Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University.
Department of Research Statistical Support, Deanship of Scientific Research.
Neurologist. 2023 May 1;28(3):173-179. doi: 10.1097/NRL.0000000000000463.
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.
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 χ 2 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.
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).
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.
颅内动脉粥样硬化性疾病（ICAD）是急性缺血性脑卒中（AIS）的重要病因亚型。然而，关于沙特阿拉伯（SA）的 ICAD 相关脑卒中，目前几乎没有直接证据。本研究旨在确定 SA 队列中 ICAD 相关 AIS 的患病率，并描述其临床-放射学特征。
这是一项基于医院的回顾性研究，纳入了 2017 年至 2020 年间 ICAD 相关 AIS 患者。对电子病历进行了回顾。将脑卒中机制确定为动脉到动脉栓塞（AAE）、原位血栓闭塞、灌注不足或穿支分支闭塞。采用 Pearson χ 2 检验计算 P 值，以确定与脑卒中机制和功能结局相关的因素的统计学意义。
在 AIS 中发现 133 例 ICAD，占总数的 26%。对所有患者的数据进行了回顾。最常受累的血管是左侧颈内动脉（25%）。局灶性脑梗死（63.9%）是最常见的梗死模式，AAE（44.3%）是最常见的潜在机制。穿支分支闭塞在女性中比男性更常见。恶性和出血性转化（P=0.00）在 AAE 组更为常见。左侧血管受累与右侧相比更易出现不良结局（P=0.019）。
本研究来自西亚的队列中 ICAD 的患病率与南亚没有差异。ICA 受累比先前报道的更为常见。需要来自 SA 的进一步研究来更好地了解该地区的 ICAD 相关脑卒中。
