Intracranial Arterial Dolichoectasia Research Articles

Microcurrent wave alleviates mouse intracranial arterial dolichoectasia development

Intracranial arterial dolichoectasia (IADE) is associated with the interaction of hypertension and inflammation, and microcurrent can be effective in hypertension. Therefore, this study aimed to investigate the therapeutic effect of microcurrent electrical stimulation in a mouse IADE model. This study randomly categorized 20 mice into five groups: group 1-C (healthy control), group 2-D (IADE model), group 3-M + D (microcurrent administration before nephrectomy and until brain surgery), group 4-D + M (microcurrent administration for 4 weeks following brain surgery), and group 5-M (microcurrent administration for 4 weeks). Cerebral artery diameter and thickness and cerebral arterial wall extracellular matrix components were assessed. Among the five groups, group 2-D showed significantly higher cerebral arterial wall diameter (117.79 ± 17.05 µm) and proportion of collagen (42.46 ± 14.12%) and significantly lower arterial wall thickness (9.31 ± 2.26 µm) and proportion of smooth muscle cell (SMC) and elastin in the cerebral arterial wall (SMC: 38.05 ± 10.32%, elastin: 11.11 ± 6.97%). Additionally, group 4-D + M exhibited a non-significantly lower diameter (100.28 ± 25.99 µm) and higher thickness (12.82 ± 5.17 µm). Group 5-M demonstrated no evidence of toxicity in the liver and brain. The pilot study revealed that microcurrent is effective in preventing IADE development, although these beneficial effects warrant further investigation.

Relationships between intracranial arterial dolichoectasia and small vessel disease in patients with ischaemic stroke: a systematic review and meta-analysis.

Intracranial arterial dolichoectasia (IADE) is a common arterial finding of dilation, elongation, or both, affecting large intracranial vessels, and associated with vascular risk factors, including hypertension. Associations of IADE with neuroimaging cerebral small vessel disease (CSVD) may be relevant for diagnosis and prognosis in patients with stroke. The study aimed to conduct an updated systematic review and meta-analysis of observational studies to investigate the relationships of IADE with well-defined CSVD markers in patients with ischaemic stroke. We systematically searched PubMed, Embase, and Scopus for studies on IADE in ischaemic stroke patients with fulfilling predefined inclusion criteria. We pooled data to conduct a meta-analysis to compare the prevalence of SVD markers between patients with and without IADE groups using risk ratios (RRs) and 95% confidence intervals (CIs). From 157 retrieved abstracts, we included six studies from seven publications comprising 6102 patients with ischaemic stroke. The mean age of patients was 52.8years, and 3691 (60.5%) were male. IADE was diagnosed in 11.4% (95% CI 8.9-13.9) (761) of included patients; 51.8% (3160) had hypertension. Compared to patients without IADE, individuals diagnosed with IADE had a significantly increased prevalence of lacune (RR 1.67, 95% CI 1.36-2.06, P < 0.01, I2 = 0.00%), cerebral microbleeds (CMBs) (RR 2.56, 95% CI 1.53-4.28, P < 0.01, I2 = 84.95%) and white matter hyperintensities (WMHs) (RR 2.17, 95% CI 1.84-2.56, P < 0.01, I2 = 0.00%). In patients with ischaemic stroke, IADE is associated with a higher prevalence of CSVD markers, including lacunes, CMBs, and WMHs. Further studies are needed to clarify the mechanisms underlying these associations and their potential relevance for the understanding, diagnosis, and treatment of CSVD.

Modified Protocol for Establishment of Intracranial Arterial Dolichoectasia Model by Injection of Elastase Into Cerebellomedullary Cistern in Mice.

