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Prevalence of Intracranial Atherosclerotic Disease in Patients with Low-Risk Transient or Persistent Neurologic
1From the Departments of Clinical Neurosciences (F.B., N.S., M.G., M.D.H., S.B.C., M.A.).
Insights
Intracranial atherosclerotic disease affects over 12% of patients with minor neurologic events. This condition is linked to acute infarcts on MRI, suggesting its importance in evaluating these symptoms.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Limited data exist on intracranial atherosclerotic disease (ICAD) in patients experiencing transient or persistent minor neurologic events.
- Understanding ICAD prevalence and risk factors in this population is crucial for diagnosis and management.
Purpose of the Study:
- To determine the prevalence of ICAD in patients with low-risk transient or persistent minor neurologic events.
- To identify risk factors associated with ICAD in this patient cohort.
Main Methods:
- A post hoc analysis of the prospective multicenter DOUBT study cohort was performed.
- Intracranial vascular imaging was used to assess for significant ICAD (≥50% stenosis).
- Logistic regression evaluated associations between ICAD, baseline characteristics, and DWI lesions.
Main Results:
- Out of 661 patients, 12.3% had ICAD; 9.8% asymptomatic and 2.4% symptomatic.
- The posterior cerebral artery was the most common location (29%).
- Age was the sole risk factor for ICAD (OR 1.9 per decade). ICAD strongly correlated with acute infarcts on MRI (OR 3.47).
Conclusions:
- Intracranial atherosclerotic disease is prevalent in patients with minor neurologic events.
- ICAD is independently associated with MR imaging-proven ischemia in this context.
- Evaluating intracranial arteries is valuable for determining the etiology of low-risk neurologic events.
Background And Purpose:
There are limited data on the prevalence and outcome of intracranial atherosclerotic disease in patients with low-risk transient or persistent minor neurologic events. We sought to determine the prevalence and risk factors associated with intracranial atherosclerotic disease in patients with low-risk transient or persistent neurologic events.
Materials And Methods:
Participants with available intracranial vascular imaging from the Diagnosis of Uncertain-Origin Benign Transient Neurologic Symptoms (DOUBT) study, a large prospective multicenter cohort study, were included in this post hoc analysis. The prevalence of intracranial atherosclerotic disease of ≥50% was determined, and the association with baseline characteristics and DWI lesions was evaluated using logistic regression.
Results:
We included 661 patients with a median age of 62 years (interquartile range, 53-70 years), of whom 53% were women. Intracranial atherosclerotic disease was found in 81 (12.3%) patients; asymptomatic intracranial atherosclerotic disease alone, in 65 (9.8%); and symptomatic intracranial atherosclerotic disease, in 16 (2.4%). The most frequent location was in the posterior cerebral artery (29%). Age was the only factor associated with any intracranial atherosclerotic disease (adjusted OR, 1.9 for 10 years increase; 95% CI, 1.6-2.5). Multivariable logistic regression showed a strong association between intracranial atherosclerotic disease and the presence of acute infarct on MR imaging (adjusted OR, 3.47; 95% CI, 1.91-6.25).
Conclusions:
Intracranial atherosclerotic disease is not rare in patients with transient or persistent minor neurologic events and is independently associated with the presence of MR imaging-proved ischemia in this context. Evaluation of the intracranial arteries could be valuable in establishing the etiology of such low-risk events.
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