Autopsy prevalence of intracranial atherosclerosis in patients with fatal stroke

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Published on: February 23, 2016

Mikael Mazighi1, Julien Labreuche, Fernando Gongora-Rivera

  • 1Assistance Publique-Hôpitaux de Paris, France.

Stroke
|March 1, 2008
PubMed

Insights

Intracranial plaques and stenoses are common in fatal stroke patients, with some stenoses potentially causing stroke. Further research using advanced imaging is recommended to assess their role in living individuals.

Area of Science:

  • Neurology
  • Pathology
  • Cardiovascular Science

Background:

  • Intracranial atherosclerosis is often underestimated due to diagnostic limitations.
  • This condition has a severe prognosis, impacting stroke outcomes.

Purpose of the Study:

  • To determine the prevalence of intracranial plaques and stenoses in fatal stroke.
  • To investigate the causal role of these findings in stroke etiology.

Main Methods:

  • Systematic autopsy analysis of intra- and extracranial arteries, aortic arch, and heart in 339 stroke patients.
  • Comparison with 80 brain hemorrhage patients as controls.
  • Analysis of clinical history, risk factors, and imaging data.

Main Results:

  • Intracranial plaques (62.2%) and stenoses (43.2%) were highly prevalent in brain infarction patients.
  • Stenoses >30% were causal in 5.8% of brain infarction cases, particularly those with ulcerated plaques.
  • Diabetes, male sex, myocardial infarction history, and previous stroke were associated with intracranial findings.

Conclusions:

  • Intracranial plaques and stenoses are frequent in fatal stroke.
  • Stenoses of 30%-75% may be causally linked to stroke.
  • Advanced arterial wall imaging is needed to re-evaluate intracranial artery plaques in living stroke patients.
Abstract

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