Background and PurposeThis study aimed to construct an animal model of intracranial arterial dolichoectasia (IADE) applying the modified modeling protocol.Materials and MethodsTwenty five milliunits elastase and inactivated elastase were, respectively, injected into the cerebellomedullary cistern of 60 C57/BL6 mice which were divided into experimental group (EG, n = 30) and control group (CG, n = 30) by using a computer-based random order generator. The modified modeling protocol clarified these aspects including brain three-dimensional parameters of mouse head fixation, angle of head inclination, fixed position of taper ear, needle holding technique, needle entry depth, prevention of liquid drug back flow, and storage conditions of elastase. And it was observed for the following parts such as mortality, inflammatory factors, craniocerebral arteries scanning, vascular tortuosity index, artery diameter, pathology of the cerebrovascular.ResultsWithin differently surveyed stage, the total mortality of mice in EG was 20%. ELISA illustrated that the levels of matrix metalloproteinase-9 (MMP-9) and tumor necrosis factor α (TNF-α) in peripheral blood were increased significantly after modeling. Angiography indicated that 100% of IADE in EG were observed and the diameter and tortuosity index of the basilar artery were significantly increased (P < 0.01). EVG histological processing and staining showed the disrupted internal elastic lamina, the atrophied muscle layer, and the hyalinized connective tissue of the basilar artery with the vascular wall tunica media in EG. Micro-computed tomography reported that the craniocerebral arteries of the mice in EG were outstandingly elongated, tortuous, and dilated.ConclusionThe modified modeling protocol can reduce the mortality, improve the success rate, and provide a stable animal model for IADE.

Bilateral optic neuropathy due to dolichoectasia of internal carotid Arteries

Intracranial arterial dolichoectasia is a disorder of cerebral vasculature characterized by abnormal elongation, tortuosity, and dilatation of the cerebral arteries. The posterior circulation is more frequently affected than the anterior circulation. Dolichoectasia of internal carotid arteries (ICAs) presenting with binasal hemianopia is rare. We report a case report of a 48-year-old male who presented with a history of binasal hemianopia. Magnetic resonance (MR) imaging of the brain with MR angiography showed bilateral dolichoectasia of ICAs compressing bilateral optic nerve and optic chiasm. Diagnosis of bilateral optic neuropathy due to dolichoectasia of ICAs was made after thorough investigation and ruling out of other possible etiologies of bilateral optic neuropathy. Dolichoectasia is a rare cause of bilateral optic neuropathy and should be suspected in patients who present with gradually progressive visual field loss with onset in the nasal field.

Melittin-loaded Iron Oxide Nanoparticles Prevent Intracranial Arterial Dolichoectasia Development through Inhibition of Macrophage-mediated Inflammation

Rationale: In intracranial arterial dolichoectasia (IADE) development, the feedback loop between inflammatory cytokines and macrophages involves TNF-α and NF-κB signaling pathways and leads to subsequent MMP-9 activation and extracellular matrix (ECM) degeneration. In this proof-of-concept study, melittin-loaded L-arginine-coated iron oxide nanoparticle (MeLioN) was proposed as the protective measure of IADE formation for this macrophage-mediated inflammation and ECM degeneration.Methods: IADE was created in 8-week-old C57BL/6J male mice by inducing hypertension and elastase injection into a basal cistern. Melittin was loaded on the surface of ION as a core-shell structure (hydrodynamic size, 202.4 nm; polydispersity index, 0.158). Treatment of MeLioN (2.5 mg/kg, five doses) started after the IADE induction, and the brain was harvested in the third week. In the healthy control, disease control, and MeLioN-treated group, the morphologic changes of the cerebral arterial wall were measured by diameter, thickness, and ECM composition. The expression level of MMP-9, CD68, MCP-1, TNF-α, and NF-κB was assessed from immunohistochemistry, polymerase chain reaction, and Western blot assay.Results: MeLioN prevented morphologic changes of cerebral arterial wall related to IADE formation by restoring ECM alterations and suppressing MMP-9 expression. MeLioN inhibited MCP-1 expression and reduced CD68-positive macrophage recruitments into cerebral arterial walls. MeLioN blocked TNF-α activation and NF-κB signaling pathway. In the Sylvian cistern, co-localization was found between the CD68-positive macrophage infiltrations and the MeLioN distributions detected on Prussian Blue and T2* gradient-echo MRI, suggesting the role of macrophage harboring MeLioN.Conclusions: The macrophage infiltration into the arterial wall plays a critical role in the MMP-9 secretion. MeLioN, designed for ION-mediated melittin delivery, effectively prevents IADE formation by suppressing macrophage-mediated inflammations and MMP activity. MeLioN can be a promising strategy preventing IADE development in high-risk populations.

