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Intracranial atherosclerosis is a major cause of ischemic stroke. Depending on the population studied, it accounts for 10 to 29% of brain ischemic events.1 There is now no consensus regarding optimal medical management for these patients, although most patients receive antiplatelet agents or warfarin.2
Despite its frequency, the prognosis for patients with symptomatic intracranial stenosis is not well-defined. A retrospective, nonrandomized review of 151 patients with 50 to 99% stenosis treated at several academic centers found that the stroke rate was 10.4 per 100 patient-years with aspirin and 3.6 with warfarin.3 Another retrospective study of 102 patients with symptomatic, intracranial vertebrobasilar stenosis found that 14% of the patients had another stroke over a 15-month follow-up interval, although only 57% of the strokes were in the territory of the originally symptomatic artery.4 For patients who …
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