Intracranial atherosclerosis
- Intracranial atherosclerotic stenosis of a major intracranial artery is a leading cause of stroke
- Recurrent strokes are common features of both moyamoya and intracranial atherosclerotic stenosis
- Suspect intracranial atherosclerosis as a cause of stroke in patients with major risk factors (eg, diabetes mellitus, hypertension, dyslipidemia, smoking)
- Atherosclerosis is a process generally observed in older patients, whereas moyamoya presents in youth or middle adulthood
- MRI in patients with severe diffuse atherosclerosis may mimic moyamoya, but vessels in these patients rarely develop the puff of smoke appearance that is pathognomonic of moyamoya, and these patients often have poor extracranial to intracranial collateral vessel formation