The relationship between intracranial arterial dolichoectasia and intracranial atherosclerosis

ObjectiveWe aimed to investigate the relationship between intracranial arterial dolichoectasia (IADE) and intracranial atherosclerosis (ICAS). MethodsPatients with acute ischemic stroke were screened via the Nanjing Stroke Registry Program. Patients were diagnosed with IADE (diameter, height of bifurcation, and laterality of basilar artery) based on magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) results. Intracranial atherosclerosis was defined as a ≥50 % diameter reduction in internal carotid artery, middle cerebral artery, posterior cerebral artery, or anterior cerebral artery on MRA, computed tomography angiography, or digital subtraction angiography. We also evaluated the presence and degree of white matter changes and lacuna infarctions on MRI. ResultsOf the 469 enrolled patients, 61 (13 %) had IADE. Patients with IADE were older (64.1 ± 9.9 vs. 59.6 ± 11.4 years, P = 0.004) and had a higher prevalence of hypertension (78.7 % vs. 61.0 %, P = 0.008) than patients without IADE. Patients with ICAS were older (62.6±10.5 vs 58.1±11.6 years, P < 0.001), had higher prevalence of hypertension (72.9 % vs. 55.0 %, P < 0.001) and a previous history of stroke (21.6 % vs. 9.2 %, P < 0.001), had higher levels of serum low-density lipoprotein cholesterol (2.57±0.82 vs. 2.31±0.86mmol/l P = 0.002), and had high counts of white blood cells (7.90±3.29 vs 7.10±2.44, P = 0.004). No association was detected between IADE and extracranial carotid atherosclerosis [odds ratio (OR)=0.618; 95 % confidence interval (CI), 0.280–1.367; P = 0.235]. After adjusting for age, sex, hypertension, and ischemic heart disease, patients with IADE had a lower ICAS rate than that in those without IADE (OR 0.417, 95 % CI, 0.213–0.816, P = 0.011). Unlike patients with ICAS, patients with IADE were more likely to have infratentorial stroke lesions (OR=2.952, 95 % CI, 1.207–7.223, P = 0.018), multi-lacuna (OR=2.142, 95 % CI, 1.158–3.964, P = 0.015), and white matter changes (OR = 2.782; 95 % CI, 1.522–5.085, P = 0.001). ConclusionsIADE was associated with advanced age, hypertension, multi-lacuna, and white matter changes but was not associated with ICAS.

Arterial Stiffness is Associated with Intracranial Arterial Stenosis other than Dolichoectasia in the General Population.

