Intracranial Stenosis

What is intracranial stenosis?

Intracranial stenosis is the severe narrowing of an artery within the skull. A blood vessel narrows when fatty deposits (plaque) build up inside the vessel, a condition known as atherosclerosis. Stenosis can restrict blood flow to areas of the brain, increasing the risk of stroke.

Stenosis can occur in other parts of the body, such as the spine. Typical areas where stenosis occurs in the head and neck are the internal carotid artery, middle cerebral artery, vertebral artery, and basilar artery.

Treatments for Intracranial Stenosis

The goal of treatment is to decrease the risk of stroke. Your doctor will recommend a treatment based on factors such as the size of the blockage and your risk for a first stroke or recurrent strokes.

Medications may be used to minimize risk factors, such as high cholesterol and high blood pressure. Blood thinners, such as aspirin, may be recommended to prevent clotting in a narrowed artery.

If there is a large blockage and high risk for stroke, your doctor may recommend neurosurgery. Possible surgical procedures include:

• Angioplasty and stent placement is a minimally invasive endovascular procedure. A catheter is inserted into the femoral artery in the groin or the radial artery in the wrist and navigated through the arteries until it reaches the site of the blockage. A small balloon is then slowly inflated to push plaque outward and open up the artery, and a stent is placed to hold the vessel open.
• Bypass surgery reroutes blood flow around a blocked blood vessel. Your surgeon may create a graft bypass using a vessel from another part of your body or a tube made of synthetic fabric.