In our study, among 11 patients with diabetes mellitus history, 9 (81%) patients have

intracranial artery stenosis, and 2 (18,2%) patients don’t have intracranial artery stenosis. The
previous researches got various results. Thomas et al reported from 2.165 diabetes mellitus
patients with asympthomatic cerebrovascular involvement, presence or absence of middle
cerebral artery (MCA) stenosis could be determined in 1877 patients, where MCA stenosis
82
are identified in 385 subjects (20,6%). Diabetes mellitus was independent risk factor of
intracranial stenosis, caused increased of atherosclerotic stenosis through decreased of
fibrinolytic activity.38,80 Intervention to improve glicemic control, as seen as U.K .
Prospective Diabetes Study was more effective in decreasing microvascular than
macrovascular disease.

Among 15 patients with heart disease history, we found 11 (73,3%) patients have intracranial
artery stenosis, and 4 (26,7%) patients don’t have intracranial artery stenosis. Increase in
uncontrolled and prolonged blood pressure may cause several changes in miocard structure,
coronary vessels, and heart conduction system. This changes somehow may lead to left
ventricle hypertrophy progression, coronary artery disease, several conduction system
disease, systolic and diastolic dyscfunction, complication manifest as angina or miocard
infarction, aritmia (especially AF), and congestive heart failure.87

Other studies reported there was no significant correlation between lipid profile and
intrcranial stenosis/atherosclerosis, while some other studies reported there was correlation
between lipid profile and intrcranial stenosis/ atherosclerosis. Although blood lipid and
lipoprotein were correlated to coronary atherosclerosis, their correlation with cerebrovascular
atherosclerosis was still unclear. A review from more than 20 publications which studied
about correlation between plasma lipid and lipoprotein concentration and cerebrovascular
atherosclerosis lead to a general conclusion that the correlation was presence, and it was more
dominant in the elder than younger individual.88 But, the specific correlation was difficult to
explain because various researches cannot be compared one to another.134-89

Among 32 patients with blood abnormalities history, there was only 1 (3,1%) patient have
intracranial artery stenosis.
This hypercoagulation may cause deceleration of blood flow and can be caused by several
diseases such as antiphospholipid antibody syndrome, thrombotic thrombocytopenic purpura
(Moschcowitz Syndrome), hemolytic uremic syndrome, sickle cell disease, polycythemia
vera, trombositosis, dan trombositemia.

Among 17 patients with abnormal nutrition status, we found 12 (70,6%) patients have
intracranial artery stenosis, and 5 (29,4%) patients don’t have intracranial artery stenosis.
This study is slightly different with Kamal et al which reported nutrition status in patient with
ICAD, that is 11 16%) normal; 20 (29%) underweight; 10 (14,5%) pre-overweight; 14
(20,3%) overweight; 13 (18,8%) obese. Metabolic syndrome and abdominal obesity were
both correlated to atherosclerosis and stroke. Obesity were risk factor of atherosclerosis and
ischemic stroke in younger age and presumed that the correlation may be mediated by
hypertension, diabetes mellitus, or other variabel related to obesity.91

Among 2 patients with kidney disease history, we found 1 (50%) patients have intracranial
artery stenosis, and 1 (50%) patients don’t have intracranial artery stenosis. Age,
cardiovascular risk factor, and chronic kidney disease were related to intracranial
atherosclerosis. Meanwhile, pathophysiology that underlie correlation between kidney
disease and atherosclerosis need to be determined. Vascular factor may related to intracranial
calcification, including hypertension, diabetes, and hypercholesterolemia.

Among 6 patients with stroke history in family, we found 4 (66,7%) patients have intracranial
artery stenosis, and 2 (33,3%) patients don’t have intracranial artery stenosis. This result was
similar to Park et al which reported in patients with stroke history in family, 12 (48%) (n=25)
have ICAS and 326 (40,4%) (n=806) don’t have ICAS. This study showed ICAS proportion
are higher in patient with stroke history in family. Stroke history in family as a risk factor to
intracranial stenosis were reported in previous studies. 17,9,19,97

Stenosis were obtained most in the left MCA, that found in 11 (34,4%) patients. This result
was similar to Kwang at al which reported that MCA is the most common blood vessel that
developed to atherosclerosis.16