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Review
. 2019 Apr:124:118-132.
doi: 10.1016/j.nbd.2018.11.008. Epub 2018 Nov 12.

Intracranial atherosclerotic disease

Yuan Wang  1 , Ran Meng  1 , Gang Liu  1 , Catherine Cao  2 , Fenghua Chen  2 , Kunlin Jin  3 , Xunming Ji  4 , Guodong Cao  5
Affiliations
Review

Intracranial atherosclerotic disease

Yuan Wang et al. Neurobiol Dis. 2019 Apr.

Abstract

Intracranial atherosclerosis (ICAS) is a progressive pathological process that causes progressive stenosis and cerebral hypoperfusion and is a major cause of stroke occurrence and recurrence around the world. Multiple factors contribute to the development of ICAS. Angiography imaging techniques can improve the diagnosis of and the selection of appropriate treatment regimens for ICAS. Neither aggressive medication nor endovascular interventions can eradicate stroke recurrence in patients with ICAS. Non-pharmacological therapies such as remote ischemic conditioning and hypothermia are emerging. Comprehensive therapy with medication in combination with endovascular intervention and/or non-pharmacological treatment may be a potential strategy for ICAS treatment in the future. We summarized the epidemiology, pathophysiological mechanisms, risk factors, biomarkers, imaging and management of ICAS.

Keywords: Angiography; Biomarker; Diagnosis; Intracranial atherosclerosis; Ischemic conditioning; Treatment.

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Conflict of interest statement

Conflict of interest

All authors have no actual or potential conflict of interest including any financial, personal or other relationships with other people or organizations within three years of beginning of the submitted work.

Figures

Fig. 1.
Fig. 1.
The interrelations between different biological markers for ICAS. Factors that can enhance or inhibit the formation of ICAS are denoted by red and green lines, respectively. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 2.
Fig. 2.
Representative CTA images of ischemic stroke with stenosis. Coronal (a) and axial (b) CTA images were taken 4 days after left MCA infarction in a 55-year-old woman with right hemiparesis and aphasia. A high-grade stenosis at the proximal left MCA (M1 segment) is denoted with red arrows. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 3.
Fig. 3.
Representative TOF-MRA and HR-MRI images of ischemic stroke with stenosis. a, 3-dimesional TOF-MRA image shows severe stenosis (arrow) at the proximal portion of the right MCA (M2 segment) in a 38-year-old male. Non-contrast (b) and contrast (c) image of T1-weighted HR-MRI shows the inward remodeling of plaque (cycle). Magnified image of plaque in inlet shows slightly hyperintense (b) and enhanced (c) signals of plaque.
See this image and copyright information in PMC

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