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Review
. 2022 Sep 1:13:1001609.
doi: 10.3389/fneur.2022.1001609. eCollection 2022.

Recurrent stroke risk in intracranial atherosclerotic disease

Ahmad A Ballout  1 , David S Liebeskind  2
Affiliations
Review

Recurrent stroke risk in intracranial atherosclerotic disease

Ahmad A Ballout et al. Front Neurol. .

Abstract

Recurrent stroke risk secondary to intracranial atherosclerotic disease remains high despite aggressive medical treatment. This risk is further amplified in subgroups possessing biomarkers of hemodynamic insufficiency and potential for embolization, which have been shown to be independently and synergistically predictive of recurrent stroke. Luminal stenosis was predominantly used as entry criteria in major treatment trials, discounting the potential role of hemodynamics from primary analyses, limiting the strength of evidence and conclusions of these biomarkers to post-hoc analyses and other natural history studies. Future treatment trials should consider stratifying patients using a combination of these high-risk biomarkers. In the absence of trials, risk stratifying patients based on the presence of these markers may lend to more individualized clinical decisions. We aimed to summarize the studies that have investigated the relationship between biomarkers and their role in predicting recurrent stroke risk in intracranial atherosclerotic disease.

Keywords: hemodynamics; intracranial atherosclerosis (ICAS); intracranial atherosclerotic disease (ICAD); perfusion; quantitative magnetic resonance angiography.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Probable biomarkers of increased stroke recurrence in intracranial atherosclerotic disease.
Figure 2
Figure 2
Workflow diagram.
See this image and copyright information in PMC

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