Aims: The relationship between central arterial stiffness and aging-related intracranial arteriopathy is not well investigated in the general population. In a population-based study, we investigated arterial stiffness in relation to intracranial atherosclerotic stenosis and intracranial arterial dolichoectasia.Methods: This study was a cross-sectional analysis on 1,123 subjects (aged 56.0 ± 9.3 years, 37.9% men) of the population-based Shunyi study in China. Arterial stiffness was assessed by measuring brachial-ankle pulse wave velocity (baPWV). Intracranial atherosclerotic stenosis and intracranial arterial dolichoectasia were evaluated via brain magnetic resonance angiography. Multivariate regression models were constructed to investigate the association between baPWV and intracranial large artery diseases.Results: Increased baPWV was significantly associated with higher prevalence of intracranial atherosclerotic stenosis (odds ratio for the highest quartile of baPWV compared with the lowest quartile, 3.66 [95% confidence interval, 1.57–8.54]), after adjustment for cardiovascular risk factors in multivariate analysis. BaPWV was not associated with the presence of basilar artery dolichoectasia and dilation of basilar artery and internal carotid artery. When the diameters of intracranial arteries were regarded as continuous variables, increased baPWV was inversely related to the internal carotid artery diameter in fully adjusted models (β ± SE, −0.083 ± 0.042, p = 0.047).Conclusions: This population-based study demonstrates that arterial stiffness was more likely associated with intracranial stenotic arteriopathy other than intracranial dilative arteriopathy.

Association between Intracranial Arterial Dolichoectasia and Cerebral Small Vessel Disease and Its Underlying Mechanisms.

Intracranial arterial dolichoectasia (IADE), also known as dilatative arteriopathy of the brain vessels, refers to an increase in the length and diameter of at least one intracranial artery, and accounts for approximately 12% of all patients with stroke. However, the association of IADE with stroke is usually unclear. Cerebral small vessel disease (CSVD) is characterized by pathological changes in the small vessels. Clinically, patients with CSVD can be asymptomatic or present with stroke or cognitive decline. In the past 20 years, a series of studies have strongly promoted an understanding of the association between IADE and CSVD from clinical and pathological perspectives. It has been proposed that IADE and CSVD may be attributed to abnormal vascular remodeling driven by an abnormal matrix metalloproteinase/tissue inhibitor of metalloproteinase pathway. Also, IAD-Erelated hemodynamic changes may result in initiation or progression of CSVD. Additionally, genetic factors are implicated in the pathogenesis of IADE and CSVD. Patients with Fabry’s disease and late-onset Pompe’s disease are prone to developing concomitant IADE and CSVD, and patients with collagen IV alpha 1 or 2 gene (COL4A1/COL4A2) and forkhead box C1 (FOXC1) variants present with IADE and CSVD. Race, strain, familial status, and vascular risk factors may be involved in the pathogenesis of IADE and CSVD. As well, experiments in mice have pointed to genetic strain as a predisposing factor for IADE and CSVD. However, there have been few direct genetic studies aimed towards determining the association between IADE and CSVD. In the future, more clinical and basic research studies are needed to elucidate the causal relationship between IADE and CSVD and the related molecular and genetic mechanisms.

Intracranial Arterial Dolichoectasia in Patients with Ischemic Stroke: Preliminary Results From the IDEAS Study (905)

Intracranial Arterial Dolichoectasia in Patients with Ischemic Stroke: Preliminary Results From the IDEAS Study (905)

Intracranial arterial dolichoectasia: description of 5 cases and proposal of a systemic study protocol with angio-TC

Intracranial arterial dolichoectasia: description of 5 cases and proposal of a systemic study protocol with angio-TC

Abstract 183: Prognosis of Intracranial Arterial Dolichoectasia in Patients With Ischemic Cerebrovascular Disease

