Clearly, ICAD requires further research due to the high rates of recurrence and burden in certain ethnic groups. This can be seen in the statistics whereby the reoccurrence of strokes or death is much more common in ICAD patients. Worryingly, ICAD has worst survival statistics out of all the stroke subtypes – even if adequate medical treatment is administered. ICAD is more common in Asian, Hispanic and African populations in comparison to Caucasian people. Moreover, lifestyle modifications can also be imparted to improve survival and help to prevent a relapse.
Other forms of treatment include stenting (opening of a vessel) or, less commonly, arterial bypass surgery. One commonly known drug for antithrombotic therapy includes aspirin. Others address coagulation through certain drugs. There are two types of antithrombotic therapy: some aim to inhibit the function of platelets, tiny blood cells that help the body form clots to stop bleeding. Antithrombotic therapy focuses on making the blood less prone to coagulation (clotting) and stickiness. ICAD strokes can be managed with a variety of methods.
ICAD-related stroke has worse survival statistics and higher risk of stroke relapse compared with other stroke subtypes, despite adequate medical treatment. ICAD can be picked up using transcranial Doppler or other noninvasive imaging methods during health checks, but it is more commonly identified and diagnosed after a person has already had a stroke. ICAD can also cause a stroke if the plaque becomes dislodged and goes on to block a distal part or branch of the artery (artery-to-artery embolism). The narrowing of the artery in this way can cause the vessel to gradually reduce blood flow until a complete blockage (intracranial stenosis or occlusion) and subsequently, a stroke occurs. These build-ups, or plaques, are sticky substances which prevent the blood from reaching previously well-supplied brain tissue. ICAD causes cerebral artery disease which is when deposits of fat and cholesterol build up within the arteries. A more specific cause is a condition known as intracranial atherosclerotic disease (ICAD). Examples of factors which increase the likelihood include hypertension, diabetes, smoking, obesity, and acute infection, to name a few generic ones. There are many reasons why someone may have a stroke.
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This is because tissue starvation sets of a series of secondary, inflammatory mechanisms which further contribute to tissue damage. However, even if someone receives adequate treatment in a timely manner, sometimes the outcome can still be very serious. The idea is that the blood flow is restored as quickly as possible in order to minimise any tissue death.
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In the case of acute ischemic stroke, a drug known as tissue plasminogen activator is administered to dissolve the clot. Paradoxically, the treatment for one stroke type would almost certainly cause worsening or even a fatality if given for the other type. This is important as one treatment requires stopping a leak and the other requires dissolving a block. If the individual who has had a stroke is able to reach hospital in time, medical staff will determine whether the stroke is hemorrhagic or ischemic. The brain tissue which was previously supplied by that artery is now starved of all blood and subsequently no longer receives oxygen. Ischemic strokes are most common and are instead caused by a blockage of a cerebral artery. Hemorrhagic strokes are less common and are caused when a blood vessel supplying the brain ruptures. Strokes can be either hemorrhagic or ischemic.
Stroke is a leading cause of both death and extreme disability in the developed world. This research has implications for both the outcome and management of ICAD strokes. Prof Thomas Leung, Prof Simon Yu and Dr Xinyi Leng at the Chinese University of Hong Kong have utilised state-of-the-art imaging techniques to identify plaque morphology associated with worse outcome in ICAD strokes. ICAD-related strokes have the highest rates of stroke recurrence and death, leading to an urgent need for further research. Intracranial atherosclerotic disease (ICAD) is a subtype of stroke whereby a build-up of material causes cerebral arteries to narrow and eventually causes onset of a stroke. Stroke caused by a blood clot is a major cause of death and disability worldwide.
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