Designing Sustainable Campuses: Prevalence of Intracranial and Extracranial Arterial Stenosis in Ischemic Stroke Patients in Badr University Hospital: Review article

Background: ICAS represents a significant etiology of ischemic stroke in many populations, particularly in non-Caucasian ethnicities and is strongly associated with conventional vascular risk factors such as hypertension, diabetes mellitus and dyslipidemia. ECAS, notably carotid artery stenosis, although less dominant in some populations, remains critical in stroke risk stratification. Objective: This review examines the epidemiological evidence, pathophysiology, imaging modalities, risk factors, and outcomes associated with intracranial artery stenosis (ICAS) and extracranial artery stenosis (ECAS) among patients presenting with acute ischemic stroke and transient ischemic attack (TIA), with a view toward informing a proposed prospective observational study at Badr University Hospital. Methods: We synthesized data from peer-reviewed literature (2005–2025). We searched PubMed, Google Scholar, and Science Direct for Atherosclerosis, Carotid stenosis, Intracranial stenosis, Risk factors and Stroke focusing on prevalence, recurrent stroke risk, and management strategies to synthesize evidence from national and international literature between 1991 and 2025. The writers evaluated relevant literature references as well. Documents written in languages other than English have been ignored. Papers that were not regarded as significant scientific research included dissertations, oral presentations, conference abstracts, and unpublished manuscripts were excluded. Conclusion: Imaging modalities including magnetic resonance angiography (MRA) and Doppler ultrasonography offer non-invasive assessment with good diagnostic performance, but variation in sensitivity and specificity persists. High-risk plaque features in intracranial arteries (e.g., enhancement, calcification) predict recurrent stroke. Secondary prevention centered on risk factor control (blood pressure, lipids & glycemic control) that reduces recurrent stroke risk underscoring the need for routine vascular imaging for secondary prevention. Thus, practical recommendations for implementing MRA and Doppler studies in stroke units, particularly in resource-constrained settings like Badr University Hospital, and identifies gaps for future research.