Intracranial stenosis is the severe narrowing of an artery within the skull. A blood vessel narrows when fatty deposits (plaque) build up inside the vessel, a condition known as atherosclerosis. Stenosis can restrict blood flow to areas of the brain, increasing the risk of stroke.
Stenosis can occur in other parts of the body, such as the spine. Typical areas where stenosis occurs in the head and neck are the internal carotid artery, middle cerebral artery, vertebral artery, and basilar artery.
How common is intracranial stenosis?
Intracranial stenosis is responsible for about 10 percent of strokes each year. More than 795,000 Americans suffer a stroke each year.
Who gets intracranial stenosis?
Plaque can begin accumulating in a blood vessel as early as childhood, but atherosclerosis that is severe enough to cause symptoms is more likely to occur in older adults.
Risk factors include:
- High blood pressure
- High cholesterol
- Smoking and other tobacco use
- Family history of atherosclerosis
- Lack of exercise
How is intracranial stenosis diagnosed?
The following tests may be used to diagnose intracranial stenosis:
- CT angiography
- MR angiography
- Catheter-based angiography
- Transcranial doppler ultrasound
- Positron emission tomography (PET)
The main symptom of intracranial stenosis is having a transient ischemic attack (TIA) or stroke.
Symptoms of a stroke or TIA (“mini stroke”) include:
- Sudden, severe headache
- Paralysis or weakness on one side of the body
- Numbness or tingling
- Difficulty speaking or understanding
- Vision problems
- Dizziness or vertigo
If you think you are having a TIA or stroke, call 9-1-1 immediately.
The goal of treatment is to decrease the risk of stroke. Your doctor will recommend a treatment based on factors such as the size of the blockage and your risk for a first stroke or recurrent strokes.
Medications may be used to minimize risk factors, such as high cholesterol and high blood pressure. Blood thinners, such as aspirin, may be recommended to prevent clotting in a narrowed artery.
If there is a large blockage and high risk for stroke, your doctor may recommend surgery. Possible surgical procedures include:
- Angioplasty and stent placement is a minimally invasive endovascular procedure. A catheter is inserted into the femoral artery in the groin and passed through the network of arteries until it reaches the site of the blockage. A small balloon is then slowly inflated to push plaque outward and open up the artery.
- Endarterectomy is the surgical removal of plaque from a narrowed artery.
- Bypass surgery reroutes blood flow around a blocked blood vessel. Your surgeon may create a graft bypass using a vessel from another part of your body or a tube made of synthetic fabric.
- Date of last review: December 16, 2016
- Author: Peter Nakaji, MD