Data from: Outcomes after ischemic stroke caused by intracranial atherosclerosis versus dissection

Objective To compare the outcomes between patients with non-traumatic
intracranial arterial dissection (ICAD) and intracranial atherosclerotic
stenosis (ICAS) using high-resolution MRI (HR-MRI). Methods We conducted a
prospective study using HR-MRI in patients with acute symptomatic
cerebrovascular disease due to intracranial occlusive disease and no
dissection on luminal images. Patients were followed-up for 27.9 ± 19.3
months. We compared the functional outcome, recurrence, and changes in
vascular status between patients with ICAD (dissection and no plaque on
HR-MRI) and ICAS (atherosclerosis plaque on HR-MRI). Results We included
312 patients (mean age, 59.0 ± 14.2 years; men, 58.3%), of whom 113 had
ICAD and 199 had ICAS. The functional outcome (as measured by modified
Rankin score) on the 90th day after symptom onset was not different
between the groups, after adjusted for other factors (P = 0.095). However,
recurrent ischemic cerebrovascular disease on the relevant vascular
territory was lower in the ICAD group (7 patients, 6.2%) than in the ICAS
group (37 patients, 18.6%). ICAD was a significant independent determinant
of disease recurrence (hazard ratio, 0.43; 95% CI, 0.19–0.98). Improvement
in vascular stenosis on follow-up vascular studies was more frequently
observed in ICAD (50.7%) than in ICAS (11.6%). ICAD was an independent
determinant of vascular improvement (odds ratio, 7.94; 95% CI,
3.32–19.01). Conclusion Considering the high prevalence of ICAD in the
patients with presumed ICAS and the differential outcomes between ICAD and
ICAS, HR-MRI may be a useful diagnostic tool in this population.