지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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초록· 키워드
오류제보하기
Intracerebral hemorrhage (ICH) and lacunar infarction (LI) are the major acute clinical manifestations of cerebral small vessel diseases (cSVDs). Hypertensive small vessel disease, cerebral amyloid angiopathy, and hereditary causes, such as Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL), constitute the three common cSVD categories. Diagnosing the underlying vascular pathology in these patients is important because the risk and types of recurrent strokes show significant differences. Recent advances in our understanding of the cSVD-related radiological markers have improved our ability to stratify ICH risk in individual patients, which helps guide antithrombotic decisions. There are general goodpractice measures for stroke prevention in patients with cSVD, such as optimal blood pressure and glycemic control, while individualized measures tailored for particular patients are often needed. Antithrombotic combinations and anticoagulants should be avoided in cSVD treatment, as they increase the risk of potentially fatal ICH without necessarily lowering LI risk in these patients. Even when indicated for a concurrent pathology, such as nonvalvular atrial fibrillation, nonpharmacological approaches should be considered in the presence of cSVD. More data are emerging regarding the presentation, clinical course, and diagnostic markers of hereditary cSVD, allowing accurate diagnosis, and therefore, guiding management of symptomatic patients. When suspicion for asymptomatic hereditary cSVD exists, the pros and cons of prescribing genetic testing should be discussed in detail in the absence of any curative treatment. Recent data regarding diagnosis, risk stratification, and specific preventive approaches for both sporadic and hereditary cSVDs are discussed in this review article.
목차
등록된 정보가 없습니다.
참고문헌 (101)
참고문헌 신청
Adams HP Jr / 1993 / Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment / Stroke 24:35~41
Pantoni L / 2010 / Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges / Lancet Neurol 9:689~701
Qureshi AI / 2001 / Spontaneous intracerebral hemorrhage / N Engl J Med 344:1450~1460
Gurol ME / 2008 / Management of intracerebral hemorrhage / Curr Atheroscler Rep 10:324~331
송태진 / 2017 / Total Cerebral Small-Vessel Disease Score is Associated with Mortality during Follow-Up after Acute Ischemic Stroke / Journal of Clinical Neurology 13(2):187~195
Pantoni L / 2010 / Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges / Lancet Neurol 9:689~701
Qureshi AI / 2001 / Spontaneous intracerebral hemorrhage / N Engl J Med 344:1450~1460
Gurol ME / 2008 / Management of intracerebral hemorrhage / Curr Atheroscler Rep 10:324~331
송태진 / 2017 / Total Cerebral Small-Vessel Disease Score is Associated with Mortality during Follow-Up after Acute Ischemic Stroke / Journal of Clinical Neurology 13(2):187~195
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