Intracranial Artery Calcification and Vascular Risk Factors

Intracranial artery calcification refers to the deposition of calcium–phosphate salts within the walls of arteries supplying the brain. It occurs predominantly in two layers of the vessel wall: the tunica intima, where it often coexists with lipid‐rich atherosclerotic plaques, and the tunica media, where it contributes to arterial stiffening. Over recent decades, intracranial calcification has emerged as a reliable imaging marker for cerebral small‐vessel disease, ischaemic stroke risk and cognitive decline. Established vascular risk factors—including advancing age, hypertension, diabetes mellitus, hyperlipidaemia and smoking—drive both the development and progression of calcification. Male sex and chronic kidney disease also appear to accelerate deposition. Quantification of calcification on non‐contrast computed tomography has become a rapid and reproducible tool for risk stratification. Growing evidence links the burden and pattern of calcification to functional outcomes after stroke and long‐term risks of recurrence and dementia. As such, intracranial artery calcification bridges vascular biology, neuroimaging and clinical neurology, offering a window into both preventive strategies and personalised patient management.

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Intracranial Artery Calcification and Vascular Risk Factors publication trend

The graph below shows the total number of articles in intracranial artery calcification and vascular risk factors across all publications each year (not limited to Nature Index journals).

Technical terms

Intracranial artery calcification: Deposition of calcium salts within the walls of cerebral arteries, detectable by non-contrast CT and indicative of vascular ageing and atherosclerosis.

Intimal calcification: Calcium accumulation in the inner vessel layer (tunica intima), typically associated with lipid-rich atherosclerotic plaques and plaque stability assessments.

Medial calcification: Calcification of the middle layer (tunica media) of the arterial wall, leading to increased stiffness and reduced arterial compliance without necessarily forming plaques.

Collateral circulation: Secondary vascular pathways that develop or expand to maintain perfusion in brain regions affected by arterial narrowing or occlusion.

References

1. Intracranial arteriosclerosis and the risk of dementia: A population‐based cohort study. Alzheimer's & Dementia (2023).
2. The correlation between intracranial arterial calcification and the outcome of reperfusion therapy. Annals of Clinical and Translational Neurology (2023).
3. Intracranial Internal Carotid Artery Calcifications: Association with Vascular Risk Factors and Ischemic Cerebrovascular Disease. American Journal of Neuroradiology (2008).
4. Intracranial Carotid Calcification on Cranial Computed Tomography. Stroke (2015).
5. Understanding the Clinical Implications of Intracranial Arterial Calcification Using Brain CT and Vessel Wall Imaging. Frontiers in Neurology (2021).