Objectives: Intracranial arterial dolichoectasia (IADE) refers to the vascular abnormities of elongation, tortuous, and dilating of the brain vessels. The incidence of IADE in patients with ischemic cerebrovascular disease was higher, however, the prognosis of IADE in patients with ischemic cerebrovascular diseases was still not clear. The purpose of this study was to explore the association between the IADE and the clinical prognosis of patients with ischemic cerebrovascular disease in China. Methods: Patients with acute ischemic stroke and transient ischemic attack were enrolled in a prospective, multicenter cohort study. Baseline clinical information and follow-up information were collected. The imaging information of the patients (baseline magnetic resonance imaging) was collected, and IADE patients were selected through the centralized double-blinded interpretation. The endpoints included stroke recurrence, composite events, and all-cause mortality at 12 months. The multivariate Cox regression model was used to explore the association between IADE and the clinical prognosis of ischemic cerebrovascular disease. Results: 8219 patients with ischemic cerebrovascular disease were enrolled in this study, 395 patients of whom had IADE. Patients with IADE had a lower stroke recurrence rate (4.8% vs 7.8%, P=0.03) and lower composite events rate (5.3% vs 8.1%, P=0.04) at 12 months. The elongation of the basilar artery was also associated with stroke recurrence (6.8% vs 8.4%, P=0.009) and composite events rate (7.1% vs. 8.7%, P=0.009) at 12 months. After multivariate Cox regression, IADE was still independently associated with decreased stroke recurrence (HR 0.59, 95% CI 0.36-0.95,P=0.03) and composite events (HR 0.63, 95% CI 0.40-0.99,P=0.05) at 12 months . The elongation of the basilar artery was still independently associated with decreased stroke recurrence (HR 0.80, 95% CI 0.67-0.95, P=0.01) and composite events (HR 0.81, 95% CI 0.68-0.95, P=0.01) at 12 months. Conclusion: IADE and the elongation of the basilar artery were both independently associated with decreased stroke recurrence and composite events at 12 months.

Cerebral small vessel disease and systemic arteriopathy in intracranial arterial dolichoectasia patients.

To investigate clinical and demographic characteristics of patients with intracranial arterial dolichoectasia (IADE) and describe the possible coexistence of cerebral small vessel disease (SVD) and systemic arteriopathy. From January 2015 to March 2016, all the patients attending an outpatient service for chronic cerebrovascular diseases were screened for suspected IADE. Identified patients underwent a predefined protocol including: brain MR angiography for the diagnosis of IADE; brain MRI with visual rating of SVD features; whole-body CT angiography to assess signs of systemic arteriopathy; and neuropsychological examination. Among the 251 patients screened, IADE was diagnosed in seven (mean age±SD 68.8±7.2years, six males). Hypertension was the most frequent risk factor. All patients had basilar artery dolichoectasia, two also ectasia of a vessel of the anterior circulation. All patients had white matter hyperintensities that were moderate or severe in six, five had at least one lacune, and all had enlarged perivascular spaces. At least one microbleed was detected in six patients. A variable grade of global cortical atrophy was found in six patients. Systemic arterial ectasia was found in all but one patient. Neuropsychological examination showed a multidomain cognitive impairment in five patients. Our study confirms the high prevalence of cerebral SVD in IADE. The involvement of the brain-supplying arteries is probably part of a systemic arteriopathy in IADE patients, thus suggesting the usefulness of assessing the whole arterial tree in clinical practice. Cognitive deterioration signs are frequent in these patients.

Intracranial Arterial Dolichoectasia and Stenosis

Intracranial arterial dolichoectasia (IADE) is a poorly understood arteriopathy compared with intracranial atherosclerotic stenosis (ICAS). We aimed to investigate the risk factors of IADE and ICAS and their relationship with neuroimaging markers of cerebral small vessel disease in a population-based study. This study comprised 1237 participants (aged 57.2±9.4 years, 37.6% men) who underwent brain magnetic resonance imaging and magnetic resonance angiography. IADE was assessed based on basilar artery dolichoectasia (diameter, height of bifurcation, and laterality of basilar artery) and dilation of basilar artery and internal carotid artery (intracranial volume-adjusted diameter ≥2 SD). ICAS was defined as any degree of stenosis in at least 1 intracranial artery. The neuroimaging markers of cerebral small vessel disease, including lacunes, white matter hyperintensities, microbleeds, dilated perivascular spaces, and brain atrophy, were evaluated. Basilar arterial dolichoectasia was observed in 3.6% (45/1237); intracranial arterial dilation in 5.9% (67/1142); and ICAS in 15.7% (194/1237). Older age, higher systolic blood pressure, diabetes mellitus, higher LDL-C (low-density lipoprotein cholesterol) and lower HDL-C (high-density lipoprotein cholesterol) were associated with the presence of ICAS (all P<0.001), whereas only older age was associated with IADE. ICAS was associated with lacunes (odds ratio, 2.91; 95% confidence interval, 1.96-4.34; P<0.001), increased white matter hyperintensities volume (β±SE, 0.54±0.13; P<0.001), and brain atrophy (β±SE, -1.16±0.21; P<0.001), whereas basilar arterial dolichoectasia was mainly associated with dilated perivascular spaces in basal ganglia (odds ratio, 2.20; 95% confidence interval, 1.20-4.02; P=0.01) and, to a lesser extent, associated with lacunes and microbleeds. IADE and ICAS had different risk factor profiles and associated with different imaging phenotypes of cerebral small vessel disease, suggesting different underlying mechanisms.

