J Clin Neurol.  2016 Jul;12(3):253-261. 10.3988/jcn.2016.12.3.253.

Intracranial Artery Calcification and Its Clinical Significance

Affiliations
  • 1Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. fionachen@cuhk.edu.hk
  • 2Department of Neurology, The First Hospital of Jilin University, Jilin, China.

Abstract

Intracranial arterial calcification (IAC) is an easily identifiable entity on plain head computed tomography scans. Recent studies have found high prevalence rates for IAC worldwide, and this may be associated with ischemic stroke and cognitive decline. Aging, traditional cardiovascular risk factors, and chronic kidney disease have been found to be associated with IAC. The severity of IAC can be assessed using different visual grading scales or various quantitative methods (by measuring volume or intensity). An objective method for assessing IAC using consistent criteria is urgently required to facilitate comparisons between multiple studies involving diverse populations. There is accumulating evidence from clinical studies that IAC could be utilized as an indicator of intracranial atherosclerosis. However, the pathophysiology underlying the potential correlation between IAC and ischemic stroke-through direct arterial stenosis or plaque stability-remains to be determined. More well-designed clinical studies are needed to explore the predictive values of IAC in vascular events and the underlying pathophysiological mechanisms.

Keyword

intracranial arterial calcification; ischemic stroke; computed tomography; risk factor; vascular stenosis

MeSH Terms

Aging
Arteries*
Constriction, Pathologic
Head
Intracranial Arteriosclerosis
Methods
Prevalence
Renal Insufficiency, Chronic
Risk Factors
Stroke
Weights and Measures

Figure

  • Fig. 1 Examples of different degrees of intracranial artery calcification on a noncontrast CT image. According to Babiarz's visual grading scales, continuous calcifications were graded as follows. A: RICA, 3 for extent and 2 for thickness. LICA, 4 for extent and 3 for thickness. B: RACA, 2 for extent and 2 for thickness. C: RVA, 3 for extent and 3 for thickness. LVA, 2 for extent and 2 for thickness. LICA: left internal carotid artery, LVA: left vertebral artery, RACA: right anterior cerebral artery, RICA: right internal carotid artery, RVA: right vertebral artery.

  • Fig. 2 Color-overlay images showing semiautomatic segmentations of the bilateral intracranial carotid artery calcification by commercial software in our center (red for calcification in RICA and green for calcification in LICA). LICA: left internal carotid artery, RICA: right internal carotid artery.


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