Intracranial stenosis is a vascular stenosis of brain-supplying arteries in the skull. Stenoses are frequent in brain-supplying arteries but most frequently in arteria cerebri media und arteria basilaris as well as the intracranial arteria carotis interna.
Intracranial stenosis has, if symptomatic and not yet treated, a very high risk of an apoplectic stroke and should be treated urgently.
The conservative drug therapy (either platelet aggregation inhibition drugs like ASS or Clopidogrel) is not very successful. Marcumar should not be applied because it is not more effective than ASS but has a significantly higher bleeding complication rate.
The most appropriate treatment of intracranial stenosis is the neuroradiological-interventional treatment. This is either a widening of the vessels by means of a balloon (dilatation) or stent placement. Based on our experiences, the stent should be a drug eluting stent (DES). The stent placement in case of carotid stenosis comes along with local anesthetic whereas intracranial stent placement necessitates general anesthetic.