Intracranial Artery Calcification and Its Clinical Significance

Wu, Xinke; Chen, Xiang Yan; Wang, Li Juan; Wong, Ka Sing

doi:10.3988/jcn.2016.12.3.253

Cited by 73 publications

(93 citation statements)

References 55 publications

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“…Calcification is another frequently detected plaque component, which also indicates complexed or advanced atherosclerotic lesions [ 58 , 59 ]. Our most recent retrospective study illustrated the correlation of high extent of internal carotid artery calcification with downstream microembolic signal detected by transcranial Doppler, suggesting that severe cerebral artery calcification might indicate complex or unstable atherosclerotic lesions [ 60 ].…”

Section: Histopathological Evidence From Human Cadaversmentioning

confidence: 99%

Intracranial Atherosclerosis: From Microscopy to High-Resolution Magnetic Resonance Imaging

2017

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Intracranial atherosclerosis is one of the leading causes of ischemic stroke and occurs more commonly in patients of Asian, African or Hispanic origin than in Caucasians. Although the histopathology of intracranial atherosclerotic disease resembles extracranial atherosclerosis, there are some notable differences in the onset and severity of atherosclerosis. Current understanding of intracranial atherosclerotic disease has been advanced by the high-resolution magnetic resonance imaging (HRMRI), a novel emerging imaging technique that can directly visualize the vessel wall pathology. However, the pathological validation of HRMRI signal characteristics remains a key step to depict the plaque components and vulnerability in intracranial atherosclerotic lesions. The purpose of this review is to describe the histological features of intracranial atherosclerosis and to state current evidences regarding the validation of MR vessel wall imaging with histopathology.

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Section: Histopathological Evidence From Human Cadaversmentioning

confidence: 99%

Intracranial Atherosclerosis: From Microscopy to High-Resolution Magnetic Resonance Imaging

2017

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“…Introduction Arterial calcifications (AC) are frequently observed on unenhanced brain Computed Tomography (CT) and have been reported to occur in up to 90% of atherosclerotic lesions and considered as an integral part of active process of atherosclerosis [1]. There are studies reporting the presence of AC as a risk factor for ischemic stroke [2][3][4].…”

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confidence: 99%

The association of vertebrobasilar calcification with etiological subtypes, stroke recurrence and outcome in acute brainstem ischemic stroke

Gökçal

Niftaliyev

Özdemir

et al. 2018

Neurologia i Neurochirurgia Polska

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Arterial calcification (AC), a frequent finding on imaging studies, has been reported as a risk factor for ischemic stroke. However few studies have explored the association of AC with etiological subtypes and prognostic implications. The purpose of this study was to investigate the association of AC with demograhics, risk factors and etiological subtypes and to determine whether it predicts stroke recurrence and functional outcome in patients with acute brainstem ischemic stroke. We analyzed our database consisting of patients who were diagnosed as acute brainstem ischemic stroke admitted within 24hours of onset. Etiological classification of stroke was made based on The Trial of ORG in Acute Stroke Treatment (TOAST) Classification. AC in vertebral and basilar arteries were assessed from baseline brain CT. AC degree was categorized according to calcification along the circumference in the densest calcified segment of each vessel (0 point if no calcification in any of the CT slices, 1 point if calcification <50% of circumference and 2 points if calcification ≥50% of circumference). Three AC categories were defined according to the total AC score as follows: no AC (0 point), mild AC (1-2 points), severe AC (≥3 points). Recurrent stroke within the first 3 months of follow up and modified Rankin Score (mRS) at 3-month were reviewed. 42% of 188 patients had AC in at least of the vertebrobasilar arteries. Severe AC was related to age and the presence of diabetes mellitus and coronary artery disease. The prevalence of AC was significantly higher in large artery atherosclerosis subtype. The presence of AC was marginally associated with recurrent stroke but did not find to be related with functional outcome. Further studies with larger sample size are warranted to explore this topic.

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“…The main limitation of this study is the retrospective design. Although most important vascular risk factors could be reliably and fully obtained, there is missing data on current smoking as well as other predictors of ICAC such as kidney disease, alcohol intake, previous cardiac disease, and raised white blood cell count (23). The visual ICAC assessment was limited by the slice thickness on CT imaging.…”

Section: Discussionmentioning

confidence: 99%

Vitamin K Antagonist Use and Risk for Intracranial Carotid Artery Calcification in Patients With Intracerebral Hemorrhage

et al. 2019

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Background: Intracranial carotid artery calcification (ICAC) on computed tomography (CT) is a marker of atherosclerosis and an independent predictor of vascular events including stroke. While vitamin K antagonists (VKAs) are used to prevent embolic stroke, they have been shown to increase levels of both coronary and extracoronary artery calcification. This has not been studied for (intracranial) carotid arteries. The aim of this study is to investigate the association between VKA use and degree of ICAC. We tested our hypothesis in a cohort of patients with nontraumatic intracerebral hemorrhage (ICH) of which a substantial part used VKAs. Materials and Methods: We retrospectively semiquantified ICAC on brain unenhanced CT of consecutive adult patients with nontraumatic ICH. Assessment was performed blinded to clinical characteristics and status of VKA use. We used a 5-point visual scale and dichotomized degree of ICAC in low and high degree. Patient demographics, VKA use, duration of VKA treatment, as well as known risk factors for intracranial calcification were collected. Univariable and multivariable logistic regression analyses were performed to investigate the association between ICAC and VKA use. Results: Three hundred and seventy-six nontraumatic ICH patients were included of whom 77 were using VKAs (20.5%) with a median treatment duration of 35 months. Any degree of ICAC was detected in 289 patients (76.9%). Univariable analysis showed that a high degree of ICAC was significantly associated with older age [odds ratio (OR), 1.06, 95% confidence interval (CI), 1.03-1.08], hypertension (OR, 2.14; 95% CI, 1.27-3.62), diabetes mellitus (OR, 2.38; 95% CI, 1.27-4.49), and the use of VKAs (OR, 1.84; 95% CI, 1.06-3.20). In multivariable regression analysis, only older age was significantly associated with a higher degree of ICAC (OR, 1.05; 95% CI, 1.02-1.08), while VKA use was not (OR, 1.22; 95% CI, 0.67-2.24). Conclusions: Our findings do not support VKA use as an independent risk factor for higher ICAC degree in patients with ICH. We could not confirm the concerns about VKA use and intracranial carotid vascular calcification. We suggest further research in other cohorts with VKA users such as patients with ischemic stroke and atrial fibrillation.

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Intracranial Artery Calcification and Its Clinical Significance

Cited by 73 publications

References 55 publications

Intracranial Atherosclerosis: From Microscopy to High-Resolution Magnetic Resonance Imaging

Intracranial Atherosclerosis: From Microscopy to High-Resolution Magnetic Resonance Imaging

The association of vertebrobasilar calcification with etiological subtypes, stroke recurrence and outcome in acute brainstem ischemic stroke

Vitamin K Antagonist Use and Risk for Intracranial Carotid Artery Calcification in Patients With Intracerebral Hemorrhage

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