Prevalence and Clinico-Radiologic Spectrum of Intracranial Atherosclerotic Disease-Related Stroke

Azra Zafar, Aishah Albakr, Rizwana Shahid, Fahd Alkhamis, Majed Alabdali, Danah Aljaafari, Saima Nazish, Noman Ishaque, Nehad Mahmoud Soltan, Amir H. Msmar, Sari Saleh Al-Suhibani, Hosam Al-Jehani

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Intracranial atherosclerotic disease (ICAD) is an important etiologic subtype of acute ischemic stroke (AIS). However, little direct evidence is available regarding ICAD-related stroke in Saudi Arabia (SA). This study aimed to identify the prevalence and describe the clinico-radiological spectrum of ICAD-related AIS in a SA cohort. Methods: This was a hospital-based retrospective study enrolling patients with ICAD-related AIS between 2017 and 2020. The electronic charts were reviewed. The mechanisms of stroke were identified as artery-to-artery embolization (AAE), in situ thrombotic occlusion, hypoperfusion, or perforator branch occlusion. Pearson's χ2 test was performed to calculate the P values to establish the statistical significance of factors that could correlate with the mechanisms of stroke and functional outcome. Results: ICAD was found in 133 of AIS comprising 26% of total. Data from all patients were reviewed. Left ICA (25%) was the most frequently affected vessel. Territorial pattern (63.9%) was the most common infarct pattern, and AAE (44.3%) was the most common underlying mechanism. Perforator branch occlusion was more prevalent in women than in men. Malignant and hemorrhagic transformation (P = 0.00) were more prevalent in the AAE group. Left-sided vascular involvement was statistically associated with unfavorable outcomes than the right (P = 0.019). Conclusions: The prevalence of ICAD in our cohort from Western Asia did not differ from that in Southern Asia. ICA involvement was observed more frequently than previously reported. Further research from SA is required to better understand ICAD-related strokes in this region.

Original languageEnglish (US)
Pages (from-to)173-179
Number of pages7
Issue number3
StatePublished - May 19 2023


  • Male
  • Humans
  • Female
  • Retrospective Studies
  • Ischemic Stroke/complications
  • Prevalence
  • Saudi Arabia/epidemiology
  • Stroke/diagnostic imaging
  • Intracranial Arteriosclerosis/complications

ASJC Scopus subject areas

  • Clinical Neurology


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