title: Cilostazol improves symptomatic intracranial artery stenosis - Evaluation of cerebral blood flow with single photon emission computed tomography.
abstract: BACKGROUND
  To evaluate the effectiveness of cilostazol in patients with intracranial arterial stenosis, we used magnetic resonance angiography (MRA). The drug's effect on the cerebral blood flow (CBF) was examined by single photon emission computed tomography (SPECT).
  
  
  METHODS
  In this retrospective study, we evaluated the clinical outcomes of 20 patients with stenosis in the M1 segment of the middle cerebral artery (MCA) who had suffered ischemic stroke within 12 weeks or manifested asymptomatic stenosis exceeding 50%. All patients received cilostazol (100 mg twice daily). MRA and SPECT (at rest and after acetazolamide challenge) studies were performed before and 6 and 12 months after the start of cilostazol treatment.
  
  
  RESULTS
  In 5 patients the stenotic lesion showed improvement on MRA. Mean stenosis before cilostazol therapy was 71.7 ± 4.9%, which improved to 39.0 ± 3.2% at 6 months and to 27.2 ± 2.8% at 12 months. SPECT study showed that CBF was improved in 3 patients; in one there was improvement at rest and the other 2 manifested improvement upon acetazolamide challenge.
  
  
  CONCLUSIONS
  Cilostazol had a remodeling effect on stenotic lesions due to arteriosclerotic changes and improved CBF in some patients.
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Kumamoto University, Kumamoto, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kai
authors.forename: Masaki
authors.initials: M
authors.lastname: Watanabe
authors.forename: Motohiro
authors.initials: M
authors.lastname: Morioka
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Hirano
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yano
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ohmori
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kawano
authors.forename: Jun-Ichiro
authors.initials: J
authors.lastname: Hamada
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Kuratsu