Intracranial atherosclerotic disease

Authors

  • V. Battistella,

    Corresponding author
    1. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
    • Correspondence: V. Battistella, Department of Neurology, College of Physicians and Surgeons, Columbia University, 710 W 168th Street, New York, NY 10032, USA (tel.: +1 212 305 1710; fax: +1 212 305 1658; e-mail: val.bat@globo.com).

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  • M. Elkind

    1. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
    2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Abstract

Atherosclerotic disease of the intracranial arteries is responsible for at least 10% of ischaemic strokes worldwide. Symptomatic disease has been extensively studied in the past few years, using diagnostic methods including multi-slice computed tomography and high resolution magnetic resonance imaging. A literature search was performed using PubMed and OvidSP between 1984 and May 2013. Variations of the terms ‘intracranial atherosclerosis’ plus ‘ischemic stroke’, ‘plaque’, ‘morphology’, ‘imaging’ were used and a combination of them. The reference lists of identified articles were also consulted for additional references. Amongst symptomatic patients the prevalence of intracranial atherosclerotic disease is around 10%, depending on race ethnicity, and the diagnosis requires the presence of ≥50% stenosis in the territory of the symptomatic vessel in a patient with stroke or transient ischaemic attack. The prognosis of intracranial atherosclerotic disease related stroke is poor. Although risk factor control can lead to a better outcome of intracranial atherosclerotic disease related strokes, the significance of asymptomatic disease is still a matter of debate.

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