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Review
. 2018 May;20(2):208-217.
doi: 10.5853/jos.2018.00150. Epub 2018 May 31.

Intracranial Large Artery Disease of Non-Atherosclerotic Origin: Recent Progress and Clinical Implications

Oh Young Bang  1 , Kazunori Toyoda  2 , Juan F Arenillas  3 , Liping Liu  4 , Jong S Kim  5
Affiliations
Review

Intracranial Large Artery Disease of Non-Atherosclerotic Origin: Recent Progress and Clinical Implications

Oh Young Bang et al. J Stroke. 2018 May.

Abstract

Intracranial large artery disease (ILAD) is the major cause of stroke worldwide. With the application of recently introduced diagnostic techniques, the prevalence of non-atherosclerotic ILAD is expected to increase. Herein, we reviewed recent reports and summarized progress in the diagnosis and clinical impact of differentiation between ILAD of atherosclerotic and non-atherosclerotic origin. Our review of the literature suggests that more careful consideration of non-atherosclerotic causes and the application of appropriate diagnostic techniques in patients with ILAD may not only provide better results in the treatment of patients, but it may also lead to more successful clinical trials for the treatment of intracranial atherosclerosis.

Keywords: Atherosclerosis; Intracranial; Ischemic stroke; Magnetic resonance imaging; Stenosis.

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Figures

Figure 1.
Figure 1.
Prevalence of intracranial large artery disease of non-atherosclerotic origin demonstrated by high-resolution magnetic resonance imaging (HR-MRI) in (A) non-stroke subjects,[62] (B) young-age stroke patients,[63] and (C) acute stroke patients[64]. TIA, transient ischemic attack; PD, proton-density; Gd, gadolinium-enhancement. *Middle cerebral artery disease; † Excluding cases with typical luminal features of intracranial atherosclerosis (multiple tandem stenosis or carotid stenosis), moyamoya disease, or intracranial dissection; ‡ Both anterior and posterior circulation disease.
Figure 2.
Figure 2.
Trends of moyamoya disease (MMD) and intracranial atherosclerosis in Korea. (A) Increase in the number of publications on MMD and (B) increasing annual incidence of patients diagnosed with MMD in East Asian countries (nationwide data), with a decrease in the proportion of patients with anterior circulation intracranial atherosclerosis (A-ICAS) (nationwide hospital-based data)[65]-.
See this image and copyright information in PMC

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