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Postmortem Study Exploring Distribution and Patterns of Intracranial Artery Calcification

Wen-Jie Yang1, Lu Zheng2, Xiao-Hong Wu3

  • 1From the Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (W.-J.Y.).

Stroke
|October 26, 2018
PubMed

Insights

Intracranial artery calcification has three patterns: intimal, internal elastic lamina, and adventitial. Only intimal calcification is linked to progressive atherosclerotic lesions, serving as a marker for intracranial atherosclerosis.

Area of Science:

  • Neurology
  • Pathology
  • Radiology

Background:

  • Intracranial artery calcification (IAC) on computed tomography (CT) is linked to ischemic stroke and intracranial atherosclerosis.
  • Histopathological details of IAC remain largely unexplored.

Purpose of the Study:

  • To investigate the histopathological patterns and distribution of intracranial calcification.
  • To correlate these patterns with atherosclerotic plaque characteristics and luminal stenosis.

Main Methods:

  • Analysis of 32 adult autopsy cases, examining middle cerebral, vertebral, and basilar arteries.
  • Histological assessment of calcification patterns and their association with plaque phenotype and stenosis.
  • Correlation of CT-detected calcification with histological findings.

Main Results:

  • Calcification was found in 39% of segments, with intimal calcification being most common (25 segments).
  • Calcification prevalence varied by artery: vertebral (51%), middle cerebral (35%), and basilar (14%).
  • Intimal calcification strongly correlated with progressive atherosclerotic lesions (100%) and severe luminal stenosis (46% vs. 21%).

Conclusions:

  • Intracranial artery calcification exhibits three distinct histological patterns: intimal, internal elastic lamina, and adventitial.
  • Only intimal calcification is associated with progressive atherosclerotic lesions.
  • Intimal calcification serves as a histological proxy for intracranial atherosclerosis.

Keywords:
atherosclerosisbasilar arterycalcificationmiddle cerebral arterystrokevertebral artery

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