Intracranial Atherosclerosis and Ischemic Stroke Risk Factors

Intracranial atherosclerosis arises from lipid‐rich plaque accumulation within the walls of major cerebral arteries, leading to narrowing or occlusion of the vessel lumen. This process impairs cerebral perfusion and predisposes to ischaemic stroke, a condition defined by insufficient blood flow causing focal brain infarction. The burden of intracranial atherosclerosis is particularly high in Asian, Black and Hispanic populations, where it accounts for a substantial proportion of strokes. Established risk factors include age, hypertension, diabetes mellitus, dyslipidaemia and smoking. These factors promote endothelial dysfunction, inflammatory activation and smooth muscle proliferation within the vessel wall. Asymptomatic intracranial stenosis may remain clinically silent yet carries a significant risk of subsequent stroke, underscoring the importance of early detection. Non‐invasive imaging techniques such as transcranial Doppler ultrasonography and magnetic resonance angiography enable surveillance of intracranial vessels. Optimised management strategies combine aggressive risk factor control with antithrombotic therapy and, in selected cases, endovascular intervention. Continued research aims to refine risk stratification, identify novel biomarkers and develop targeted therapies to reduce the global burden of stroke due to intracranial atherosclerosis.

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Intracranial Atherosclerosis and Ischemic Stroke Risk Factors publication trend

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

Technical terms

Intracranial atherosclerosis: Build-up of lipid and fibrous material within the walls of arteries inside the skull, leading to vessel narrowing.

Ischaemic stroke: Brain injury resulting from inadequate blood flow due to arterial blockage.

Stenosis: Pathological narrowing of a blood vessel lumen.

Biomarker: Measurable biological parameter that indicates a normal or pathological process.

Transcranial Doppler ultrasonography: Non-invasive ultrasound method for assessing blood flow velocity in intracranial arteries.

Magnetic resonance angiography: MRI-based imaging technique for visualising blood vessels without ionising radiation.

References

1. Predictive value of neutrophil to apolipoprotein A1 ratio in patients with acute ischaemic stroke. Brain Communications (2024).
2. Sex difference in cerebral atherosclerotic stenosis in Chinese asymptomatic subjects. Heliyon (2023).
3. A Prospective Study of Asymptomatic Intracranial Atherosclerotic Stenosis in Neurologically Normal Volunteers in a Japanese Cohort. Frontiers in Neurology (2016).