Fig. 2

Mechanisms of ischemic stroke in Intracranial Atherosclerosis. Intracranial atherosclerotic disease (ICAD) can lead to ischemic events through various pathophysiological mechanisms, either individually or in combination. These comprise: (i) in-situ thrombosis and occlusion of the parent artery; (ii) artery-to-artery embolism, both resulting from atherosclerotic plaque rupture; (iii) progressive luminal stenosis causing hemodynamic compromise and cerebral hypoperfusion; and (iv) branch occlusive disease due to plaque expansion over small perforator artery openings, that leads to subcortical and/or lacunar strokes in the presence of ICAD. Adapted by Chen et al. [18] Image created with Biorender