Prevalence and Calcification of Intracranial Arterial Stenotic Lesions as Assessed With Multidetector Computed Tomography Angiography

Abstract

Background and Purpose-Intracranial arterial stenosis (ICAS) in patients with recent ischemic stroke is associated with a high risk of recurrent stroke. More insight into the pathophysiology of ICAS could help identify patients at high risk requiring more aggressive secondary prevention. We evaluated the prevalence, distribution, calcification, and the risk factors predisposing ICAS in a European stroke population. Methods-Consecutive patients with a transient ischemic attack or ischemic stroke (nϭ786) were evaluated for the presence and distribution of ICAS (Ն30% luminal narrowing) by CT angiography. ICAS were categorized as symptomatic or asymptomatic, and the presence of calcification was assessed. The association of traditional cerebrovascular risk factors and the erythrocyte sedimentation rate with ICAS was analyzed. Results-In 178 of 786 patients (23%), 288 ICAS were observed. Most stenoses (nϭ194/288; 67%) were located in the posterior circulation arteries. In 59 of 786 patients (8%), ICAS were considered symptomatic. ICAS in the basilar artery and arteries beyond the circle of Willis were mainly noncalcified. In addition to age, gender, and several traditional cerebrovascular risk factors, erythrocyte sedimentation rate was independently associated with the presence of ICAS (OR, 1.20; 95% CI, 1.06 -1.36) and with the presence of noncalcified ICAS in particular (OR, 1.20; 95% CI, 1.05-1.37). Conclusions-ICAS

Italian symptomatic intracranial atherosclerosis study (ISIDE)

“…Finally, mild (\50 %) intracranial atherosclerosis could determine a stroke just as in mild carotid disease, and this type of patients are currently excluded by most studies, including ours. Using a lower threshold (C30 %) for detection of ICAS, a higher prevalence (up to 17.8 %) was documented [8,35]. Noteworthy, most of the above-mentioned limitations of the ISIDE study could actually be interpreted as strengths, since they could only give rise to an underestimation of the prevalence of ICAS.…”

Quantitative Intracranial Atherosclerotic Plaque Characterization at 7T MRI: An Ex Vivo Study with Histologic Validation

“…30, 42 The calcifications that were detected showed low values in all quantitative maps. The PD map showed the largest differences between calcifications and other plaque components and the intracranial vessel wall.…”

Localización y frecuencia de placas ateromatosas intracraneales en pacientes mayores de 40 años

“…La región más afectada fue el sifón carotídeo y luego el segmento vertebral V4, mientras que las arterias cerebrales mostraron un compromiso escaso. No obstante, otros autores encontraron una mayor incidencia en el territorio vertebrobasilar o posterior, con afectación del segmento V4 y el tronco basilar en un 40-48% y de las arterias carótidas internas intracraneales en un 25-30% (siendo el sifón carotídeo el más afectado) 7,8 .…”