on January 31, 2008
Published online before print January 31, 2008, doi: 10.1161/STROKEAHA.107.499475
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Submitted on July 17, 2007
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. * To whom correspondence should be addressed. E-mail: fnahab{at}emory.edu.
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.
Accepted on August 8, 2007
Prevalence and Prognosis of Coexistent Asymptomatic Intracranial Stenosis
Fadi Nahab MD*;
Key words: atherosclerosis • diabetes • intracranial disease • intracranial stenosis • prognosis • risk factors • stroke