Intracranial Stenosis, or intracranial atherosclerotic disease (ICAD), is the narrowing or constriction of an artery inside the brain. Similar to carotid artery stenosis, intracranial stenosis is often caused by atherosclerosis—disease of the arteries characterized by the deposition of plaques of fatty material on their inner walls—and can lead to stroke.
The prevalence of ICAD varies among countries—and Asians, African Americans and Hispanics demonstrate higher rates of disease.
Hypertension, diabetes, smoking, high blood cholesterol and history of heart disease are all risk factors for ICAD.
The symptoms of intracranial stenosis vary depending on the location of the narrowed vessel:
- Patients with stenosis in the anterior circulation, often experience eye flickering, coupled with weakness and numbness of the arm or hand.
- Stenosis in the middle cerebral artery may result in facial weakness as well as weakness and numbness in the arm or hand.
- In the posterior circulation, vertebral artery stenosis often leads to dizziness, blurred or double vision and vertigo.
- Basilar artery blockages cause bilateral weakness of legs and arms, dizziness, double vision and dysphasia, or difficulty speaking and understanding speech.
- Stenosis in the posterior cerebral artery is commonly associated with visual field deficits.
Medical management is currently the gold standard for the management of ICAD. Certain cases of recurrent symptoms, despite the best medical management, will require endovascular intervention. This has led neurosurgeons like Dr. Demetrius Lopes at Rush University Medical Center to the development of endovascular therapies, such as the minimally invasive stenting of vessels supplying blood to the brain inspired by the stents originally developed for use in the vessels supplying blood to the heart.
During the procedure, Dr. Lopes uses small stent made specifically for the brain to open up the blood vessel and reestablish blood flow.
Dr. Lopes recently published research regarding this topic
- Ringer AJ, Khalessi AA, Mocco J, Boulos A, Welch B, Siddiqui AH, Lopes D, Intervention for intracranial atherosclerosis after SAMMPRIS. World Neurosurg. 2012 Nov;78(5):409-12. PubMed PMID: 22819755.