Intracranial Atherosclerosis

Abstract

Atherosclerosis remains the most widespread disorder leading to death and serious morbidity causing stroke, ischaemic heart disease, and vascular insufficiency of the extremities (World Health Report, 1995 ).

The atherosclerotic fibrous plaque is the basic pathologic entity of atherosclerosis encountered in middle aged and elderly persons. Fatty streaks are harbingers of the future atherosclerosis and are seen in early childhood (Masud and Ross, 1990).

On e of the earliest events in atherosclerosis is an increased adhesion of monocytes to the endothelium causing cell injury. Macrophages are implicated in the oxidative lipoprotein ( LDL ). Under the influence of growth factors released by the injured endothelium and macrophages, smooth muscle cells migrate to the intima and proliferate leading to further progression of the atherosclerotic plaque. The advanced lesions become complicated by mural thrombosis, plaque ulceration, calcification and plaque hemorrhage (Guyton and klemp, 1996).

The lesions of atherosclerosis tend to have a characteristic pattern of distribution in the vascular tree. The abdominal aorta is involved earlier and more extensively than other vessels, while · lesions in the cerebral vessels occur relatively late and are less extensive (Strong, 1992).