Interní Med. 2003; 5(5): 16-21
Ateroskleróza v neurologii
- MUDr. Michal Dufek
- Cerebrovaskulární centrum, Neurologická klinika, Fakultní nemocnice u sv. Anny, Brno
Keywords: atherosclerosis, stenosis, occlusion, stroke, endarterectomy, angioplasty, stent.
Published: December 31, 2003 Show citation
Dufek M. Ateroskleróza v neurologii. Interní Med. 2003;5(5):16-21.
Ateroskleróza je onemocnění velkých a středních arterií a je charakterizována endoteliální dysfunkcí, vaskulárním zánětem a hromaděním lipidů, cholesterolu, vápníku a buněčného odpadu v cévní stěně. Tyto změny vedou ke vzniku plátu, vaskulární remodelaci, akutní a chronické obstrukci lumina tepny, k abnormalitám krevního průtoku a sníženému zásobení cílových orgánů kyslíkem.
Ateroskleróza tvoří hlavní část neurovaskulární problematiky, setkáváme se s ní zejména u stenotických procesů magistrálních mozkových tepen. Diagnostické a terapeutické možnosti jsou diskutovány.
Atherosclerosis in neurology
Atherosclerosis represents disease of large and medium-sized arteries and is characterized by endothelial dysfunction, vascular inflammation and deposits of lipds, cholesterol, calcium and cell debris in the vessel wall. These changes lead to the development of plaque, vascular remodelation, acute and chronic obstruction of arterial lumen, they cause abnormalities in blood flow and thus decrease oxygen supply to the target organs. Atherosclerosis represents the fundamental part of neurovascular area, for example stenotic processes of principal cerebral arteries. Diagnostic and therapeutic modalities are discussed.
Download citation
References
- Adams HP, delZoppo G, von Kummer R. Management of Stroke Proffesional Communications Inc. Second Edition 2002: 42.
- Biller J, et al. Guidelines for Carotid Endarterectomy. A statement for health care professionals from a special writing group of the stroke council, American Heart Association. Circulation 1998; 97: 501-509.
Go to original source...
Go to PubMed...
- Clark WM, Barnwell SL, Nesbit G, O'Neill OR, Wynn ML, Coull BM. Safety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis. Stroke 1995; 26: 1200-1204.
Go to original source...
Go to PubMed...
- Cloud GC, Markus HS. Diagnosis and Management of Vertebral Artery Stenosis. QJMed 2003; 96: 27-34.
Go to original source...
Go to PubMed...
- Collins R, Peto R, MacMahon S, Herbert P, Fiebach NH, Eberlein KA, Godwin J, Qiyilbash A, Taylor JO, Hennekens CH. Blood presure, stroke and coronary heart disease, part 2: short-term reductions in blood pressure. Overview of randomized drug trials in their epidemiological context. Lancet 1990; 335: 827-838.
Go to original source...
Go to PubMed...
- Connors JJ, Seidenwurm D, Wojak JC, Hurst RW, Jensen ME, Wallace R, Tomsick T, Barr J, Kerber C, Russell E, Nesbit GM, Fox AJ, Tsai FY. Treatment of atherosclerotic disease at the cervical carotid bifurcation: current status and reciew of the literature. AJNR Am J Neuroradiol 2000; 21: 444-450.
- da Silva AF, McCollum P, Szymanska T, de Cossart L. Prospective study of carotid endarterectomy and contralateral carotid occlusion. Br J Surg 1996; 10:1370-1372.
Go to original source...
Go to PubMed...
- EC/IC by pass study group. Failure of extrakranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of a international randomized trial. N Engl J Med 1985; 313: 1191-1200.
- Executive Committee for Asymptomatic Carotid Atherosclerosis Study. Endarte22. North American Symptomatic Carotid Endarterectomy Trial Colaborators. Benefical effect of carotid endarterectomy in symptomatic patients with high-grade carotic stenosis. A Engl J Med 1991; 325: 445-453.
Go to original source...
Go to PubMed...
- Hans C Nahser, Hans Henkes, Werner Weber, Elisabeth Berg-Dammer, Tarek A. Yousry, and Dietmar Kuhne. Intracranial Vertebrobasilar Stenosis: Angioplasty and Follow-up. AJNR Am J Neuroradiol 2000; 21: 1293-1301.
