Common Questions About Intracranial Stenting for Stroke Treatment

Understanding Risk Factors

Who is predisposed to Intracranial stenosis? Intracranial stenosis is a condition that causes the buildup of plaque inside the arteries in your brain. There are several risk factors that indicate a predisposition for intracranial stenosis, including ethnicity, family medical history, and existing health risks.

People of Asian or African descent have a higher risk of intracranial stenosis, as do people with a family history of diabetes or atherosclerosis (a condition that causes arterial plaque).

Other risk factors include:

• High blood pressure
• High cholesterol
• Diabetes
• Metabolic syndrome
• Obesity
• Smoking and tobacco use
• Age
• Lack of exercise

Indications for Intracranial Stenting: When Do You Need It?

Not all patients with intracranial stenosis require intracranial stenting. First, your doctor will guide you through medical treatments and lifestyle changes intended to reduce arterial plaque. However, not everyone is responsive to these treatments.

Patients who are still at a high risk of stroke after medical treatment become candidates for intracranial stenting. If you are still experiencing recurrent stroke symptoms after medical therapy, intracranial stenting may become necessary as a life-saving measure.

Recognizing Symptoms of Intracranial Stenosis and Impending Stroke

Intracranial stenosis is a direct cause of strokes. When the artery is blocked, a section of the brain is deprived of blood, which results in a stroke and potential brain damage.

The first symptoms of intracranial stroke include transient ischemic attacks (TIAs) and ischemic strokes. TIAs are like strokes but are very brief. They are often referred to as a 'warning stroke' but only last 2-30 minutes.

Symptoms of a TIA include:

• Sudden numbness or weakness on one side of the body
• Sudden severe headache without a known cause
• Dizziness and loss of balance
• Sudden confusion
• Trouble speaking
• Sudden vision problems
• Sudden coordination and walking trouble

These symptoms are shared with those of a more severe ischemic stroke, but a full stroke has more lasting effects. TIAs occur when an artery is temporarily blocked, but blood eventually gets through. This should be taken as a warning, as a more severe stroke will occur when the blockage can no longer be cleared by normal blood pressure.

Diagnosis: How Intracranial Stenosis is Detected

Intracranial stenosis is often detected only after the first TIA or stroke. It is imperative to seek immediate medical attention. In order to confirm the diagnosis, a series of tests are conducted, including magnetic resonance imagery (MRI) and computed tomography (CT) angiography. These scans can diagnose the condition and observe the affected area to determine the risk level and if any damage has been caused by a recent stroke.

Transcranial Doppler (TCD) ultrasounds and angiograms can also be used to analyze blood vessels and blood flow within the body.

The Intracranial Stenting Procedure: What to Expect

In order to insert the mesh stent into your brain artery, it is delivered by catheter through a larger artery near the skin. The usual entry point is a tiny incision at the groin. The catheter is a very thin and flexible plastic tube. It is threaded up the arterial system to the specific clogged artery in the brain. Then, through the catheter, the compressed mesh is delivered.

Once deployed, the mesh tube expands and conforms to the shape of the artery, pushing the walls open to allow for clear blood flow. Then, the catheter is removed.

Post-Stenting Recovery: Rehabilitation and Monitoring

Recovery from intracranial stenting is remarkably mild. Patients may be tired for a few days after the procedure, but often return to normal life after 3 to 7 days. Patients may experience some bruising or soreness around the incision point, but this should also heal in a fairly short amount of time.

The doctor will likely prescribe clot-prevention medications and schedule several follow-up appointments to allow for recovery monitoring to confirm that the stent is working and the patient is no longer at risk of a stroke.  From there, it may be necessary to monitor arteries to ensure any plaque-forming conditions do not develop a new risk location.

Follow-Up Care

After the intracranial stent procedure, patients should consult with their doctor on lifestyle changes to help prevent further arterial blockages. Patients should allow the incision site to heal fully before engaging in strenuous activities and take steps to minimize cholesterol or blood pressure.

Other Minimally Invasive Stroke Treatment Options

Intracranial stenting isn't the only way to solve a stroke. Depending on the problem, there are other forms of micro-surgery and treatment that offer minimally invasive solutions to combat the risk of a stroke. Each offers a different route to remove, dissolve, or otherwise resolve the clot.

• Mechanical thrombectomy
• Stereotactic surgery
• Endoscopic removal

When to Consider an Intracranial Stenting Specialist Assessment

Narrowing of the brain arteries can increase the risk of stroke, particularly when associated with symptoms or previous neurological events. A specialist assessment helps determine the underlying cause, evaluate stroke risk and understand whether further treatment may be appropriate.

Consider arranging a specialist assessment if you:

• Have been diagnosed with narrowing of the arteries inside the brain.
• Have experienced a stroke or transient ischaemic attack (TIA).
• Have recurrent neurological symptoms despite medical treatment.
• Have been advised that you may need a procedure to improve blood flow to the brain.
• Want to understand whether intracranial stenting is suitable for your condition.
• Would like a second opinion regarding stroke prevention options.
• Have risk factors such as high blood pressure, diabetes or high cholesterol and concerns about your stroke risk.

At the Supreme Vascular and Interventional Clinic, assessment includes a detailed review of your neurological symptoms, medical history and vascular imaging. Your specialist will evaluate the location and severity of the artery narrowing, explain available treatment options and develop a personalised stroke prevention plan based on your individual condition.

Through specialist-led neurovascular care, patients receive guidance throughout their journey — from diagnosis and treatment decisions through follow-up and long-term stroke prevention.

Seek emergency medical attention immediately if you experience sudden weakness or numbness on one side of the body, facial drooping, difficulty speaking, sudden vision changes, severe dizziness or loss of coordination, as these may indicate a stroke.

Visit Our Stroke Specialist in Singapore

If you have experienced a TIA or "warning stroke," or if your stroke symptoms have been resistant to medication, intracranial stenting may be the answer. No matter what the solution, don't wait for the next stroke to occur. Bring yourself or your at-risk loved one to the Supreme Vascular and Interventional Clinic. Dr. Manish Taneja, our stroke specialist, has the expertise in arterial and vascular disorders anywhere in the body and can provide minimally invasive treatments for those with intracranial stenosis. Contact us for your first appointment.

Stroke Resources

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Supreme Vascular and Interventional Stroke Programs

Neurointerventional / Stroke Treatments

Brain Aneurysm

The Supreme Vascular and Interventional Clinic is your "go-to" facility for various neurointerventional / stroke conditions and treatments. To arrange an appointment with Dr. Manish Taneja, our stroke specialist, contact us. You can also call us at (+65) 6904 8084 for a consultation.