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  • Review Article
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Dolichoectasia—an evolving arterial disease

Nature Reviews Neurology volume 7, pages 41–50 (2011)Cite this article

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Abstract

Dolichoectasia is an arterial disease that causes dilatation and/or tortuosity of the affected vessel. The prevalence of dolichoectasia increases with age, and this disease is also associated with other traditional cardiovascular risk factors. Multiple pathophysiological processes might lead to the development of dolichoectatic vessels, and activation of metalloproteinases and irregular turbulent blood flow seem to cause irreversible disruption of the internal elastic lamina. Intracranial dolichoectasia commonly presents with ischemic or hemorrhagic stroke, and/or cranial neuropathies. The posterior circulation is more frequently affected by the dolichoectatic process than the anterior circulation. A positive diagnosis of dolichoectasia requires visual assessment of vessel shape and, if the posterior circulation is affected, application of Smoker's criteria. Reproducible criteria that aid diagnosis of dolichoectasia in the anterior circulation are lacking. No specific treatment for dolichoectasia exists, and the surgical and medical therapies that have been used to treat this condition have not been systematically evaluated. More evidence is needed to better understand the underlying dilatatory artheriopathy that causes this disease, and to determine whether patients with dolichoectasia might benefit from early diagnosis. In this article, we provide a comprehensive review of current knowledge regarding dolichoectasia, and highlight gaps in our knowledge to aid future research.

Key Points

  • Dolichoectasia is a disease that can affect both intracranial and extracranial arteries, and can be asymptomatic or manifest with compressive and/or vascular symptoms

  • Dolichoectasia is associated with traditional cardiovascular risk factors such as hypertension, old age and male sex, but can also be associated with nonatherosclerotic diseases

  • Disruption of the internal elastic lamina and subsequent weakness and deformation of the arterial wall are characteristic features of dolichoectasia

  • Limited evidence exists to recommend a specific therapy for dolichoectasia, although treatment of the underlying risk factors seems to be the safest approach

  • Future studies are needed to address multiple questions regarding the physiopathology, treatment and prognosis of dolichoectasia

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Figure 1: Modifiable and nonmodifiable dolichoectasia risk factors.
Figure 2: Radiological diagnosis of dolichoectasia.

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References

  1. Halsey, C. S. An Etymology of Latin and Greek (Ginn & Company, Boston, 1889).

    Google Scholar 

  2. Morgagni, G. De Sedibus et Causis Morborum per Anatomen Indigatis Libri Quinque. Venice: Ex Typographia Remondiana (1761).

    Google Scholar 

  3. Housepian, E. M. & Pool, J. L. A systematic analysis of intracranial aneurysms from the autopsy file of the Presbyterian Hospital, 1914 to 1956. J. Neuropathol. Exp. Neurol. 17, 409–423 (1958).

    CAS  PubMed  Google Scholar 

  4. Miner, M. E., Rea, G. L., Handel, S. & Bertz, J. Trigeminal neuralgia due to dolichoectasia: angiographic and CT findings in a patient with the EEC syndrome. Neuroradiology 20, 163–166 (1980).

    CAS  PubMed  Google Scholar 

  5. McFarland, W. & Fuller, D. E. Mortality in Ehlers–Danlos syndrome due to spontaneous rupture of large arteries. N. Engl. J. Med. 271, 1309–1310 (1964).

    CAS  PubMed  Google Scholar 

  6. Hayes, W. T., Bernhardt, H. & Young, J. M. Fusiform arteriosclerotic aneurysm of the basilar artery. Five cases including two ruptures. Vasc. Surg. 1, 171–178 (1967).

    CAS  PubMed  Google Scholar 

  7. Deeb, Z. L., Jannetta, P. J., Rosenbaum, A. E., Kerber, C. W. & Drayer, B. P. Tortuous vertebrobasilar arteries causing cranial nerve syndromes: screening by computed tomography. J. Comput. Assist. Tomogr. 3, 774–778 (1979).

    CAS  PubMed  Google Scholar 

  8. Mourgela, S., Anagnostopoulou, S., Sakellaropoulos, A. & Spanos, A. Dolichoectatic cervical arteries (carotid and vertebral arteries) heralded by recurrent cerebral ischemia: case illustration. Angiology 59, 107–110 (2008).

