Clinical Studies of Severe Cerebrovascular Disease in Recent 20 Years

doi:10.3969/j.issn.1673-5765.2025.05.004

Abstract

Abstract: Severe cerebrovascular disease is the most common type of disease in neurocritical care medicine. Clinical studies in this domain have laid the foundation for clinical practice. Over the past two decades, key and hot topics in the diagnosis and treatment of severe cerebrovascular disease have included: endovascular thrombectomy for anterior circulation stroke with large infarct cores and for posterior circulation ischemic stroke, blood pressure management after reperfusion therapy, decompressive craniectomy for large hemispheric infarction, anti-edema therapy for ischemic stroke, minimally invasive and medical hemostatic treatment for intracerebral hemorrhage, reversal of anticoagulation therapy, blood pressure management during the acute phase of intracerebral hemorrhage, management of ruptured aneurysms in aneurysmal subarachnoid hemorrhage, and monitoring and treatment of delayed cerebral ischemia and elevated intracranial pressure. Addressing these issues, this article outlines key clinical studies conducted by domestic and international scholars, discusses the inspirations drawn from these studies. Based on the summarized clinical research, researchers outline the future research trends in this area.

Key words: Neurology; Critical care medicine; Cerebrovascular disease; Clinical trial; Ischemic stroke; Intracerebral hemorrhage; Subarachnoid hemorrhage

摘要： 重症脑血管病是神经重症医学专业最常见的疾病种类。重症脑血管病领域的研究为此类疾病的临床诊疗奠定了基础。近20年来，重症脑血管病诊疗领域的重点、热点问题有前循环大梗死核心和后循环缺血性卒中的再灌注治疗，以及再灌注治疗后的血压管理，大面积半球性脑梗死去骨瓣减压术，缺血性卒中抗水肿治疗，脑出血的微创手术、药物止血、逆转抗凝治疗，脑出血急性期血压管理，动脉瘤性蛛网膜下腔出血患者破裂动脉瘤的处理，迟发性脑缺血和颅内压增高的监测及处理等。本文概述国内外学者围绕这些问题开展的重要临床研究，探讨其带来的启发，总结重症脑血管病临床研究的发展规律并展望未来研究的趋势。

关键词: 神经病学; 重症医学; 脑血管病; 临床研究; 缺血性卒中; 脑出血; 蛛网膜下腔出血

CLC Number:

ZHANG Zhe, ZHENG Li’na, YANG Zhonghua, LIU Liping. Clinical Studies of Severe Cerebrovascular Disease in Recent 20 Years[J]. Chinese Journal of Stroke, 2025, 20(5): 555-565.

张哲, 郑丽娜, 杨中华, 刘丽萍. 重症脑血管病临床研究20年[J]. 中国卒中杂志, 2025, 20(5): 555-565.

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