Intracranial Atherosclerosis in Asian Populations

Abstract

Caucasians have a higher incidence rate of extracranial atherosclerosis, whereas African-Americans and Asians have a higher rate of intracranial atherosclerosis. Carotid stenosis was extensively studied in terms of epidemiology, pathophysiology, and treatment. Unfortunately, relatively little is known about intracranial atherosclerosis until recently when modern neuroimaging methods allowed noninvasive screening of susceptible patients. In China, stroke became the first cause of death in 2008, and the prevalence is increasing steadily. In Chinese populations, intracranial atherosclerosis accounts for about 50% of stroke. Similar prevalence was observed in Thailand, Korea, and Singapore. As the majority of the world’s populations are Asians, it is reasonable to conclude that intracranial atherosclerosis is the most common vascular lesion in stroke patients worldwide. This point is now of interest to Europe because the observed ethnic variance in the distribution of cerebral atherosclerosis might require a different approach to screening of high-risk patients belonging to ethnic minorities.