Intracranial Atherosclerosis

About Intracranial Atherosclerosis

Intracranial atherosclerosis (IA) is a common cause of stroke. Also called intracranial atherosclerotic disease or intracranial large artery atherosclerosis. IA is a hardening of the arteries inside the skull caused by an accumulation of plaque. Plaque is a sticky substance made of fat and cholesterol that causes the narrowing or complete blockage of an artery that supplies blood to the brain.

Symptoms of Intracranial Atherosclerosis

Intracranial atherosclerosis is often found only after a stroke, but symptoms you may have experienced can include:

  • Numbness or weakness in the face or limb extremities
  • Dizziness and confusion
  • Problems speaking or understanding speech
  • Difficulty seeing in one or both eyes
  • Loss of balance and coordination
  • Sudden, severe headache
  • Difficulty swallowing

In some cases, if you or a loved one suffered a stroke caused by IA, you may have had a seizure or fell unconscious.

Risk factors for intracranial atherosclerosis are similar to those of the well-known hardening of the arteries that leads to heart attack.

You can’t change some risk factors for IA. They include race (about half of IA sufferers are of Asian descent), age (those over 50 face a greater risk), gender (IA is more common in men than in women), a family history of stroke or atherosclerosis and a personal history of heart attack, cardiovascular disease or stroke.

As your doctor or surgeon has probably explained to you, though, you can modify many risk factors for IA. These include the usual culprits in cardiovascular disease: hypertension, diabetes, obesity, smoking and high cholesterol levels. A sedentary lifestyle and limited exercise also increase the risk of IA.

Diagnosing Intracranial Atherosclerosis

Your neurologists has probably used several kinds of tests to diagnose intracranial atherosclerosis. Leading the list is cerebral angiography, a procedure in which dye is injected through a catheter into the blood vessels leading to your brain. Tracked by x-ray, computed tomography or magnetic resonance imaging, the path of the dye reveals blockages, narrowing or other abnormalities of these blood vessels.

Although cerebral angiography has been called the gold standard of testing for IA, other kinds of diagnostics may also be used. Carotid Doppler is a noninvasive procedure that uses ultrasound technology to examine the large arteries in your neck for abnormalities or plaque blockages. You may also get an MRI and CT scans with or without an injectable contrast agent to reveal images of blood vessels in the body and brain.

Treatment Options for Intracranial Atherosclerosis

Depending on your circumstances, IA can be treated either with medications or with surgical procedures to neovascularize affected arteries. Treatment may begin with anticoagulant or antiplatelet medications such as aspirin, Warfarin or Plavix. These drugs help keep blood flowing through the arteries, and for some patients, may be the only treatment needed to manage IA.

In some cases, you may need surgical interventions such as cerebral angioplasty, stenting or bypass surgery to restore blood flow to arteries damaged by plaque. Cerebral angioplasty is a procedure in which our surgeon inserts a tiny balloon into your blocked artery through a catheter in the leg or arm. When the balloon is inflated, it cracks the plaque blocking the artery and presses it into the artery wall so that blood can flow freely. The balloon is then removed.

The neurosurgeon may use an intracranial stent alone or in combination with angioplasty to keep arteries open. Once the surgeon clears your blockage, a stent, or tiny mesh tube, is inserted into the artery. Stents help to hold plaque deposits against the artery wall, which reduces the risk that they might break loose and travel to another area of the brain.

Cerebral, or intracranial, bypass surgery, is a procedure similar to a coronary bypass in which surgeons use arterial grafts to reroute blood flow around a blockage. This kind of surgery is usually performed by cerebrovascular specialists in clinics such as Neurosurgeons of New Jersey.

Why Choose Neurosurgeons of New Jersey?

The Neurosurgeons of New Jersey provide patient-centered treatment for intracranial atherosclerosis and other cerebrovascular health issues. As one of the largest subspecialty clinics in the tristate area, we use cutting-edge technology for procedures such as carotid angioplasty, stenting and neovascularization. A part of the century-old Neurological Institute of New York, Neurosurgeons of New Jersey’s primary focus is to provide outstanding patient care by the country’s leading specialists in a broad range of neurological conditions.

Our Doctors Who Treat Intracranial Atherosclerosis

Dr. Dorothea Altschul


Dr. Ahsan Sattar