The Present and Future
JACC Review Topic of the Week
Intracranial Arterial Calcification: Prevalence, Risk Factors, and Consequences: JACC Review Topic of the Week

https://doi.org/10.1016/j.jacc.2020.07.056Get rights and content
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Highlights

  • Intracranial arterial calcifications are common on CT imaging in the general population and, although some calcifications are considered innocent, others are associated with adverse clinical outcomes.

  • Intimal and medial calcification in large intracranial arteries differ with respect to risk factors and clinical outcomes.

  • Investigation of intracranial calcification might lead to new therapeutic options for prevention of stroke and dementia.

Abstract

Intracranial large and small arterial calcifications are a common incidental finding on computed tomography imaging in the general population. Here we provide an overview of the published reports on prevalence of intracranial arterial calcifications on computed tomography imaging and histopathology in relation to risk factors and clinical outcomes. We performed a systematic search in Medline, with a search filter using synonyms for computed tomography scanning, (histo)pathology, different intracranial arterial beds, and calcification. We found that intracranial calcifications are a frequent finding in all arterial beds with the highest prevalence in the intracranial internal carotid artery. In general, prevalence increases with age. Longitudinal studies on calcification progression and intervention studies are warranted to investigate the possible causal role of calcification on clinical outcomes. This might open up new therapeutic directions in stroke and dementia prevention and the maintenance of the healthy brain.

Key Words

cognitive impairment
computed tomography
dementia
epidemiology
histology
intracranial arterial calcification
stroke

Abbreviations and Acronyms

CT
computed tomography
IEL
internal elastic lamina
MCA
middle cerebral artery
PFBC
primary familial brain calcification

Cited by (0)

Dr. Hendrikse has received funding from the European Research Council under the European Union's Horizon 2020 Programme (H2020), grant agreement 637024 (HEARTOFSTROKE), and H2020 grant agreement 666881, SVDs@target; however, none of these was received during the conduct of the study. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC author instructions page.

Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.