Published Online
on June 5, 2008

A more recent version of this article appeared on August 1, 2008

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Submitted on September 28, 2007
Revised on January 16, 2008
Accepted on January 18, 2008

Large Artery Intracranial Occlusive Disease. A Large Worldwide Burden but a Relatively Neglected Frontier

Philip B. Gorelick MD, MPH^*; Ka Sing Wong MD; Hee Jae Bae MD, PhD; and Dilip K. Pandey MD, PhD

From the Center for Stroke Research, Department of Neurology and Rehabilitation (P.B.G.), University of Illinois College of Medicine, Chicago; the Department of Medicine & Therapeutics (K.S.W.), Chinese University of Hong Kong, Hong Kong, China; the Stroke Center (H.J.B.), Seoul National University, Bundang Hospital, and the Department of Neurology, College of Medicine, Seoul National University, Seoul, Korea; and the Neuroepidemiology and Clinical Trials Unit, Department of Neurology and Rehabilitation and Center for Stroke Research (D.K.P.), University of Illinois College of Medicine, Chicago.

^* To whom correspondence should be addressed. E-mail: pgorelic{at}uic.edu.

Background and Purpose—Large artery intracranial occlusive disease (LAICOD) is a common and important stroke subtype. In this commentary, we review key epidemiological aspects of LAICOD.

Summary of Review— LAICOD has emerged as the most common stroke subtype worldwide and is associated with a high risk of recurrent stroke. Hypotheses have been proposed to explain causation, which include such factors as traditional cardiovascular risk factors, high blood volume states, and genetic abnormalities. Approaches to treatment such as antithrombotic therapies, revascularization procedures, and counterpulsation devices hold promise.

Conclusions—LAICOD poses a major stroke problem worldwide and is likely the most common stroke subtype. The etiology and treatment of this disorder remain poorly defined. International collaborations are needed to pool collective knowledge and develop definitive studies to better understand causation and treatment of LAICOD.

Key words: intracranial occlusive disease • risk factors • high-risk populations

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