Treatment and prognosis of middle cerebral artery stenosis

Abstract

Intracranial arterial stenosis is the most common vascular lesions in patients with acute stroke in Chinese population, and most of them are middle cerebral artery （MCA） stenosis. The treatment of asymptomatic MCA stenosis is mainly to control the risk factors and treat with drugs, and the prognosis is better. Statins can reduce new stroke events. The treatment programs of symptomatic MCA stenosis are mainly to control the risk factors, treat with drugs and stenting. Now it is considered that anticoagulants are not superior to antiphtelet drugs in the treatment of MCA stenosis, but whether dual antiplatelet drugs are superior to monotherapy and stenting remains to be determined. The prognosis of symptomatic MCA stenosis is poor. The prognosis of acute phase mainly depends upon imaging features, and the risk of recurrent stroke is primarily associated with the MCA stenosis. Future research should focus on whether dual antiplatelet therapy is superior to monotherapy, and whether stenting is superior to drug treatment, as well as the relationship between the degree of MCA stenosis and prognosis of acute phase or the risk of recurrent stroke. Key words: Intracranial Arteriosclerosis; Middle Cerebral Artery; Angioplasty, Balloon; Stents; Recurrence; Treatment Outcome; Prognosis