    PubMed  Google Scholar 

  9. Klinge, H. & Braunsdorf, W. E. Clinical signs associated with megadolichobasilar artery anomaly. Neurosurg. Rev. 14, 303–307 (1991).

    CAS  PubMed  Google Scholar 

  10. Anson, J. A., Lawton, M. T. & Spetzler, R. F. Characteristics and surgical treatment of dolichoectatic and fusiform aneurysms. J. Neurosurg. 84, 185–193 (1996).

    CAS  PubMed  Google Scholar 

  11. Drake, C. G. & Peerless, S. J. Giant fusiform intracranial aneurysms: review of 120 patients treated surgically from 1965 to 1992. J. Neurosurg. 87, 141–162 (1997).

    CAS  PubMed  Google Scholar 

  12. Resta, M. et al. Clinical–angiographic correlations in 132 patients with megadolichovertebrobasilar anomaly. Neuroradiology 26, 213–216 (1984).

    CAS  PubMed  Google Scholar 

  13. Caplan, L. R. Dilatative arteriopathy (dolichoectasia): what is known and not known. Ann. Neurol. 57, 469–471 (2005).

    PubMed  Google Scholar 

  14. Flemming, K. D. et al. Prospective risk of hemorrhage in patients with vertebrobasilar nonsaccular intracranial aneurysm. J. Neurosurg. 101, 82–87 (2004).

    PubMed  Google Scholar 

  15. Smoker, W. R., Price, M. J., Keyes, W. D., Corbett, J. J. & Gentry, L. R. High-resolution computed tomography of the basilar artery: 1. Normal size and position. AJNR Am. J. Neuroradiol. 7, 55–60 (1986).

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Yu, Y. L., Moseley, I. F., Pullicino, P. & McDonald, W. I. The clinical picture of ectasia of the intracerebral arteries. J. Neurol. Neurosurg. Psychiatry 45, 29–36 (1982).

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Ubogu, E. E. & Zaidat, O. O. Vertebrobasilar dolichoectasia diagnosed by magnetic resonance angiography and risk of stroke and death: a cohort study. J. Neurol. Neurosurg. Psychiatry 75, 22–26 (2004).

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Pico, F., Labreuche, J., Touboul, P. J. & Amarenco, P. Intracranial arterial dolichoectasia and its relation with atherosclerosis and stroke subtype. Neurology 61, 1736–1742 (2003).

    PubMed  Google Scholar 

  19. Passero, S. G. & Rossi, S. Natural history of vertebrobasilar dolichoectasia. Neurology 70, 66–72 (2008).

    PubMed  Google Scholar 

  20. Schievink, W. I., Torres, V. E., Wiebers, D. O. & Huston, J. 3rd. Intracranial arterial dolichoectasia in autosomal dominant polycystic kidney disease. J. Am. Soc. Nephrol. 8, 1298–1303 (1997).

    CAS  PubMed  Google Scholar 

  21. Yamada, K., Hayakawa, T., Ushio, Y. & Mitomo, M. Cerebral arterial dolichoectasia associated with moyamoya vessels. Surg. Neurol. 23, 19–24 (1985).

    CAS  PubMed  Google Scholar 

  22. Finney, L. H., Roberts, T. S. & Anderson, R. E. Giant intracranial aneurysm associated with Marfan's syndrome. Case report. J. Neurosurg. 45, 342–347 (1976).

    CAS  PubMed  Google Scholar 

  23. Pico, F. et al. Association of small-vessel disease with dilatative arteriopathy of the brain: neuropathologic evidence. Stroke 38, 1197–1202 (2007).

    PubMed  Google Scholar 

  24. Wolfe, T., Ubogu, E. E., Fernandes-Filho, J. A. & Zaidat, O. O. Predictors of clinical outcome and mortality in vertebrobasilar dolichoectasia diagnosed by magnetic resonance angiography. J. Stroke Cerebrovasc. Dis. 17, 388–393 (2008).

    PubMed  Google Scholar 

  25. Smoker, W. R. et al. High-resolution computed tomography of the basilar artery: 2. Vertebrobasilar dolichoectasia: clinical–pathologic correlation and review. AJNR Am. J. Neuroradiol. 7, 61–72 (1986).

