GeneHealth - Your precision medicine

Intracranial Arteriosclerosis

Disease Details

Family Health Simplified

Buy Membership

Description: Intracranial arteriosclerosis involves the thickening and hardening of the walls of the arteries within the brain, leading to restricted blood flow and an increased risk of stroke.
Type: Intracranial arteriosclerosis is primarily a non-hereditary condition stemming from lifestyle factors, such as high blood pressure, high cholesterol, smoking, and diabetes, rather than a specific genetic transmission pattern. However, certain genetic factors may predispose individuals to conditions like hypertension or hypercholesterolemia, which can contribute to the development of arteriosclerosis.
Signs And Symptoms: Atherosclerosis is asymptomatic for decades because the arteries enlarge at all plaque locations, thus there is no effect on blood flow. Even most plaque ruptures do not produce symptoms until enough narrowing or closure of an artery, due to clots, occurs. Signs and symptoms only occur after severe narrowing or closure impedes blood flow to different organs enough to induce symptoms. Most of the time, patients realize that they have the disease only when they experience other cardiovascular disorders such as stroke or heart attack. These symptoms, however, still vary depending on which artery or organ is affected.Early atherosclerotic processes likely begin in childhood. Fibrous and gelatinous lesions have been observed in the coronary arteries of children. Fatty streaks have been observed in the coronary arteries of juveniles.While coronary artery disease is more prevalent in men than women, atherosclerosis of the cerebral arteries and strokes equally affect both sexes.Marked narrowing in the coronary arteries, which are responsible for bringing oxygenated blood to the heart, can produce symptoms such as chest pain of angina and shortness of breath, sweating, nausea, dizziness or lightheadedness, breathlessness or palpitations. Abnormal heart rhythms called arrhythmias—the heart beating either too slowly or too quickly—are another consequence of ischemia.Carotid arteries supply blood to the brain and neck. Marked narrowing of the carotid arteries can present with symptoms such as: a feeling of weakness; being unable to think straight; difficulty speaking; dizziness; difficulty in walking or standing up straight; blurred vision; numbness of the face, arms and legs; severe headache; and loss of consciousness. These symptoms are also related to stroke (death of brain cells). Stroke is caused by marked narrowing or closure of arteries going to the brain; lack of adequate blood supply leads to the death of the cells of the affected tissue.Peripheral arteries, which supply blood to the legs, arms and pelvis, also experience marked narrowing due to plaque rupture and clots. Symptoms of the narrowing are numbness within the arms or legs, as well as pain. Another significant location for plaque formation is the renal arteries, which supply blood to the kidneys. Plaque occurrence and accumulation lead to decreased kidney blood flow and chronic kidney disease, which, like in all other areas, is typically asymptomatic until late stages.In 2004, US data indicated that in ~66% of men and ~47% of women, the first symptom of atherosclerotic cardiovascular disease was a heart attack or sudden cardiac death (defined as death within one hour of onset of the symptom).Case studies have included autopsies of U.S. soldiers killed in World War II and the Korean War. A much-cited report involved the autopsies of 300 U.S. soldiers killed in Korea. Although the average age of the men was 22.1 years, 77.3 percent had "gross evidence of coronary arteriosclerosis".
Prognosis: The prognosis for intracranial arteriosclerosis, also known as intracranial atherosclerosis, varies depending on several factors, including the severity of the disease, the presence of symptoms, and the patient's overall health. Generally, it is a progressive condition that can lead to serious complications such as stroke or transient ischemic attacks. Early detection and effective management of risk factors like hypertension, hyperlipidemia, diabetes, and smoking can improve outcomes. However, because the disease can cause narrowing and hardening of the arteries in the brain, it remains a significant risk factor for cerebrovascular events. Therefore, ongoing medical supervision and lifestyle changes are crucial in managing the condition and improving the prognosis.
Onset: The onset of intracranial arteriosclerosis typically occurs in middle-aged to older adults. This condition is characterized by the thickening and hardening of the arterial walls within the brain, often developing over many years due to factors like high blood pressure, smoking, diabetes, and high cholesterol.
Prevalence: The exact prevalence of intracranial arteriosclerosis can vary based on population demographics, particularly age and ethnicity. It is more common in older adults and certain ethnic groups, such as African Americans, Asians, and Hispanics. However, detailed prevalence rates are not consistent across all studies and regions.
Epidemiology: Cardiovascular disease, which is predominantly the clinical manifestation of atherosclerosis, is one of the leading causes of death worldwide.Almost all children older than age 10 in developed countries have aortic fatty streaks, with coronary fatty streaks beginning in adolescence.In 1953, a study was published which examined the results of 300 autopsies performed on U.S. soldiers who had died in the Korean War. Despite the average age of the soldiers being just 22 years old, 77% of them had visible signs of coronary atherosclerosis. This study showed that heart disease could affect people at a younger age and was not just a problem for older individuals.In 1992, a report had shown that microscopic fatty streaks were seen in the left anterior descending artery in over 50% of children aged 10–14 and 8% had even more advanced lesions with more accumulations of extracellular lipid.In a 2005 report of a study done between 1985 and 1995, it was found that around 87% of aortas and 30% of coronary arteries in age group 5–14 years had fatty streaks which increased with age.
Intractability: Intracranial arteriosclerosis can be challenging to treat but is not necessarily intractable. Management involves controlling risk factors like hypertension, diabetes, and high cholesterol, alongside lifestyle modifications. Medical treatments may include antiplatelet therapy or statins, and in some cases, surgical interventions like angioplasty or stenting may be necessary. The effectiveness of these treatments varies based on individual circumstances.
Disease Severity: Intracranial arteriosclerosis, also known as intracranial atherosclerosis, refers to the build-up of plaque within the arteries in the brain. The severity of this condition can vary widely:

