Interview with Prof. Song Haiqing: Essentials of Recognition and Management of Cerebral Small Vessel Diseases CSA & TISC 2021

On July 9-11, the 7th Annual Conference of the Chinese Stroke Society and the Tiantan International Cerebrovascular Disease Conference 2021 (CSA & TISC 2021) were successfully held in Beijing in the form of offline + online conferences
.

During the meeting, Yimaitong had the honor to interview Professor Song Haiqing from the Department of Neurology, Xuanwu Hospital of Capital Medical University, on issues related to the identification and management of cerebrovascular diseases
.

The author of this article: Yimaitong Tiantan will report the report group Yimaitong organizes the report, please do not reprint without authorization
.

Professor Song Haiqing, PhD in Neurology, Xuanwu Hospital of Capital Medical University, Chief Physician, Deputy Director of Neurology Department, Xuanwu Hospital of Capital Medical University
.

Secretary-General of the Neurology Branch of the China Association for the Promotion of International Medical and Health Care, Stroke Prevention and Treatment Engineering Expert of the National Health Commission, Brain Prevention Committee, Chairman of the Drug-induced Diseases Committee of the Chinese Pharmacological Society Chairman of the Stroke Branch of the Beijing Association of Integrative Medicine and Chinese Medical Association Member of the Rehabilitation Group of the Neurology Branch Member of the Cerebrovascular Diseases Group of the Neurology Branch of the Chinese Medical Doctor Association Deputy Chairman of the Brain Function Testing and Regulation Rehabilitation Committee of the Chinese Rehabilitation Medicine Association Secretary-General and Deputy Chairman of the Neurology Branch of the Chinese Medical Education Association China Executive Director of the Stroke Society, Vice President, Beijing Association for Cerebrovascular Disease Prevention and Treatment (Beijing Stroke Society), Deputy Director, Beijing Stroke Quality Control Center, Deputy Director, Internet Medical Diagnosis and Treatment Technology, National Engineering Laboratory, Deputy Director, "Journal of Cerebrovascular Disease", Editorial Board, "Chinese Brain Yi Maitong, editorial board member of the Journal of Vascular Diseases, the Journal of Adverse Drug Reactions, and the editorial board of the Chinese Journal of Cerebrovascular Diseases: Cerebrovascular disease can increase the cognitive impairment and stroke risk of patients, but it is usually in clinical practice.
It is only discovered during MRI examination, so what can we do to prevent and control this risk? The so-called cerebrovascular disease of Professor Song Haiqing is actually not a disease in the general sense.
The traditional disease is that the patient has specific symptoms and then undergoes an examination, finds some basic lesions, and finally determines the cause for intervention and treatment
.

But cerebrovascular disease is a disease related to aging.
In other words, it is a disease that is gradually progressing and manifests in the form of a small stroke without particularly prominent symptoms
.

In fact, the patients are still relatively lucky.
If the cognitive screening, management and follow-up are started after the patient has a minor stroke, then the risk of cognitive impairment in the future can be predicted or reduced earlier
.

Because as long as patients with small blood vessel disease appear clinically, the risk of transforming to cognitive impairment in the future will increase
.

At present, with the popularization of imaging examinations, the elderly should focus on brain health during normal health examinations or self-health management
.

If possible, it is recommended to do brain imaging examinations.
These can detect cerebral small vessel disease as soon as possible, and then discover the risk of cerebral small vessel disease causing cognitive impairment, and can also reduce the risk of cognitive impairment in the future
.

In addition, more importantly, if there is no condition to do such an accurate examination, the occurrence and progression of cerebral small vessel disease can also be reduced by controlling the risk factors of blood vessels, so as to reduce the risk of cognitive impairment caused by cerebral small vessel disease
.

Yimaitong: In order to reduce the risk of stroke, what protective measures should be taken for patients with cerebral small vessel disease? Professor Song Haiqing’s stroke is actually a serious health threat.
Acute cerebrovascular disease is usually defined as stroke
.

Once a stroke occurs, it needs to be recognized as soon as possible.
If it is an ischemic stroke, such as cerebral infarction, it needs to be recanalized as soon as possible, and the ischemic brain tissue is reperfused in time, so that the patient's risk of disability and death Will be significantly reduced, especially the risk of disability will be significantly reduced
.

We are a major country with cerebrovascular diseases, and the incidence of stroke is also on the rise
.

If we can move the entire prevention threshold of stroke forward, we can really change the huge health and economic burden caused by stroke, that is, the control of stroke risk factors that we know so far, and the management of people at high risk of stroke
.

For example, the management of blood pressure, blood sugar, blood lipids and bad habits of such patients, such as smoking cessation, hypertonic chronic hemolysis, and folic acid deficiency
.

Implement a series of protective measures ranging from nutrition to life>
.

Yimaitong: For patients with cerebral small vessel disease, especially those with cerebral microhemorrhage, what should be paid attention to when other diseases are complicated, such as when patients need anticoagulation and antiplatelet therapy? Professor Song Haiqing As the sequence of MRI becomes more and more abundant, we can easily find cerebral microhemorrhage lesions at present
.

Initially we thought that cerebral microhemorrhage may be a very important imaging manifestation, but as the research continues, we have found that it may increase the additional risk of cerebrovascular disease treatment, especially the antithrombotic of ischemic stroke , Anticoagulation therapy, which may increase the risk of bleeding, and is highly related to the location, etiology, and number of microbleeding lesions
.

In clinical practice, doctors cannot detect a microbleeding in the patient, so they are anxious to reduce antiplatelet therapy or stop anticoagulants; instead, they need to perform careful evaluation to find out the real reasons for the increased risk of microbleeds
.

Antithrombotic therapy, including antiplatelet and anticoagulant therapy, is also very important for the benefit of preventing ischemic stroke
.

Therefore, we must weigh the risks and benefits of antithrombotic therapy before evaluating the impact of microbleeding on antithrombotic therapy, so that we can be more objective and prudent
.

In short, in clinical practice, you must not rush to stop the drug when you see microbleeds in the patient, but should determine the direction of antithrombotic therapy after a comprehensive assessment based on the real cause of the microbleeds
.

Lock to the medlive-neurology channel (medlive-neurology) to view the latest information of CSA & TISC 2021! Long press the QR code to follow the CSA & TISC 2021 special report ☟☟☟ You can also click "Read the original text" to view More CSA & TISC 2021 topics related content!