title: Ischemic stroke related to intracranial branch atheromatous disease and comparison with large and small artery diseases.
abstract: BACKGROUND
  The mechanism of ischemic stroke in intracranial branch atheromatous disease (BAD) is different from large artery atherothrombotic disease (LAD) or lacunar infarction (LACI). The concept of BAD is underused in clinical practice and research.
  
  
  METHODS
  Patients admitted over 24-months with ischemic stroke caused by atherosclerotic disease were reviewed retrospectively and classified according to radiological±clinical criteria into LAD, BAD and LACI. The BAD cases were further divided into 5 BAD syndromes. Clinical characteristics, vascular risk factors, results of vascular workup and outcome among these subgroups were compared.
  
  
  RESULTS
  123 cases of LAD (17% of all stroke patients or 33% of all studied patients), 147 BAD (20% or 40%) and 102 LACI (14% or 27%) presented during the study period. Compared to LAD, BAD patients had milder neurological deficits, were less often diabetic and carotid stenosis was less common, while stenosis of the intracranial arteries was more frequent in BAD as compared with LACI patients. Outcome in BAD patients was intermediate between LAD and LACI. Comparisons among the BAD syndromes indicated they were homogenous conditions.
  
  
  CONCLUSIONS
  BAD is the most prevalent ischemic stroke subtype in our cohort. The homogeneity among the BAD syndromes suggests they might represent a distinctive stroke entity.
authors.affiliation: Department of Medicine, Queen Mary Hospital, University of Hong Kong, China.
authors.forename: May Wai-Mei
authors.initials: MW
authors.lastname: Kwan
authors.forename: Windsor
authors.initials: W
authors.lastname: Mak
authors.forename: Raymond Tak-Fai
authors.initials: RT
authors.lastname: Cheung
authors.forename: Shu-Leong
authors.initials: SL
authors.lastname: Ho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020144:Basal Ganglia Cerebrovascular Disease / Q000473:pathology; D002545:Brain Ischemia / Q000150:complications / Q000473:pathology*; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000473:pathology*; D002544:Cerebral Infarction / Q000473:pathology; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D011149:Pons / Q000473:pathology; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome