Analysis of the risk of ischemic stroke in intracranial atherosclerotic stenosis by CBF measurement and plaque characterization

Atherosclerotic intracranial stenosis is considered one of the major causes of ischemic stroke. We analyzed cerebral blood flow (CBF) and plaque characteristics in atherosclerotic intracranial internal carotid stenosis (iICS) patients to evaluate the risk of ischemic stroke. Since November 2003, 26 lesions in 25 patients were treated at our institution. All patients underwent plaque characterization using MRI and CBF evaluation using single photon emission computed tomography (SPECT). Only one lesion caused severe hemodynamic insufficiency and two patients had vulnerable plaque in their stenotic segments. Tandem lesions were existent in 9 lesions (35%) and contralateral lesions were existent in 11 patients (44%). Based on the CBF and plaque imaging results, the risk of ischemic stroke due to iICS itself is not thought to be so high as previously reported. (author)