Intracranial Arterial Dolichoectasia.

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.

Concomitant aneurysm detection in an intracranial dolichoectasia mouse model using a MicroFil polymer perfusion technique

ObjectiveTo assess the feasibility of using MicroFil polymer perfusion to detect concomitant saccular aneurysms in an intracranial arterial dolichoectasia (IADE) model in mice, and to report detailed histomorphometric features of...

Dolichoectasia of vertebral artery presenting as Tenth cranial nerve palsy

Intracranial arterial dolichoectasia is characterized by enlargement, tortuosity or elongation of major arteries at the base of the brain. It usually involves distal vertebral arteries, basilar artery or distal internal carotid artery. Here we present a case of vertebrobasilar dolichoectasia presenting as tenth cranial nerve palsy.

Abstract W P168: Intracranial Dolichoectasia in Patients with Recent Lacunar Strokes: The SPS3 Trial

Background and Purpose: Intracranial arterial dolichoectasia (IADE) is associated with atherothrombotic strokes, but its relationship with lacunar infarcts is less certain. We investigated the prevalence of IADE and associated risk of recurrent stroke and death in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial. Methods: Maximum diameter of the intracranial internal carotid artery (ICA), middle cerebral artery (MCA), vertebral artery (VA), and basilar artery (BA) were measured on 2794 MRAs with IADE defined a priori as &gt;7.0 mm for ICA, &gt;4.0 mm for MCA, &gt;4.0 mm for VA, and &gt;4.5 mm for BA. Patient characteristics and outcomes were compared between patients with and without IADE. Results: IADE was present in ≥1 artery in 210 (7.1%) patients, none in ICA, 5 MCA, 163 BA, and 116 VA. Patients with IADE were more often older (65 vs. 63 years; p = 0.01) male (81% vs. 61 %; p &lt;0.001) and had hypertension (82% vs. 74%; p = 0.008), while diabetes (29% vs. 37%; p = 0.01) was more frequent in patients without IADE. White matter hyperintensities (ARWMC score) were more frequent (severe) in patients with IADE (31% vs. 21%, p = 0.001). In multivariable logistic regression analyses, after adjusting for age, assigned treatments, and hypertension, IADE was not predictive of recurrent stroke (OR 1.2, 95% CI 0.8-1.8) or death (OR 1.5, CI 0.94-2.3). In similar analyses, neither BA nor VA diameter as a continuous measure was predictive of recurrent stroke, however, increased BA diameter was predictive of death (OR 1.2 per mm, CI 1.0-1.5, p = 0.04). VA diameter was not. Conclusion: In this large well characterized cohort of lacunar stroke patients, dilatation of BA was independently associated with death but not recurrent stroke, and IADE in other arteries did not predict stroke or death. IAED in lacunar stroke patients seems to be unrelated to the mechanism and severity of small vessel disease.

