The most common treatments for cerebral atherosclerosis are statin medication, antiplatelet or anticoagulant, and/or antihypertensive. Treatment for cerebrovascular disease includes surgery and/or embolic agents. The combination of antipsychotic and antiplatelet/anticoagulant drugs may yield better results in people suffering from primary or secondary progressive atherothrombosis of the brain.
About half a million Americans develop cerebral infarction (stroke) a year, which can make cerebrovascular disease a major risk factor of ischemia and infarction. Although the term 'cerebral' atherosclerosis' is generally not used for the vast majority of cerebral infarctions, a significant proportion (8.7% of all ischemic stroke in the United States a year) of cerebral infarcts are attributable to arterial disease of the brain affecting the cerebral arteries, predominantly the occlusive disease of the circle of Willis. This can be accurately quantified by CT angiography or MRI.
Cerebral atherosclerosis is the presence of advanced lesions from lipoproteins and fibrin within the brain which can grow substantially. This can occur in any age group, including children. The underlying causes of the formation of atherosclerotic lesions are usually due to genetics, smoking, diabetes and hyperlipidemia and other risk factors. The presence of atherosclerotic plaque in the brain is called cerebrovascular disease (CVD). This is the condition in which the atherosclerotic plaque becomes unstable and forms a thrombus. The thrombi in the brain can be very large and cause ischaemic strokes. This can lead to partial or total brain damage.
Patients with cerebral atherosclerosis can have some improvement in symptoms after statin therapy. But since some patients are non-responsive to statin therapy, further trials and new treatment methods should be considered.
Atherosclerosis of intracranial arteries, the arteries of the brain and the brain's white matter, is found in around 1% of the general population screened for a variety of cardiovascular risk factors. It most often presents as a subacute ischemic-like syndrome but can also occur as a chronic, slowly progressive condition in a form of ‘slow-acting’ atherosclerosis.
Signs of cerebrovascular disease may include headache, visual abnormalities, transient ischemic attacks, strokes, and seizures. Transient ischemic attacks may be the only clinical signs of cerebrovascular disease. Visual symptoms and seizures may not correlate well with focal neurologic signs such as those attributable to an infarct.
We report the first report of successful surgical decompression of cerebral atherosclerosis in humans. We think that this report has the potential to initiate the development of new treatment options for cerebral atherosclerosis.
Cerebral atherosclerosis continues to be an important research point in the recent literature owing to various new findings about the subject in the field of cardiovascular medicine. However, additional long-term follow-up data will be needed in order to evaluate the effects of current research on the prognosis of the subject. Research in this field shows progress in the creation of new treatments and, furthermore, in understanding atherosclerosis as a disease.
In the [Longitudinal Study of Eye and Brain Ageing] study, the average age of diagnosis of cerebral atherosclerosis was 84.3 years, and was about nine (average: 0.1) years earlier than the typical age of diagnosis for stroke, which is about 83.4 years. Given current prevalence of atherosclerosis and current trends in age of onset, these numbers are reassuring.
Results from a recent clinical trial suggests that (a) the ferumoxytol-labeled contrast agent of the [CAT scan] (ICU; Iron), that is most popularly named as Fe and (b) the ferumoxymide-labeled (labeled) paramagnetic contrast agent of the MRI that is called F are both effective and safe for patients with a high-risk for iron-responsive and iron-sensitive brain lesions, respectively, because iron plays a vital role in both these processes.
In patients treated with ferumoxytol injectable product alone, treatment was typically only prescribed at centers with access to magnetic resonance imaging; no other therapies have specifically been identified as being frequently prescribed when used with ferumoxytol.
On the basis of this study, we conclude that cerebral atherosclerosis is genetically dominant and not rare. On the basis of this study, however, we are concerned that future genetic studies might lose power to detect a true association.