Deans' stroke musings: Association between intracranial arterial stenosis severity and recurrent stroke risk in elderly ischemic stroke patients

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, May 25, 2026

Association between intracranial arterial stenosis severity and recurrent stroke risk in elderly ischemic stroke patients

Why do 'association' research instead of EXACTLY PREVENTING this problem from occurring? Your mentors and senior researchers incompetently didn't tell you that stroke research is supposed to solve survivors problems?

Association between intracranial arterial stenosis severity and recurrent stroke risk in elderly ischemic stroke patients

Z
Zhen Tao 1
Hongwei Guo 2*
Y
Yingying Liu 2
Jun-Bin Yin 2
Hu Huai Qiang 2
H
Haowen Lu 2

1. No. 971 Hospital of the People's Liberation Army Navy, Qingdao, China
2. Department of Neurology, The 960(th) Hospital of Joint Logistics Support, PLA, Jinan, China

Abstract

Background and aim:

Intracranial arterial stenosis (ICAS) is a major cause of ischemic stroke in older adults and is associated with substantial risk of recurrent cerebrovascular events. Whether increasing ICAS severity confers incremental recurrence risk in medically treated elderly patients in routine clinical practice remains incompletely characterized. This study aimed to investigate the association between intracranial arterial stenosis severity and 12-month recurrent stroke risk in elderly patients with ischemic stroke.

Methods:

This single-center retrospective cohort study screened 614 consecutive patients aged 65 years or older who were admitted with acute ischemic stroke between January 2022 and December 2023. After predefined exclusions, 527 patients were included in the final analysis. Intracranial arterial stenosis was assessed using computed tomography angiography or magnetic resonance angiography and categorized as none-to-mild (<50%; including no stenosis), moderate (50–69%), or severe (≥70%) according to the highest-grade lesion. The primary outcome was recurrent ischemic stroke within 12 months. Univariable and multivariable logistic regression models were used to evaluate independent predictors of recurrence.

Results:

Among the 527 included patients, recurrent ischemic stroke occurred in 86 (16.3%) during 12-month follow-up. Recurrence rates increased stepwise across stenosis categories, occurring in 18/214 (8.4%) patients with none-to-mild stenosis, 29/173 (16.8%) with moderate stenosis, and 39/140 (27.9%) with severe stenosis (p < 0.001). After adjustment for age, sex, vascular risk factors, stroke subtype, baseline NIHSS score, and medication use, severe ICAS remained independently associated with recurrent stroke (adjusted OR 3.12, 95% CI 1.85–5.26, p < 0.001); moderate stenosis was also independently associated with recurrence (adjusted OR 1.96, 95% CI 1.04–3.69, p = 0.037).

Conclusion:

In elderly patients with ischemic stroke, greater intracranial arterial stenosis severity is independently associated with higher 12-month recurrence risk despite contemporary medical management. These findings support early vascular imaging and risk stratification in elderly patients with ischemic stroke.