Abstract TMP117: Intracranial Dolichoectasia in Patients with Lacunar Strokes: The SPS3 Trial

Background and Purpose: Intracranial arterial dolichoectasia (IADE) is a common finding in atherothrombotic strokes, but its relationship with lacunar infarcts is less certain. We investigated the prevalence of IADE and its correlation with risk factors as well as with recurrent stroke within the Secondary Prevention of Small Subcortical Strokes (SPS3) study cohort. Methods: The greatest diameter of the following arteries was measured on MRA: bilateral internal carotid artery (ICA), middle cerebral artery (MCA), vertebral artery (VA), and the basilar artery (BA). IADE criteria were a diameter of over 7.0 mm for ICA, over 4.0 mm for MCA, over 4.0 mm for VA, and over 4.5 mm for BA. BA elongation was assessed according to Smoker’s criteria. Results: Of the 3020 SPS3 participants, 2562 MRAs were assessed. Diameters were: ICA, 4.4 +/- 0.6 mm; MCA, 2.6 +/- 0.4 mm; BA, 3.4 +/- 0.7 mm; and VA, 2.4 +/- 0.7 mm. Of the measured participants 8% met criteria for IADE; 65% had IADE in a single artery, 28% in two arteries, and 7% in more than two arteries. Abnormality in either height of the bifurcation (66.7% vs. 4.6%, p&lt;0.001) or lateral displacement (45.6% vs. 1.4%, p&lt;0.001) of the BA was observed more frequently in patients with IADE than without. Conclusion: In this large and well characterized cohort of lacunar stroke patients, IADE was present in 8%, approximately half of whom demonstrated BA elongation. The relationship between IADE and incidence of recurrent stroke will be presented. Ongoing analyses from SPS3 will likely elucidate if IADE is a risk factor for stroke recurrence in lacunar stroke patients.

English

Introduction Anomalies and variations of the anterior communicating artery are common. Fenestration has been reported as the most common variation of this artery. Dolichoectasia of intracranial arteries is a rare arteriopathy characterised by elongation and widening of the arteries, mostly involving vertebral and basilar arteries. This report discusses large anterior communicating artery fenestration associated with posterior circulation anomalies. Case Report We report here a rare case of large anterior communicating artery fenestration associated with mild dolichoectasia of the basilar artery and marked dolichoectasia of the left posterior inferior cerebellar artery, forming a large vascular loop at the area of cisterna magna, as well as hypoplasia of the left anterior inferior cerebellar artery. The study discusses the details of this case. Conclusion Dolichoectasia of intracranial arteries is a rare arteriopathy characterised by elongation and widening of the arteries and disturbance of the laminar blood flow, mostly involving vertebral and basilar arteries.

Vertebral and/or basilar dolichoectasia in human adult cadavers

Intracranial arterial dolichoectasia is a condition in which arteries demonstrate an increase in length and diameter, with the vertebrobasilar system being the most commonly affected segment. Because the criteria for and degree of vertebrobasilar dolichoectasia are usually established on three-dimensional time-of-flight MR angiography, we presented the results of an anatomic study of vertebrobasilar dolichoectasia cadaveric specimens. Examination was carried out on the brains of human adult cadavers, routinely dissected at the Institute of Forensic Medicine. Measurement of the outer diameter and length of vertebral and/or basilar arteries was performed using the ImageJ processing program. There were 14 cases (14/216) of vertebral and/or basilar (dolicho)ectasia. Their classification into special (sub)types is made according to the basilar and/or vertebral diameter. The basilar length ranged from 32.91-59.37mm, and the basilar outer diameter ranged from 3.51-8.92mm in relation to the corresponding point of its measurement. The outer diameter of the vertebral arteries ranged from 0.67-5.91mm. The Games-Howell post hoc test additionally showed that a basilar outer diameter of grade III and IV was significantly larger than in grade II (p < 0.05). We noted a predisposition of males older than 40 years to arterial dolichoectasia in the vertebrobasilar system, independently from population group, as well as its asymptomatic appearance, independently from the presence of atherosclerotic plaques.