Intracranial atherosclerosis: the current state of the problem (literature review)

This review presents current data on the epidemiology, pathogenesis, diagnosis and treatment of intracranial atherosclerosis — one of the most relevant areas of vascular neurology of the last decade. Intracranial atherosclerosis is a common cause of ischemic stroke worldwide, accounting for up to half of all ischemic strokes in South-East Asia, Latin America and Africa. Research is actively underway to assess the prevalence of intracranial atherosclerosis among the Caucasian race. New diagnostic methods for the study of intracranial atherosclerosis appear every year, in particular, the introduction of high-resolution magnetic resonance imaging of the vascular wall, the search for specific blood biomarkers broaden horizons of research in this field even at the earliest asymptomatic stages of the disease. Treatment and prevention in this cohort of patients remain ambiguous, given the high risk of recurrence of ischemic stroke. Most studies (SAMMPRIS, VISSIT, VAST) relate to the comparison of aggressive drug treatment with endovascular surgical treatment techniques. According to the latest research results, antiplatelet therapy has a significant advantage in preventing stroke.