- Higashida RT, Tsai FY, Halbach VV, Dowd CF, Smith T, Fraser K, Hieshima GB. Transluminal angioplasty for atherosclerotic disease of the vertebral and basilar arteries. J Neurosurg 1993; 78: 192-198.
Go to original source...
Go to PubMed...
- Higashida RT, Tsai FY, Halbach VV, Dowd CF, Smith T, Fraser K, Hieshima GB. Transluminal angioplasty for atherosclerotic disease of the vertebral and basilar arteries. J Neurosurg 1993; 78: 192-198.
Go to original source...
Go to PubMed...
- Hobson RW, Weiss DG, Fields WS, et al. Efficacy of carotid endarterectomy for asymptomatic carotid stenosis: The Veterans Affairs Cooperative Study Group. N Engl J Med 1993; 328: 221-227.
Go to original source...
Go to PubMed...
- Chimowitz MI, et el. Prognosis of patients with Symptomatic Vertebral or Basilar artery stenosis. Stroke 1998; 29: 1389-1392.
Go to original source...
Go to PubMed...
- Juan F, Arenillas MD, Carlos A, Molina MD, Joan Montaner MD, S?nia Abilleira MD, Miguel A, González-Sánchez, José Álvarez-Sabín PhD. Progression and Clinical Recurrence of Symptomatic Middle Cerebral Artery Stenosis. A Long-Term Follow-Up Transcranial Doppler Ultrasound Study. Stroke 2001; 32: 2898.
Go to original source...
Go to PubMed...
- MacMahon S, Rodgers A. Blood presure, antihypertensive treatment and stroke risk. J Hypertens Suppl 1994; 12: S5-S14.
- Mayo Asymptomatic Carotid Endarterectomy Study Group. Results of a randomized controlled trial of carotid endarterectomy for asymptomatic carotid stenosis. Mayo Clin Proc 1992; 67: 513-518. rectomy for asymptomatic carotid artery stenosis. JAMA 1995; 273:1421-1428.
Go to original source...
Go to PubMed...
- Michael P Marks MD, Mary Marcellus RN, Alexander M Norbash MD, Gary K Steinberg MD PhD, David Tong MD, Gregory W Albers MD. Outcome of Angioplasty for Atherosclerotic Intracranial Stenosis. Stroke 1999; 30: 1065-1069.
Go to original source...
Go to PubMed...
- Moufarrij NA, Little JR, Furlan AJ, Leatherman JR, William GW. Basilar and diastal vertebral artery stenosis: long term follow up. Stroke 1986; 17: 938-942.
Go to original source...
Go to PubMed...
- Moufarrij NA, Little JR, Furlan AJ, Williams G, Marzewski DJ. Vertebral artery stenosis: long-term follow-up. Stroke 1984; 15: 260-263.
Go to original source...
Go to PubMed...
- Muller-Kuppers M, Graf KJ, Pessin MS, DeWitt LD, Caplan LR. Intracranial vertebral artery disease in the New England Mediacal Center Posterior Circulation Registry. EurNeurol 1997; 37: 146-156.
Go to original source...
- North American Symptomatic Carotid Endarterectomy Trial Colaborators. Benefical effect of carotid endarterectomy in symptomatic patients with high-grade carotic stenosis. A Engl J Med 1991; 325: 445-453.
Go to original source...
Go to PubMed...
- Perry JR, Szalai JP, Norris JW. Consensus against both endarterectomy and routine screening for asymptomatic carotid artery stenosis: Canadian Stroke Consortium. Arch Neurol 1996; 54: 25-28.
Go to original source...
Go to PubMed...
- SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program. JAMA 1991; 265:3255-3264.
Go to original source...
- Shin HK, Yoo KM, Chang HM, Caplan LR. Bilateral intracranial vertebral artery disease in the New England Medical Center, Posterior Circulation Registry. Arch Neurol 1999; 56: 1353-1358.
- The CASANOVA Study Group. Carotid surgery versus medical therapy in asymptomatic carotid stenosis. Stroke 1991; 22: 1229-1235.
Go to original source...
Go to PubMed...
- The Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Study Group. Prognosis of patients with symptomatic vertebral or basilar artery stenosis. Stroke 1998; 29: 1389-1392.
Go to original source...
Go to PubMed...
- Touho H. Percutaneous transluminal angioplasty in the treatment of atherosclerotic disease of the anterior cerebral circulation and hemodynamic evaluation. J Neurosurg 1995; 82: 953-960.
Go to original source...
Go to PubMed...
- Wayne M, Clark MD, Stanley L, Barnwell MD PhD, Gary Nesbit, MD, Oisin R, O'Neill MD, FRCSI Michael L, Wynn DO, Bruce M, Coull MD. Safety and Efficacy of Percutaneous Transluminal Angioplasty for Intracranial Atherosclerotic Stenosis. Stroke 1995; 26: 1200-1204.
Go to original source...
Go to PubMed...
- Wityk RJ, Chang HM, Rosengart A, Han WC, DeWitt LD, Pessin MS, Caplan LR. Proximal extracranial vertebral artery disease in the New England Medical Center Posterior Circulation Registry. Arch Neurol 1998; 55: 470-478.
Go to original source...
Go to PubMed...
- Adams HP, delZoppo G, von Kummer R. Management of Stroke Proffesional Communications Inc. Second Edition 2002: 42.
- Biller J, et al. Guidelines for Carotid Endarterectomy. A statement for health care professionals from a special writing group of the stroke council, American Heart Association. Circulation 1998; 97: 501-509.
Go to original source...
Go to PubMed...
- Clark WM, Barnwell SL, Nesbit G, O'Neill OR, Wynn ML, Coull BM. Safety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis. Stroke 1995; 26: 1200-1204.
Go to original source...
Go to PubMed...
- Cloud GC, Markus HS. Diagnosis and Management of Vertebral Artery Stenosis. QJMed 2003; 96: 27-34.
Go to original source...
Go to PubMed...
- Collins R, Peto R, MacMahon S, Herbert P, Fiebach NH, Eberlein KA, Godwin J, Qiyilbash A, Taylor JO, Hennekens CH. Blood presure, stroke and coronary heart disease, part 2: short-term reductions in blood pressure. Overview of randomized drug trials in their epidemiological context. Lancet 1990; 335: 827-838.
Go to original source...
Go to PubMed...
- Connors JJ, Seidenwurm D, Wojak JC, Hurst RW, Jensen ME, Wallace R, Tomsick T, Barr J, Kerber C, Russell E, Nesbit GM, Fox AJ, Tsai FY. Treatment of atherosclerotic disease at the cervical carotid bifurcation: current status and reciew of the literature. AJNR Am J Neuroradiol 2000; 21: 444-450.
- da Silva AF, McCollum P, Szymanska T, de Cossart L. Prospective study of carotid endarterectomy and contralateral carotid occlusion. Br J Surg 1996; 10:1370-1372.
Go to original source...
Go to PubMed...
- EC/IC by pass study group. Failure of extrakranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of a international randomized trial. N Engl J Med 1985; 313: 1191-1200.
- Executive Committee for Asymptomatic Carotid Atherosclerosis Study. Endarte22. North American Symptomatic Carotid Endarterectomy Trial Colaborators. Benefical effect of carotid endarterectomy in symptomatic patients with high-grade carotic stenosis. A Engl J Med 1991; 325: 445-453.
Go to original source...
Go to PubMed...
- Hans C Nahser, Hans Henkes, Werner Weber, Elisabeth Berg-Dammer, Tarek A. Yousry, and Dietmar Kuhne. Intracranial Vertebrobasilar Stenosis: Angioplasty and Follow-up. AJNR Am J Neuroradiol 2000; 21: 1293-1301.
- Higashida RT, Tsai FY, Halbach VV, Dowd CF, Smith T, Fraser K, Hieshima GB. Transluminal angioplasty for atherosclerotic disease of the vertebral and basilar arteries. J Neurosurg 1993; 78: 192-198.
Go to original source...
Go to PubMed...
- Higashida RT, Tsai FY, Halbach VV, Dowd CF, Smith T, Fraser K, Hieshima GB. Transluminal angioplasty for atherosclerotic disease of the vertebral and basilar arteries. J Neurosurg 1993; 78: 192-198.
Go to original source...
Go to PubMed...
- Hobson RW, Weiss DG, Fields WS, et al. Efficacy of carotid endarterectomy for asymptomatic carotid stenosis: The Veterans Affairs Cooperative Study Group. N Engl J Med 1993; 328: 221-227.
Go to original source...
Go to PubMed...
- Chimowitz MI, et el. Prognosis of patients with Symptomatic Vertebral or Basilar artery stenosis. Stroke 1998; 29: 1389-1392.
Go to original source...
Go to PubMed...
- Juan F, Arenillas MD, Carlos A, Molina MD, Joan Montaner MD, S?nia Abilleira MD, Miguel A, González-Sánchez, José Álvarez-Sabín PhD. Progression and Clinical Recurrence of Symptomatic Middle Cerebral Artery Stenosis. A Long-Term Follow-Up Transcranial Doppler Ultrasound Study. Stroke 2001; 32: 2898.
Go to original source...
Go to PubMed...
- MacMahon S, Rodgers A. Blood presure, antihypertensive treatment and stroke risk. J Hypertens Suppl 1994; 12: S5-S14.
- Mayo Asymptomatic Carotid Endarterectomy Study Group. Results of a randomized controlled trial of carotid endarterectomy for asymptomatic carotid stenosis. Mayo Clin Proc 1992; 67: 513-518. rectomy for asymptomatic carotid artery stenosis. JAMA 1995; 273:1421-1428.
Go to original source...
Go to PubMed...
- Michael P Marks MD, Mary Marcellus RN, Alexander M Norbash MD, Gary K Steinberg MD PhD, David Tong MD, Gregory W Albers MD. Outcome of Angioplasty for Atherosclerotic Intracranial Stenosis. Stroke 1999; 30: 1065-1069.
Go to original source...
Go to PubMed...
- Moufarrij NA, Little JR, Furlan AJ, Leatherman JR, William GW. Basilar and diastal vertebral artery stenosis: long term follow up. Stroke 1986; 17: 938-942.
Go to original source...
Go to PubMed...
- Moufarrij NA, Little JR, Furlan AJ, Williams G, Marzewski DJ. Vertebral artery stenosis: long-term follow-up. Stroke 1984; 15: 260-263.
Go to original source...
Go to PubMed...
- Muller-Kuppers M, Graf KJ, Pessin MS, DeWitt LD, Caplan LR. Intracranial vertebral artery disease in the New England Mediacal Center Posterior Circulation Registry. EurNeurol 1997; 37: 146-156.
Go to original source...
- North American Symptomatic Carotid Endarterectomy Trial Colaborators. Benefical effect of carotid endarterectomy in symptomatic patients with high-grade carotic stenosis. A Engl J Med 1991; 325: 445-453.
Go to original source...
Go to PubMed...
- Perry JR, Szalai JP, Norris JW. Consensus against both endarterectomy and routine screening for asymptomatic carotid artery stenosis: Canadian Stroke Consortium. Arch Neurol 1996; 54: 25-28.
Go to original source...
Go to PubMed...
- SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program. JAMA 1991; 265:3255-3264.
Go to original source...
- Shin HK, Yoo KM, Chang HM, Caplan LR. Bilateral intracranial vertebral artery disease in the New England Medical Center, Posterior Circulation Registry. Arch Neurol 1999; 56: 1353-1358.
- The CASANOVA Study Group. Carotid surgery versus medical therapy in asymptomatic carotid stenosis. Stroke 1991; 22: 1229-1235.
Go to original source...
Go to PubMed...
- The Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Study Group. Prognosis of patients with symptomatic vertebral or basilar artery stenosis. Stroke 1998; 29: 1389-1392.
Go to original source...
Go to PubMed...
- Touho H. Percutaneous transluminal angioplasty in the treatment of atherosclerotic disease of the anterior cerebral circulation and hemodynamic evaluation. J Neurosurg 1995; 82: 953-960.
Go to original source...
Go to PubMed...
- Wayne M, Clark MD, Stanley L, Barnwell MD PhD, Gary Nesbit, MD, Oisin R, O'Neill MD, FRCSI Michael L, Wynn DO, Bruce M, Coull MD. Safety and Efficacy of Percutaneous Transluminal Angioplasty for Intracranial Atherosclerotic Stenosis. Stroke 1995; 26: 1200-1204.
Go to original source...
Go to PubMed...
- Wityk RJ, Chang HM, Rosengart A, Han WC, DeWitt LD, Pessin MS, Caplan LR. Proximal extracranial vertebral artery disease in the New England Medical Center Posterior Circulation Registry. Arch Neurol 1998; 55: 470-478.
Go to original source...
Go to PubMed...