title: Predominance of Nonatherosclerotic Internal Elastic Lamina Calcification in the Intracranial Internal Carotid Artery.
abstract: OBJECTIVE
  Calcification of the intracranial internal carotid artery (iICA) is an independent risk factor for stroke. These calcifications are generally seen as manifestation of atherosclerosis, but histological investigations are limited. The aim of this study is to determine whether calcifications in the iICA are present in atherosclerotic plaques, or in other parts of the arterial wall.
  
  
  METHODS
  Thirty-nine iICAs were histologically assessed, using digital microscopy to quantify the amount of calcification in the different layers of the arterial wall.
  
  
  RESULTS
  Calcifications were found in the intima, around the internal elastic lamina and in the medial layer of the arterial wall. In 71% of the arteries, internal elastic lamina calcification contributed most to the total calcified cross-sectional surface area. Internal elastic lamina calcification was unrelated to the occurrence of atherosclerotic intimal lesions. Intimal calcifications were most often associated with atherosclerotic lesions, but also many noncalcified atherosclerotic lesions were found.
  
  
  CONCLUSIONS
  In the iICA, calcifications are predominantly present around the internal elastic lamina, suggesting that this nonatherosclerotic type of calcification contributes to the previously observed increased risk of stroke in patients with iICA calcifications.
authors.affiliation: From the Departments of Pathology (A.V., W.V.H., W.G.M.S., R.G., A.V.), Radiology (R.K., W.P.T.M.M., P.A.J.), Anatomy (R.L.A.W.B.), and Image Sciences Institute (I.I.), University Medical Center, Utrecht, The Netherlands.
authors.forename: Annelotte
authors.initials: A
authors.lastname: Vos
authors.affiliation: From the Departments of Pathology (A.V., W.V.H., W.G.M.S., R.G., A.V.), Radiology (R.K., W.P.T.M.M., P.A.J.), Anatomy (R.L.A.W.B.), and Image Sciences Institute (I.I.), University Medical Center, Utrecht, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Van Hecke
authors.affiliation: From the Departments of Pathology (A.V., W.V.H., W.G.M.S., R.G., A.V.), Radiology (R.K., W.P.T.M.M., P.A.J.), Anatomy (R.L.A.W.B.), and Image Sciences Institute (I.I.), University Medical Center, Utrecht, The Netherlands.
authors.forename: Wim G M
authors.initials: WG
authors.lastname: Spliet
authors.affiliation: From the Departments of Pathology (A.V., W.V.H., W.G.M.S., R.G., A.V.), Radiology (R.K., W.P.T.M.M., P.A.J.), Anatomy (R.L.A.W.B.), and Image Sciences Institute (I.I.), University Medical Center, Utrecht, The Netherlands.
authors.forename: Roel
authors.initials: R
authors.lastname: Goldschmeding
authors.affiliation: From the Departments of Pathology (A.V., W.V.H., W.G.M.S., R.G., A.V.), Radiology (R.K., W.P.T.M.M., P.A.J.), Anatomy (R.L.A.W.B.), and Image Sciences Institute (I.I.), University Medical Center, Utrecht, The Netherlands.
authors.forename: Ivana
authors.initials: I
authors.lastname: Isgum
authors.affiliation: From the Departments of Pathology (A.V., W.V.H., W.G.M.S., R.G., A.V.), Radiology (R.K., W.P.T.M.M., P.A.J.), Anatomy (R.L.A.W.B.), and Image Sciences Institute (I.I.), University Medical Center, Utrecht, The Netherlands.
authors.forename: Remko
authors.initials: R
authors.lastname: Kockelkoren
authors.affiliation: From the Departments of Pathology (A.V., W.V.H., W.G.M.S., R.G., A.V.), Radiology (R.K., W.P.T.M.M., P.A.J.), Anatomy (R.L.A.W.B.), and Image Sciences Institute (I.I.), University Medical Center, Utrecht, The Netherlands.
authors.forename: Ronald L A W
authors.initials: RL
authors.lastname: Bleys
authors.affiliation: From the Departments of Pathology (A.V., W.V.H., W.G.M.S., R.G., A.V.), Radiology (R.K., W.P.T.M.M., P.A.J.), Anatomy (R.L.A.W.B.), and Image Sciences Institute (I.I.), University Medical Center, Utrecht, The Netherlands.
authors.forename: Willem P T M
authors.initials: WP
authors.lastname: Mali
authors.affiliation: From the Departments of Pathology (A.V., W.V.H., W.G.M.S., R.G., A.V.), Radiology (R.K., W.P.T.M.M., P.A.J.), Anatomy (R.L.A.W.B.), and Image Sciences Institute (I.I.), University Medical Center, Utrecht, The Netherlands.
authors.forename: Pim A
authors.initials: PA
authors.lastname: de Jong
authors.affiliation: From the Departments of Pathology (A.V., W.V.H., W.G.M.S., R.G., A.V.), Radiology (R.K., W.P.T.M.M., P.A.J.), Anatomy (R.L.A.W.B.), and Image Sciences Institute (I.I.), University Medical Center, Utrecht, The Netherlands. a.vink@umcutrecht.nl.
authors.forename: Aryan
authors.initials: A
authors.lastname: Vink
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis; D002343:Carotid Artery, Internal / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000175:diagnosis / Q000209:etiology; D017539:Tunica Intima / Q000473:pathology*; D061205:Vascular Calcification / Q000150:complications / Q000175:diagnosis*
keywords: atherosclerosis; humans; internal carotid artery; stroke; vascular calcification