1. Mild: In the early stages, patients may be asymptomatic or experience mild symptoms like transient ischemic attacks (TIAs).
2. Moderate: As the disease progresses, blood flow to the brain becomes more restricted, increasing the risk of more significant TIAs and small strokes.
3. Severe: Advanced intracranial arteriosclerosis can lead to major strokes, resulting in significant neurological deficits or death.

Monitoring and management depend on the degree of arterial narrowing and the presence of symptoms.
Healthcare Professionals: Disease Ontology ID - DOID:13097
Pathophysiology: Atherogenesis is the developmental process of atheromatous plaques. It is characterized by a remodeling of arteries leading to subendothelial accumulation of fatty substances called plaques. The buildup of an atheromatous plaque is a slow process, developed over a period of several years through a complex series of cellular events occurring within the arterial wall and in response to a variety of local vascular circulating factors. One recent hypothesis suggests that, for unknown reasons, leukocytes, such as monocytes or basophils, begin to attack the endothelium of the artery lumen in cardiac muscle. The ensuing inflammation leads to the formation of atheromatous plaques in the arterial tunica intima, a region of the vessel wall located between the endothelium and the tunica media. The bulk of these lesions is made of excess fat, collagen, and elastin. At first, as the plaques grow, only wall thickening occurs without any narrowing. Stenosis is a late event, which may never occur and is often the result of repeated plaque rupture and healing responses, not just the atherosclerotic process by itself.
Carrier Status: Intracranial arteriosclerosis, also known as intracranial atherosclerosis, is a condition where there is a buildup of fatty deposits and plaque within the arteries of the brain, leading to reduced blood flow. It is not a condition that involves carrier status, as it is not a hereditary genetic disorder passed down in a simple Mendelian fashion. Instead, it is influenced by a variety of risk factors such as hypertension, high cholesterol, diabetes, smoking, and a sedentary lifestyle.
Mechanism: Intracranial arteriosclerosis is the hardening and narrowing of the arteries within the brain, which can restrict blood flow and lead to cerebrovascular events like stroke.

Mechanism:
1. **Endothelial Dysfunction**: The inner lining of the arteries (endothelium) becomes damaged, often due to high blood pressure, smoking, diabetes, or high cholesterol.
2. **Lipid Accumulation**: Lipids, particularly low-density lipoproteins (LDL), accumulate in the arterial walls.
3. **Inflammation**: Endothelial damage evokes an inflammatory response, attracting immune cells (macrophages) to the site.
4. **Plaque Formation**: Macrophages ingest lipids, turning into foam cells and contributing to the formation of atherosclerotic plaques. The plaques contain a core of lipids and a cap of fibrous tissue.
5. **Arterial Stiffening**: Over time, plaques can harden and calcify, leading to the stiffening and narrowing of the affected arteries.

Molecular Mechanisms:
1. **Oxidative Stress**: Reactive oxygen species (ROS) generated from metabolic processes or external factors (e.g., smoking) can oxidize LDL, making it more atherogenic.
2. **Inflammatory Cytokines**: Molecules like interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-alpha (TNF-α) are elevated, contributing to the inflammatory processes in the arterial walls.
3. **Endothelial Nitric Oxide Synthase (eNOS) Depletion**: Reduced eNOS activity limits the availability of nitric oxide (NO), impairing vasodilation, and promoting vascular stiffness.
4. **Platelet Activation**: Dysregulation of platelet function can promote thrombosis (clot formation) on top of atherosclerotic plaques, exacerbating occlusion.
5. **Matrix Metalloproteinases (MMPs)**: These enzymes degrade extracellular matrix components within the arterial wall, contributing to plaque instability and the potential for rupture.

Overall, intracranial arteriosclerosis is a multifactorial condition involving complex interplays between lipids, inflammatory responses, endothelial health, and cellular mechanisms.
Treatment: Treatment of established disease may include medications to lower cholesterol such as statins, blood pressure medication, or medications that decrease clotting, such as aspirin. A number of procedures may also be carried out such as percutaneous coronary intervention, coronary artery bypass graft, or carotid endarterectomy.Medical treatments often focus on alleviating symptoms. However measures which focus on decreasing underlying atherosclerosis—as opposed to simply treating symptoms—are more effective. Non-pharmaceutical means are usually the first method of treatment, such as stopping smoking and practicing regular exercise. If these methods do not work, medicines are usually the next step in treating cardiovascular diseases and, with improvements, have increasingly become the most effective method over the long term.The key to the more effective approaches is to combine multiple different treatment strategies. In addition, for those approaches, such as lipoprotein transport behaviors, which have been shown to produce the most success, adopting more aggressive combination treatment strategies taken on a daily basis and indefinitely has generally produced better results, both before and especially after people are symptomatic.
Compassionate Use Treatment: Compassionate use treatment for intracranial arteriosclerosis may involve access to investigational drugs or therapies not yet approved by regulatory authorities but showing potential benefit in clinical trials. These treatments are typically accessed through a physician's request to the appropriate regulatory body, such as the FDA in the United States.

Off-label or experimental treatments might include drugs approved for other conditions but used for intracranial arteriosclerosis based on emerging evidence or clinical judgment. Examples include:

1. **Statins**: Primarily used to lower cholesterol, statins may reduce the progression of arteriosclerosis due to their anti-inflammatory and plaque-stabilizing properties.
2. **Antiplatelet Agents**: Medications like clopidogrel are used off-label to reduce the risk of stroke by preventing blood clots.
3. **Angioplasty and Stenting**: Although primarily used for coronary artery disease, some neurologists or interventional radiologists might consider these procedures in certain cases of intracranial stenosis.
4. **Novel Anticoagulants**: These are sometimes used experimentally to manage blood clotting and reduce stroke risk.
5. **Experimental Therapies**: Includes ongoing clinical trials investigating new drugs, such as those targeting specific pathways in atherosclerosis or using advanced imaging technologies to better guide treatment.

Patients should consult with their healthcare providers for personalized advice and to explore eligibility for experimental treatments or clinical trials.
Lifestyle Recommendations: For intracranial arteriosclerosis, here are some lifestyle recommendations:

1. **Healthy Diet**:
- Focus on a diet rich in fruits, vegetables, whole grains, and lean proteins.
- Limit intake of saturated fats, trans fats, cholesterol, salt, and added sugars.

2. **Regular Exercise**:
- Engage in at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity activity each week.
- Include muscle-strengthening exercises on two or more days per week.

3. **Quit Smoking**:
- Avoid smoking and use of tobacco products. Seek professional help if needed to quit.

4. **Limit Alcohol**:
- Consume alcohol in moderation, if at all. Generally, up to one drink per day for women and up to two drinks per day for men.

5. **Weight Management**:
- Maintain a healthy weight through a balanced diet and regular exercise.

