Symptomatic intracranial stenosis: A university hospital-based ultrasound study

Introduction

Stenosis of intracranial arteries are responsible for 30–50% of strokes in Orientals, 11% in Hispanics, 6% in Blacks and only 1% in Caucasians. However, the clinical importance of intracranial stenosis in Whites may have been underestimated.

Subjects and methods

We examined our database registry of all TIA/ischemic stroke Caucasian patients over a two-year period, from January 1st 2009 to December 31st 2010. All patients underwent a complete cervical and intracranial ultrasound assessment, MRA and/or CTA and/or DSA.

Results

Among 292 patients (males 79.7%; mean age, 71.0 ± 12.8 years), we found 59 (20.2%) subjects harboring at least one intracranial stenosis and 20 (33.9%) patients with 2 stenosis; the total number of intracranial stenosis was 95. Regarding risk factors, hypertension was present in 67.8% of patients, diabetes in 27.1%, smoking in 30.5%, obesity in 10.2%, hypercholesterolemia in 37.3%, previous TIA/stroke in 23.7%, heart disease in 18.6%. Forty-six (77.9%) patients presented with stroke, while 13 (22.1%) with TIA. Concerning the site of stenosis, 50 (52.6%) were located in the anterior circulation [MCA 46 (48.4%), ACA 4 (4.2%)], 45 (47.4%) in the posterior circulation: [PCA 28 (29.5%), BA 11(11.6%), VA 6(6.5%)]; 46 (54.8%) on the right hemisphere, 38 (45.2%) on the left hemisphere.

Conclusions

In this university hospital-based study among Caucasian patients with acute cerebral ischemia, ultrasound disclosed a higher prevalence of intracranial stenosis than previously thought, suggesting the clinical importance of this condition in White European TIA/stroke patients.