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Topics:
Neurology • Vascular Neurology
Do you recommend any medical management for patients with evidence of intracranial atherosclerosis without evidence for stroke?
Answer from: at Community Practice
I would focus more on primary prevention strategies, including lifestyle modifications and high-intensity statin therapy if LDL is elevated. The evidence supporting antiplatelet therapy for primary prevention in patients with stroke risk or intracranial atherosclerosis is either lacking or not stron...
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Answer from: at Community Practice
Agree with the above answers. I also look at the presence of microvascular changes, and if present at Fazeka 2 or higher grades (with or without silent infarct), then in addition to strict risk factor control, screening and management of underlying sleep disorders, I do start an antiplatelet, provid...
Answer from: at Academic Institution
If the MRI shows no silent strokes, antiplatelet meds would be considered if the patient has significant vascular risk factors.
Answer from: at Community Practice
As long as there are no contraindications, prophylaxis seems logical.