The clinical picture of ectasia of the intracerebral arteries

Abstract

SUMMARY Thirty-one patients with ectasia of intracranial arteries were studied. The carotid system was more frequently involved than the vertebrobasilar. The condition is relatively rare and usually occurs with other vascular disease. Ectasia presents with a variety of neurological symptoms, amongst which visual disorders are common. The overall mortality was 52 %, but the prognosis was appreciably worse for the vertebrobasilar group, probably because of a higher incidence of compression of surrounding neural structures. Defects in the internal elastic lamina, with or without associated atheroma, are often found in the affected arteries.Ectasia, or pathological enlargement of the cerebral arteries is a rare, though well recognised finding at cerebral angiography. Several series of vertebrobasilar ectasia,1-4 and one of carotid ectasia5 have previously been published, but there has not been a comprehensive account of the symptomatology and the natural history of this condition. We have therefore, reviewed the experience of ectasia of cerebral arteries in the National Hospitals over the past 22 years. Material and methodsOf the approximately 40 000 carotid and 10 000 vertebral angiograms performed at the National Hospital, Queen Square between 1959 and 1980, films of those reported as showing dilatation and tortuosity of vessels were reviewed. Measurements were made of the diameter (corrected for magnification) of the major vessels as demonstrated by cerebral angiography. In addition, the course of the ectatic basilar and vertebral arteries was noted, as were the relationships of the internal carotid arteries and the termination of the basilar arteries in the sella and suprasellar regions. Thirty-two normal carotid and 18 normal vertebral angiograms of an age-matched group of patients were also examined. Ectasia was diagnosed when the diameter of the vessels was greater than normal along all or part of their course, and when they were also abnormally tortuous. Whereas the former was determined by measurement, the latter feature was

Morphology and Function of Cerebral Arteries in Adults with Pompe Disease

“…Old age and hypertension could have caused the dolichoectasia in P9 and P10. However, our adult Pompe patients had no to mild atherosclerosis and normal kidney function, and, as reported, most were younger (Yu et al 1982;Ubogu and Zaidat 2004;Ichikawa et al 2009). In some families with Pompe disease, the dilative arteriopathy accumulates at a premature age (Makos et al 1987;Matsuoka et al 1988;Cipullo et al 2013), indicating the importance of hereditary factors.…”

“…Vertebrobasilar dolichoectasia was found in the two oldest patients. This is a higher incidence that is reported for the general population, where the incidence of vertebrobasilar dolichoectasia was between 0.3 and 4.4% (Yu et al 1982;Ubogu and Zaidat 2004). The predominance of dolichoectasia in the vertebrobasilar circulation has already been reported in adult Pompe patients (Laforêt et al 2008;Sacconi et al 2010).…”

“…The pathological basis of dilative arteriopathy and dolichoectasia in the general population is unknown, but both conditions are usually associated with severe atherosclerosis. Dilative arteriopathy is combined with chronic kidney dysfunction, old age, male sex and cardiovascular risk factors as hypertension, smoking and coronary heart disease (Yu et al 1982;Ichikawa et al 2009). Old age and hypertension could have caused the dolichoectasia in P9 and P10.…”

Coil Embolization for a Ruptured Posterior Cerebral Artery Aneurysm With Vertebrobasilar Dolichoectasia -Case Report-

“…17) The working definition for elongation of VBD is over 21 mm from the dorsum sellae to the basilar tip. The ordinary diameter of the basilar artery ranges from 1.5 mm to 3.5 mm, 31) and angiographical measurements of the basilar artery averaged 4 mm. 1) Ectasia of greater size is also known, as the average diameter in 15 cases of dolichoectasia of the basilar artery was 8.6 mm.…”

Vertebrobasilar dolichoectasia as a cause of trigeminal neuralgia: the role of microvascular decompression. Case report

“…motor deficits, cerebellar dysfunction, central sleep apnea, hydrocephalus and ischemic stroke [11][12][13] . D i rect compression by vert e b robasilar dolichoectasia is an uncommon cause for trigeminal neuralgia.…”