摘要颅内动脉粥样硬化性狭窄（ICAS）是缺血性卒中和短暂性脑缺血发作（TIA）的重要病因，亦可引起认知障碍和痴呆。总体而言，亚洲ICAS患病率显著高于西方国家。近年来，关于ICAS的流行病学、诊断、评估、预后和治疗方面出现了很多新的证据，国外亦有相关指南或共识发布。为了更好地指导我国各级医疗机构进行ICAS的筛查、诊断和治疗工作，中国研究型医院学会、中国医师协会神经介入专业委员会以及中国神经科学学会脑血管功能与疾病分会成立专家组，制订《颅内动脉粥样硬化性狭窄诊治指南（2025版）》。本指南依据已发表的临床研究证据并结合国内外相关指南或专家共识，拟进一步明确ICAS的相关定义、流行病学特征、预后情况及高危人群特征，并基于现有证据就相关筛查、诊断、评估及治疗方法和策略提出30条推荐意见，旨在提高相关临床和科研人员对ICAS的重视和认知、促进对相关患者的规范化治疗，以期最终降低ICAS的患病率及相关的卒中、认知障碍和其他临床事件风险，改善患者的预后。

abstractsIntracranial atherosclerotic stenosis (ICAS) is an important cause of ischemic stroke and transient ischemic attack (TIA), which can also lead to cognitive impairment and dementia. Overall, the prevalence of ICAS is significantly higher in Asian than in Western countries/regions. In recent years, new evidence has emerged regarding the epidemiology, diagnosis, assessment, prognosis and treatment of ICAS, hence there have been guidelines or consensus statements published on the topic in other countries/regions. To better guide the screening, diagnosis and treatment of ICAS in China, the Chinese Research Hospital Association, the Neurointerventional Professional Committee of Chinese Medical Doctor Association, and the Branch of Cerebrovascular Function & Disease convened an expert panel to develop the'Guidelines for Diagnosis and Treatment of Intracranial Atherosclerotic Stenosis (2025 edition). The guidelines are developed based on published research evidence and in reference to relevant domestic and international guidelines or expert consensus, aiming to further clarify the definition, epidemiology and prognosis of ICAS and profiles of high-risk ICAS patients, and provide 30 recommendations on screening, diagnosis, assessment and treatment strategies based on current evidence. We also aim to enhance awareness and understanding of ICAS among clinical and research professionals, promote standardized patient management, and ultimately reduce the prevalence of ICAS and the subsequent risks of stroke, cognitive impairment and other clinical events, thereby improving patient outcomes.