Intracranial Arterial Dolichoectasia

Abstract

An increased diameter (ectasis) and/or long and tortuous course (dolichosis) of at least one cerebral artery define intracranial arterial dolichoectasia (IADE). IADE could be detected incidentally or may give rise to an array of neurological complications including ischemic stroke, intracranial hemorrhage, or compression of surrounding neural structures. The basilar artery is preferentially affected and has been studied in more detail, mainly due to the presence of accepted diagnostic criteria proposed by Smoker and colleagues in 1986 (1). Criteria for the diagnoses of dolichoectasia in other cerebral arteries have been suggested. However, they lack validation across studies. The prevalence of IADE is approximately 0.08–6.5% in the general population, while in patients with stroke, the prevalence ranges from 3 to 17%. Variations among case series depend on the characteristics of the studied population, diagnostic tests used, and diagnostic criteria applied. In rare instances, an underlying hereditary condition, connective tissue disorder, or infection predispose to the development of IADE. However, most cases are sporadic and associated with traditional vascular risk factors including advanced age, male gender, and arterial hypertension. The link between this dilative arteriopathy and other vascular abnormalities, such as abdominal aortic aneurysm, coronary artery ectasia, and cerebral small vessel disease, suggests the underlying diffuse vascular process. Further understanding is needed on the physiopathology of IADE and how to prevent its progression and clinical complications.

Pulse pressure correlates poorly with basilar artery diameter in community‐dwelling older adults: The Atahualpa Project

“…1 Nevertheless, increasing evidence suggests that dolichoectasia differs from atherosclerosis because it predominantly affects the internal elastic lamina, as opposed to the endothelial injury and plaque formation characteristics of atherosclerosis. [2][3][4] This is supported by studies showing a lack of association between extracranial atherosclerosis and intracranial dolichoectasia. 5 However, the relevance of intracranial atherosclerosis in patients with dolichoectasia has not been investigated at the population level.…”

Deletion of 6p25.3 Is Associated with Cerebrovascular Dolichoectasia: Report of 2 Cases

“…Dolichoectasia, or dilation and elongation of vasculature, results from the weakening of the tunica media layer surrounding the artery due to damaged smooth muscle and elastic fibers within the arterial walls [1, 7]. This allows blood pressure to affect the path of the artery, leading to vascular tortuosity and deviation.…”

“…Arterial dolichoectasia has a prevalence of approximately 0.08–6.5% in the general population [1]. The prevalence of developmental dolichoectasia is unknown and the genetic drivers predisposing to development of vascular ectasia in children is largely unexplored [2].…”

Perfusion by delayed time to peak in vertebrobasilar dolichoectasia patients with vertigo

“…Vertebrobasilar dolichoectasia (VBD) was a clinical entity characterized by elongated, dilated and/or tortuous vertebral artery, and basilar artery (BA), 1-3 ranging from 0.05% to 18%. [4][5][6] VBD presentation includes symptoms by cerebral ischemia in the vertebrobasilar territory. [2][3][4][5][6] Morphology changes of vertebrobasilar arteries subsequently changing the hemodynamics in vertebrobasilar system.…”

“…[4][5][6] VBD presentation includes symptoms by cerebral ischemia in the vertebrobasilar territory. [2][3][4][5][6] Morphology changes of vertebrobasilar arteries subsequently changing the hemodynamics in vertebrobasilar system. 7,8 Transcranial Doppler ultrasound has been in utilization of detecting a significantly decreased arterial blood flow velocity in VBD patients.…”