Prevalence and Prognosis of Coexistent Asymptomatic Intracranial Stenosis

• Type of Material: Article
• Authors: Fadi Nahab, Emory University; George A Cotsonis, Emory University; Michael Lynn, Emory University; Edward Feldmann, Brown University; Seemant Chaturvedi, Wayne State University; J. Claude Hemphill, University of California; Richard Zweifler, University of South Alabama; Karen Johnston, University of Virginia; David Bonovich, San Francisco General Hospital; Scott Kasner, University of Pennsylvania; Marc Chimowitz, Emory University
• Language: English
• Date: 2008-03
• Publisher: American Heart Association
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2008 American Heart Association, Inc. All rights reserved.
• Final Published Version (URL): http://stroke.ahajournals.org/content/39/3/1039.long
• Title of Journal or Parent Work: Stroke
• ISSN: 0039-2499
• Volume: 39
• Issue: 3
• Start Page: 1039
• End Page: 1041
• Grant/Funding Information: E.F. is funded by a research grant (1 RO1 NS 39131–04) from the US Public Health Service National Institute of Neurological Disorders and Stroke (NINDS).; J.C.H. has received research support from NIH/NINDS.; S.C. has received financial support from Boehringer-Ingelheim Pharmaceuticals, Inc, Suntory and Pfizer.; M.L. reports receiving grant support from NINDS and the National Eye Institute (grant U 10EY013287).; S.E.K. reports having received grant support from NINDS and Boehringer-Ingelheim.; M.I.C. is the recipient of a research grant (1R01 NS36643) from the US Public Health Service National Institute of Neurological Disorders and Stroke (NINDS) to fund this trial. He is also supported by grant 1 K24 NS050307 from the NIH/NINDS.
• Keywords: intracranial disease; stroke; prognosis; risk factors; diabetes; atherosclerosis; intracranial stenosis
• Research Categories: Biology, Biostatistics; Biology, Neuroscience

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.