title: Is intracranial atherosclerosis an independent risk factor for cerebral atrophy? A retrospective evaluation.
abstract: BACKGROUND
  Our purpose was to study the association between the intracranial atherosclerosis as measured by cavernous carotid artery calcification (ICAC) observed on head CT and atrophic changes of supra-tentorial brain demonstrated by MRI.
  
  
  METHODS
  Institutional review board approval was obtained for this retrospective study incorporating 65 consecutive patients presenting acutely who had both head CT and MRI. Arterial calcifications of the intracranial cavernous carotids (ICAC) were assigned a number (1 to 4) in the bone window images from CT scans. These 4 groups were then combined into high (grades 3 and 4) and low calcium (grades 1 and 2) subgroups. Brain MRI was independently evaluated to identify cortical and central atrophy. Demographics and cardiovascular risk factors were evaluated in subjects with high and low ICAC. Relationship between CT demonstrated ICAC and brain atrophy patterns were evaluated both without and with adjustment for cerebral ischemic scores and cardiovascular risk factors.
  
  
  RESULTS
  Forty-six of the 65 (71%) patients had high ICAC on head CT. Subjects with high ICAC were older, and had higher prevalence of hypertension, diabetes, coronary artery disease (CAD), atrial fibrillation and history of previous stroke (CVA) compared to those with low ICAC. Age demonstrated strong correlation with both supratentorial atrophy patterns. There was no correlation between ICAC and cortical atrophy. There was correlation however between central atrophy and ICAC. This persisted even after adjustment for age.
  
  
  CONCLUSIONS
  Age is the most important determinant of atrophic cerebral changes. However, high ICAC demonstrated age independent association with central atrophy.
authors.affiliation: Department of Radiology, Tufts-New England Medical Center, Boston, MA, USA. serbay@msn.com
authors.forename: S
authors.initials: S
authors.lastname: Erbay
authors.forename: R
authors.initials: R
authors.lastname: Han
authors.forename: M
authors.initials: M
authors.lastname: Aftab
authors.forename: Kelly H
authors.initials: KH
authors.lastname: Zou
authors.forename: J F
authors.initials: JF
authors.lastname: Polak
authors.forename: Rafeeque A
authors.initials: RA
authors.lastname: Bhadelia
mesh_terms: D017668:Age of Onset; D000368:Aged; D001284:Atrophy / Q000000981:diagnostic imaging / Q000209:etiology*; D001921:Brain / Q000473:pathology*; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed