At least 10% of ischemic strokes are caused by Intracranial Atherosclerosis (ICAD). If you have an intracranial atherosclerotic disease, you may not experience any overt symptoms until the condition becomes advanced.
At Cura Medical Specialist, we have expert neurologists specialising in Sydney’s cerebrovascular disease treatment. If you have had a stroke, have symptoms of ICAD, or have underlying conditions that put you at high risk for the condition, book an appointment with Cura Medical Specialists for diagnosis and personalized treatment.
Intracranial Atherosclerosis is a neurovascular disorder that occurs when the large arteries within the brain become narrowed by cholesterol plaque, reducingbloodsupply to the brain tissues. ICAD can develop over years, and increases your risk of stroke and may be asymptomatic until a stroke occurs.
Blockage of arteries restricts the proper flow of blood to the brain.
ICAD is mainly caused by the formation of plaque or fat deposits in the large arteries that supply the brain with blood. These include the internal, middle , anterior cerebral and posterior cerebral arteries.
When fatty deposits or cholesterol build up and form plaque in the blood vessels that supply the brain, the arteries harden and become narrow. This makes it harder for blood to flow to the brain resulting in intracranial atherosclerotic stenosis.
People with the following conditions associated with cardiovascular disease are at a higher risk of developing ICAD since they are more likely to have vascular disease.
- High blood pressure
- High cholesterol
- Peripheral arterial disease
- Older people over the age of 50
Weakness on one side of the face is common in ICAD.
Stents expand the artery restoring the
proper flow of blood to the brain.
ICAD is typically asymptomatic in the early stages. However, if you have a symptomatic intracranial atherosclerotic disease, you may experience the following symptoms.
- Severe headache
- Confusion or dizziness
- Speech difficulties such as slurring or inability to speak
- Vision problems like blurring or double vision
- Trouble swallowing
- Difficulty with balance and coordination
- Numbness or weakness typically on one side of the face
Treatment for ICAD is available. When you visit Cura Medical Specialists, our neurologists will arrange the necessary tests if they have not been already performed and then prescribe the best course of treatment depending on the degree of severity.
If you are still in the early stages of ICAD, the doctor may prescribe medication and recommend lifestyle changes. Other treatment options may include:
Our neurologist will recommend the best
course of treatment based on your diagnosis.
A percutaneous transluminal angioplasty may be done to open up blocked arteries. This procedure involves inserting a balloon catheter into the blocked artery whjich is usually navigated through an artery in the wrist or groin. This balloon is then inflated to widen the artery which improves the flow of blood to the brain.
Following a balloon angioplasty where a balloon is used to widen the artery, the surgeon may also perform stenting. In this case, a stent is placed where the arterial blockage was and a balloon is inflated to dilate the stent.
Once the stent is in place, the balloon is retracted while the stent remains in a position to open up the artery for a better flow of blood to the brain. The stent may be coated with medication in some cases to help the artery heal with minimal scarring.
In some cases, instead of using a balloon to expand the stent to be placed in the artery, the surgeon may use self-expanding stents. These types of stents rely on a mechanical design to expand and open up the artery where the blockage was.
The most recent research evidence supports the use of medical therapy as first-line option. Stenting or balloon angioplasty procedures were outperformed by medication in many of the previous research trials. Therefor, if we choose to perform a procedure for this condition it is usually because usually after a patient has failed medication therapy (i.e. has had a TIA or stroke while on medication)
The consultation cost will vary depending on the service enquired, appointment duration, medicare availability and other factors. Please use this calculator to get an estimate of your cost on the day of your consultation.
At Cura Medical Specialists, we specialize in the treatment of ICAD, stroke and other neurological conditions. Our team is made up of two of a handful of interventional neurologists in Sydney, Australia and health care professionals experienced in providing patient-centric care that centres on ensuring the best health outcomes possible for our patients.
Both neurologists are staff specialists at Royal Prince Alfred Hospital and have access to outpatient and inpatient neurointerventional services.
You can learn more about asymptomatic and symptomatic intracranial
artery stenosis in the answers to frequently asked questions.
Intracranial atherosclerotic stenosis is common among people with vascular disorders like hypertension and high cholesterol. It is also common in people aged over 50 and has been found to be more prevalent in people of Asian, African and Hispanic.
Both asymptomatic and symptomatic intracranial atherosclerosis are serious conditions since they increase the risk of stroke significantly. ICAD causes obstruction of the major arteries supplying the brain. This obstruction restricts the flow of blood to the brain which can lead to a transient ischemic attack or an acute ischemic stroke.
Calcification of the arteries occurs when fat, cholesterol and other deposits accumulate in the walls of cerebral blood vessels. These deposits form plaque which leads to calcification and narrowing of blood vessels, restricting the proper flow of blood to the brain.
Both asymptomatic and symptomatic intracranial arterial stenosis can be diagnosed using MRI or a CT angiogram (CTA). A transcranial doppler ultrasound (TCD) or positron emission tomography (PET) may also be used for diagnosis.
No, ICAD is not the same as an ischemic stroke. ICAD is a hardening or blockage of the arteries that supply blood to the brain and is one of the major causes of transient ischemic attack and stroke.
Atherosclerotic lesions that occur in the early stages of ICAD can be reversed with medication and cholesterol-lowering therapy. In cases of symptomatic atherosclerotic lesions which occur in the advanced stages of symptomatic intracranial stenosis, the damage cannot be reversed but treatment options are available.
Yes, ICAD occurs because plaque that is deposited along the artery walls causes hardening and narrowing of the arteries resulting in obstruction of the normal flow of blood to the brain.