farklý mekanizmalar altýnda geliþebilir ve üstelik ýlýmlý stenoz (<%50) varlýðýnda dahi klinik olarak anlamlý bulgular görülebilmektedir. Rekürren inmelerin ÝKAH'da sýk görülmesinde bu farklý mekanizmalarýn rolü olup olmadýðý, taný ve tedavide hangi stratejilerin uygulanmasý gerektiði cevap bekleyen sorulardandýr. Bu derlemede ÝKAH'a yaklaþým güncel yayýnlar eþliðinde tartýþýlacaktýr.

Anahtar Kelimeler: Ateroskleroz, inme, intrakranial, intrakranial aterosklerotik hastalýk.

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Management of intracranial atherosclerotic disease

Bilgehan Atýlgan Acar¹, Atilla Özcan Özdemir^2
1Sakarya University Faculty of Medicine, Department of Neurology, Sakarya, Turkey
²Eskiþehir Osmangazi University Faculty of Medicine, Department of Neurology, Eskiþehir, Turkey

Intracranial Atherosclerotic Disease (ICAD) is a significant cause of ischemic stroke which is used to be neglected. Due to developments in imaging technologies as well as increased use of endovascular interventional procedures and conventional catheter angiography on practice of stroke, ICAD found being much more associated with the etiology of ischemic stroke and transient ischemic attack today. That it is more common among Asians, Hispanics and Afro-Americans compared to caucasians indicates the heterogeneous tendency of this subgroup of stroke in terms of race and ethnicity. Stroke due to ICAD occurs in various mechanisms such as thrombotic occlusion, artery to artery embolism, hemodynamic ischemia and penetrating vascular occlusion, and moreover, clinically significant findings can be seen in the presence of moderate stenosis (<%50). It is required to be clarified whether such various mechanisms have a role in frequent occurrence of recurrent strokes in ICAD, and which strategies are required to be applied in diagnosis and treatment. In this review, the management of ICAD will be discussed in accompaniment of current publications.

Keywords: Atherosclerosis, stroke, intracranial, intracranial atherosclerotic disease.

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