Intracranial Atherosclerotic Disease — ICAD
Intracranial Atherosclerotic Disease, or ICAD, is narrowing of the arteries inside the brain due to plaque buildup. When these vessels become severely narrowed, blood flow to the brain may reduce, increasing the risk of TIA, mini-stroke, or ischemic stroke. Common risk factors include high blood pressure, diabetes, high cholesterol, smoking, obesity, and heart disease.
At Dr. Sukalyan Purkayastha’s neurovascular care unit, ICAD is evaluated using advanced brain imaging such as MRI/MRA, CT angiography, digital subtraction angiography, and blood-flow assessment when required. Treatment usually begins with intensive medical management, including antiplatelet medicines, cholesterol control, blood pressure and diabetes management, and lifestyle correction. Current guidelines suggest angioplasty or intracranial stenting is not the first-line treatment for most patients, but it may be considered in carefully selected high-risk cases where symptoms continue despite best medical therapy.
Treatment includes:
- Best Medical Management
Antiplatelet medicines, cholesterol-lowering therapy, blood pressure control, diabetes control, smoking cessation, diet, and exercise. - Advanced Imaging & Monitoring
MRI/MRA, CT angiography, catheter angiography, and flow-based assessment help understand the severity of narrowing. - Endovascular Treatment
In selected patients, balloon angioplasty or intracranial stenting may be used to improve blood flow when symptoms recur despite proper medical treatment.
FAQs
ICAD is plaque-related narrowing of brain arteries, which can reduce blood flow and increase stroke risk.
Sudden weakness, slurred speech, vision loss, dizziness, numbness, confusion, or severe headache need urgent care.
Yes. Many patients are managed with medicines, risk-factor control, and lifestyle changes.
Stenting may be considered only in selected cases, especially when symptoms continue despite best medical treatment.