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Ferry, P. C., Kerber, C., Peterson, D. & Gallo, A. A. Jr. Arteriectasis, subarachnoid hemorrhage in a three-month-old infant. Neurology 24, 494–500 (1974).

    CAS  PubMed  Google Scholar 

  27. Miyazaki, M. et al. Central sleep apnea and arterial compression of the medulla. Ann. Neurol. 29, 564–565 (1991).

    CAS  PubMed  Google Scholar 

  28. Passero, S. & Filosomi, G. Posterior circulation infarcts in patients with vertebrobasilar dolichoectasia. Stroke 29, 653–659 (1998).

    CAS  PubMed  Google Scholar 

  29. Pico, F., Labreuche, J., Touboul, P. J., Leys, D. & Amarenco, P. Intracranial arterial dolichoectasia and small-vessel disease in stroke patients. Ann. Neurol. 57, 472–479 (2005).

    PubMed  Google Scholar 

  30. Pico, F., Labreuche, J., Cohen, A., Touboul, P. J. & Amarenco, P. Intracranial arterial dolichoectasia is associated with enlarged descending thoracic aorta. Neurology 63, 2016–2021 (2004).

    CAS  PubMed  Google Scholar 

  31. Mizutani, T., Miki, Y., Kojima, H. & Suzuki, H. Proposed classification of nonatherosclerotic cerebral fusiform and dissecting aneurysms. Neurosurgery 45, 253–260 (1999).

    CAS  PubMed  Google Scholar 

  32. Flemming, K. D. et al. The natural history of radiographically defined vertebrobasilar nonsaccular intracranial aneurysms. Cerebrovasc. Dis. 20, 270–279 (2005).

    PubMed  Google Scholar 

  33. Graf, S. et al. Intracranial aneurysms and dolichoectasia in autosomal dominant polycystic kidney disease. Nephrol. Dial. Transplant. 17, 819–823 (2002).

    PubMed  Google Scholar 

  34. Singh, S. & Bresnan, M. J. Menkes kinky-hair syndrome. (Trichopoliodystrophy). Low copper levels in the blood, hair, and urine. Am. J. Dis. Child. 125, 572–578 (1973).

    CAS  PubMed  Google Scholar 

  35. Rubinstein, M. K. & Cohen, N. H. Ehlers–Danlos syndrome associated with multiple intracranial aneurysms. Neurology 14, 125–132 (1964).

    CAS  PubMed  Google Scholar 

  36. Laforet, P. et al. Dilative arteriopathy and basilar artery dolichoectasia complicating late-onset Pompe disease. Neurology 70, 2063–2066 (2008).

    CAS  PubMed  Google Scholar 

  37. Baccin, C. E., Krings, T., Alvarez, H., Ozanne, A. & Lasjaunias, P. L. A report of two cases with dolichosegmental intracranial arteries as a new feature of PHACES syndrome. Childs Nerv. Syst. 23, 559–567 (2007).

    PubMed  Google Scholar 

  38. Heyer, G. L. et al. The cerebral vasculopathy of PHACES syndrome. Stroke 39, 308–316 (2008).

    PubMed  Google Scholar 

  39. Blumenkopf, B. & Huggins, M. J. Tuberous sclerosis and multiple intracranial aneurysms: case report. Neurosurgery 17, 797–800 (1985).

    CAS  PubMed  Google Scholar 

  40. Kanemoto, Y., Hisanaga, M. & Bessho, H. Association of a dolichoectatic middle cerebral artery and an intracranial cavernous hemangioma—case report. Neurol. Med. Chir. (Tokyo) 38, 40–42 (1998).

    CAS  Google Scholar 

  41. Nakahara, I., Taki, W., Tanaka, M., Matsumoto, K. & Kikuchi, H. Dolichoectasia of the middle cerebral artery—case report. Neurol. Med. Chir. (Tokyo) 35, 822–824 (1995).

    CAS  Google Scholar 

  42. Gutierrrez, J. et al. A dangerous combination for stroke in young patient: assimilation of the atlas and anti β2-glycoprotein I antibodies. [Spanish] Rev. Med. Inst. Mex. Seguro. Soc. 47, 89–94 (2009).

    PubMed  Google Scholar 

  43. Tronc, F. et al. Role of matrix metalloproteinases in blood flow-induced arterial enlargement: interaction with NO. