TY - CHAP M1 - Book, Section TI - Intracranial Arterial Disease A1 - Tummala, Ramachandra P. A1 - Jahromi, Babak S. A1 - Hopkins, L. Nelson A2 - Dieter, Robert S. A2 - Dieter, Raymond A. A2 - Dieter, Raymond A. Y1 - 2009 N1 - T2 - Peripheral Arterial Disease AB - All aspects of the management of intracranial arterial disease have undergone major transformations in the past two decades. Alternatives are now available for conditions previously treatable only with a single modality. Moreover, some conditions that would have been considered untreatable in the past now have safe and effective therapies. Although the credit for these advances is attributable to many factors, several fundamental achievements are recognized. First, the advances in noninvasive diagnostic neuroimaging, namely, computed tomographic (CT) and magnetic resonance (MR) imaging and their respective variants have resulted in the increased detection of asymptomatic vascular lesions and improved diagnostic sensitivity. As will be discussed later, this early detection presents a clinical dilemma in determining the appropriate management on the basis of the natural history of specific lesions. Second, the refinement of microneurosurgical techniques has resulted in improved surgical outcomes. This experience has also allowed us to recognize the limitations of cerebrovascular surgery. Third, the advances in neurological critical care have resulted in improved morbidity rates and shorter hospitalizations. Finally, the emergence of neuroendovascular therapy into a multidisciplinary field involving neurosurgeons, neurologists, and radiologists has changed practice patterns dramatically. The ongoing explosion in endovascular advances has allowed for catheter-based therapeutics in virtually every aspect of cerebrovascular disease. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesscardiology.mhmedical.com/content.aspx?aid=1127166820 ER -