Intracranial arterial dolichoectasia and its relation with atherosclerosis and stroke subtype

Pico, Fernando; Labreuche, Julien; Touboul, Pierre‐Jean; Amarenco, Pierre

doi:10.1212/01.wnl.0000103168.14885.a8

Cited by 155 publications

(225 citation statements)

References 16 publications

(9 reference statements)

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“…Unfortunately, patients with VBD are prone to ischemic stroke and coronary artery disease as well. 12,33 At some stage or other of their illness, more than half of our patients experienced ischemic stroke and one-third had coronary artery disease. In patients with VBD, the risk of brain ischemia clearly is higher than that of intracranial bleeding.…”

Section: Discussionmentioning

confidence: 91%

Intracranial Bleeding in Patients With Vertebrobasilar Dolichoectasia

Passero

Calchetti

Bartalini

2005

Stroke

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Background and Purpose-Intracranial bleeding in patients with vertebrobasilar dolichoectasia (VBD) is considered uncommon, but there are no precise data to support this opinion. The purpose of this study was to examine the incidence and characteristics of intracranial hemorrhage in patients with VBD and to evaluate factors that may promote bleeding. Methods-We conducted a prospective study of 156 consecutive VDB patients followed-up for an average 9.35 years. The association of demographic, clinical, and imaging features with occurrence of intracranial bleeding was evaluated by multivariate analysis. Survival analysis was used to evaluate rates of incidence. Results-32 hemorrhagic strokes were observed in 28 patients either as a diagnostic event (nϭ10) or during follow-up (nϭ22

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Section: Discussionmentioning

confidence: 91%

Intracranial Bleeding in Patients With Vertebrobasilar Dolichoectasia

Passero

Calchetti

Bartalini

2005

Stroke

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“…6,7 Because they have risk factors in common, the relation between IADE and atherosclerosis is a matter of debate, atherosclerosis being either the cause or the consequence of dolichoectatic processes. 4,5,8 In a large population of patients with brain infarction, we found no association between the prevalence and severity of carotid atherosclerosis on ultrasound examination and the presence of IADE on brain magnetic resonance imaging (MRI). 8 No studies have investigated the relation between IADE and location of atherosclerosis from the heart to the brain, which could help us to understand the pathophysiology and may have practical implications, such as work-up and prevention in stroke patients with IADE.…”

mentioning

confidence: 85%

Association of Small-Vessel Disease With Dilatative Arteriopathy of the Brain

Pico

Labreuche

Seilhean

et al. 2007

Stroke

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Background and Purpose-Clinical and imaging studies have reported an independent and intriguing association between intracranial arterial dolichoectasia (IADE) and markers of small-vessel disease (SVD) such as lacune(s). We used a large brain-autopsy collection to investigate the relation between IADE and pathologically assessed cerebral SVD. Methods-The entire arterial tree from the heart to the intracranial small intracerebral arteries was investigated in 381 consecutive autopsies from patients with stroke. Vascular risk factors, heart status (weight, coronary atherosclerosis, and myocardial infarction), prevalence and severity of atherosclerosis from heart to brain (aortic arch, carotid, vertebral, and intracranial arteries), dolichoectasia, cerebral SVD, and brain tissue lesions (lacune(s), état criblé) were evaluated. Analyses were adjusted for age, sex, and heart weight. Results-Twenty-three (6%) of 381 patients had IADE, affecting mainly the basilar artery, with a median basilar artery diameter of 6 mm (range, 4 to 9 mm). Patients with IADE had a Ͼ2-fold increase in the prevalence of basilar artery plaques and ulcerated plaques in the aortic arch (both Pϭ0.006), but there were no associations with coronary or cervical artery plaques. SVD was more frequent in IADE-positive than in IADE-negative patients (45% vs 18%; Pϭ0.004). The adjusted odds ratio was 3.85 (95% confidence interval, 1.56 to 9.52). Cerebral amyloid angiopathy was not observed in IADE-positive patients. Conclusions-Compared with stroke patients without IADE, those with IADE were more likely to have pathologic evidence of cerebral SVD and its consequences, independent of age, arterial hypertension, or diabetes mellitus. IADE and cerebral SVD may have unidentified biologic processes in common.

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“…acute onset (stroke or subarachnoid hemorrhage) or with chronic progressive presentation (cranial nerve palsy, compression of the midbrain, or obstructive hydrocephalus) 6,16 .…”

Section: Fig 2 (A) T1w Axial Magnetic Resonance Imaging Following Gamentioning

confidence: 99%

“…Sometimes, there is an intraluminal thrombus or an atherosclerotic plaque in the ecstatic artery 5 . The dolichoectatic arteries have an abnormally large external diameter with a thin arterial wall 16 .…”

Section: Fig 2 (A) T1w Axial Magnetic Resonance Imaging Following Gamentioning

confidence: 99%

Isolated pathetick nerve paresis by compression from a dolichoectatic basilar artery: case report

Maranhão-Filho

Souto

Nogueira

2007

Arq. Neuro-Psiquiatr.

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-The article describes a woman with 53 year-old that has presented diplopia when looking down and adopted a tilted head position in order to read for the last six months. The neuro-ophthalmic examination shows isolated right superior oblique muscle paresis. The magnetic resonance and the angioresonance show the dolicoectatic basilar artery compressing the right ventral lateral brainstem.KEY WORDS: trochlear nerve, dolichoectasy, basilar artery, ophtalmoplegy, compression. Paresia isolada do nervo patético por compressão da artéria basilar dolicoectásica: relato de casoRESUMO -O artigo descreve uma mulher de 53 anos que há seis meses apresenta diplopia ao olhar para baixo, além de adotar postura inclinada da cabeça para ler. O exame neuro-oftalmológico revelou paresia isolada do músculo oblíquo superior direito. Os exames de ressonância magnética e angioressonância evidenciaram dolicoectasia da artéria basilar, que comprimia a face ventral lateral direita do tronco cerebral.

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Intracranial arterial dolichoectasia and its relation with atherosclerosis and stroke subtype

Abstract: IADE was associated with vascular risk factors such as age, male sex, hypertension, previous history of myocardial infarction, and lacunar infarct, but not with carotid atherosclerosis.

Cited by 155 publications

References 16 publications

Intracranial Bleeding in Patients With Vertebrobasilar Dolichoectasia

Intracranial Bleeding in Patients With Vertebrobasilar Dolichoectasia

Association of Small-Vessel Disease With Dilatative Arteriopathy of the Brain

Isolated pathetick nerve paresis by compression from a dolichoectatic basilar artery: case report

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