The prevalence and distribution of intracranial carotid artery calcification in the young and middle-aged

Aim: Intracranial carotid artery calcification (ICAC) is one of the most important risk factors for stroke. Yet, surprisingly little is known about its prevalence across the age range of individuals below the age of 60. We examined the prevalence and volume of ICAC in a large sample of young and middle aged individuals. Methods: All persons aged 0 – 55 years who visited the Emergency Department of the Erasmus MC University Medical Center and University Medical Center Utrecht between January 2010 and December 2015, and underwent CT-scanning as part of trauma-screening were included in the study. In total, we analyzed CT-data of 1759 persons (mean age 29.5 years, 62.8% males). We evaluated the presence and volume of ICAC. We determined its prevalence and median volume, stratified by sex and age. Results: The overall prevalence of ICAC was 16.3%. The median volume in person with ICAC was 6.2 mm3 (IQR: 20.8mm3). We found a linear increase in prevalence and volume of ICAC with age, with the first occurrence of ICAC in the age group of 10-15 years old. We found no significant differences between men and women for ICAC prevalence (men: 14.7%, women: 18.0%, P = 0.18) or ICAC volume (men: median volume (IQR): 7.1 (23.9) mm3), women: 5.5 (14.6) mm3, P = 0.12). Conclusions: ICAC already occurs in the second decade of life and its prevalence and amount increases with age. These findings provide important insight into the widow for early interventions targeted at the prevention of stroke.