6. **Blood Pressure Control**:
- Regularly monitor blood pressure and follow medical advice to keep it within a healthy range.

7. **Diabetes Management**:
- If diabetic, manage blood sugar levels effectively with diet, exercise, and medication if prescribed.

8. **Stress Management**:
- Practice stress-reducing techniques such as meditation, deep breathing, yoga, or other relaxation methods.

9. **Regular Check-Ups**:
- Have regular medical check-ups to monitor and manage risk factors such as cholesterol and blood pressure.

10. **Medication Adherence**:
- Take medications as prescribed by your healthcare provider to manage risk factors and prevent the progression of the disease.

Implementing these lifestyle changes can help manage intracranial arteriosclerosis and reduce the risk of related complications.
Medication: For intracranial arteriosclerosis, the primary medications often used include:

1. **Antiplatelet agents** such as aspirin or clopidogrel to reduce the risk of stroke.
2. **Statins** like atorvastatin or rosuvastatin to lower cholesterol levels and stabilize plaque.
3. **Antihypertensive drugs** such as ACE inhibitors, beta-blockers, or calcium channel blockers to control blood pressure.
4. **Diabetes medications** for patients with coexisting diabetes, to control blood sugar levels.

These medications aim to manage risk factors and prevent complications, but individual treatment may vary based on patient specifics. Always consult with a healthcare professional for personalized advice.
Repurposable Drugs: There are no currently established repurposable drugs specifically for intracranial arteriosclerosis. Treatment typically focuses on managing risk factors and preventing stroke, including the use of antiplatelet agents like aspirin, cholesterol-lowering drugs such as statins, and antihypertensives. Research into repurposable drugs and novel therapies may provide additional options in the future.
Metabolites: Intracranial arteriosclerosis, also known as intracranial atherosclerosis, involves the build-up of fatty deposits and cholesterol on the inner walls of arteries within the brain. This can lead to restricted blood flow and increase the risk of strokes.

Metabolites related to this condition typically include:
1. Cholesterol derivatives: Elevated levels of LDL cholesterol can contribute to plaque formation in the arteries.
2. Inflammatory markers: C-reactive protein (CRP) and interleukins can indicate inflammation within the arteries.
3. Homocysteine: High levels of this amino acid can damage the arterial walls and promote plaque build-up.
4. Lipoproteins: Particularly lipoprotein (a), which can be a risk factor for atherosclerosis.

Nanotechnology is a developing field in the context of intracranial arteriosclerosis:
- Nanomedicine: Utilizes nanoparticles for targeted drug delivery to reduce or stabilize atherosclerotic plaques.
- Imaging: Enhances imaging techniques like magnetic resonance imaging (MRI) to better identify and monitor arterial plaque.
- Diagnostics: Development of nano-based biosensors for early detection of biochemical markers associated with arteriosclerosis.

Research in nanotechnology aims to create more effective, targeted, and less invasive treatments and diagnostic tools for managing and understanding intracranial arteriosclerosis.
Nutraceuticals: There is limited scientific evidence specifically supporting the use of nutraceuticals for intracranial arteriosclerosis. However, some nutraceuticals that may be beneficial for overall cardiovascular health, which could indirectly support brain artery health, include omega-3 fatty acids (found in fish oil), antioxidants (such as vitamin E and polyphenols), and dietary fiber. Always consult with a healthcare professional before starting any new supplement regimen.
Peptides: Intracranial arteriosclerosis refers to the thickening and hardening of the walls of the arteries within the brain, which can lead to reduced blood flow and increase the risk of stroke. Peptides are short chains of amino acids that play various roles in the body, including the regulation of physiological functions and potential therapeutic applications. In the context of intracranial arteriosclerosis, research into specific peptides could explore their potential in promoting vascular health or reducing plaque buildup. However, detailed studies are required to establish their efficacy and safety.

Nanotherapy uses nanoparticles to deliver drugs or other therapeutic agents directly to targeted areas in the body. For intracranial arteriosclerosis, nanotherapies could theoretically provide more precise treatment by delivering medications directly to the affected arteries, minimizing side effects and increasing effectiveness. Current research is exploring various nanoparticles for their potential use in treating or managing atherosclerosis and related conditions.