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(Stroke. 2008;39:1039.)
© 2008 American Heart Association, Inc.

Research Letters

Prevalence and Prognosis of Coexistent Asymptomatic Intracranial Stenosis

Fadi Nahab, MD; George Cotsonis, MS; Michael Lynn, MS; Edward Feldmann, MD; Seemant Chaturvedi, MD; J. Claude Hemphill, MD; Richard Zweifler, MD; Karen Johnston, MD; David Bonovich, MD; Scott Kasner, MD; Marc Chimowitz, MBChB for the WASID Study Group

From the Emory University (F.N., G.C., M.L., M.C.), Atlanta, Ga; Brown University (E.F.), Providence, RI; Wayne State University (S.C.), Detroit, Mich; University of California, San Francisco (J.C.H.); University of South Alabama (R.Z.), Mobile; University of Virginia, Charlottesville (K.J.); San Francisco General Hospital (D.B.), Calif; University of Pennsylvania (S.K.), Philadelphia.

Correspondence to Fadi Nahab, MD, 1001 Garden View Drive NE #711, Atlanta, GA 30319. E-mail fnahab{at}emory.edu

Abstract

Background and Purpose— There are limited data on the prevalence and prognosis of asymptomatic intracranial stenosis (AIS).

Methods— Baseline cerebral angiograms and MR angiograms were used to determine AIS (50% to 99%) coexistent to symptomatic intracranial stenosis for patients enrolled in the Warfarin-Aspirin Symptomatic Intracranial Disease study.

Results— Coexisting AIS were detected in 18.9% (n=14/74) of patients undergoing 4-vessel cerebral angiography and 27.3% (n=65/238) of patients undergoing MR angiogram. During a mean follow-up period of 1.8 years, no ischemic strokes were attributable to an AIS on cerebral angiography and 5 ischemic strokes (5.9%, 95% CI: 2.1% to 12.3%) occurred in the AIS territory on MR angiogram (risk at 1 year=3.5%, 95% CI: 0.8% to 9.0%).

Conclusions— Whereas the prevalence of coexisting AIS (50% to 99%) in patients with symptomatic stenosis is high, the risk of stroke from these asymptomatic stenoses is low.

Key Words: atherosclerosis • diabetes • intracranial disease • intracranial stenosis • prognosis • risk factors • stroke