Stroke Mechanism Evolution in Intracranial Atherosclerotic Stenosis
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Predictors of the risk of recurrent stroke for patients with symptomatic intracranial atherosclerotic stenosis (ICAS) remain unknown. The study will be to explore the stroke mechanism evolution in patients with ICAS by multi-model magnetic resonance imaging (MRI) which consists of diffusion-weighted imaging (DWI) and high-resolution MRI (HRMRI). The patients with symptomatic ICAS will undergo multi-model MRI. The baseline data, infarct patterns on DWI, and plaque features on HRMRI will be collected. The stroke mechanisms will be determined by the infarct patterns. During the 2 years follow-up, the recurrent ischemic events will be recorded. By comparing the baseline data, infarct patterns, and plaque features in patients with and without recurrent strokes, the high-risk features of patients with symptomatic ICAS will be identified. The evaluation of stroke mechanisms of patients with symptomatic ICAS will be summarized.
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Ages Eligible for Study:
18 Years and older (Adult, Older Adult)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Symtomatic patients with intracranial atherosclerostic stenosis
Patients suspected of having symptomatic ICAD at admission will be enrolled. All patients will receive a thorough evaluation to determine the cause of their ischemic event (TIA or ischemic stroke), including carotid duplex, transcranial Doppler, echocardiography, electrocardiogram, computed tomography (CT), CT angiography, MRI, magnetic resonance angiography (MRA), or digital subtraction angiography DSA.
Patients will be enrolled in this study according to if they met the following:
ischemic stroke or TIA in the target territories of the intracranial anterior or posterior circulation within 90 days;
Lack of coexistent≥50% ipsilateral extracranial carotid artery or vertebral artery stenosis;
No potential sources of cardio-aortic embolism based on the modified Trial of ORG 10172 in Acute Stroke Treatment classification;
Age ≥18 years;
One or more atherosclerotic risk factors including hypertension, hypercholesterolemia, diabetes mellitus, cigarette smoking, and obesity.
Non-atherosclerosis vasculopathy such as vasculitis and arterial dissection diagnosed by comprehensive laboratory work (such as erythrocyte sedimentation rate or C-reactive protein elevations, antinuclear antibody, or antiphospholipid antibody positivity), vascular imaging, and clinical evaluation;
Contraindication to MR examination, medical instability precluding MR examination.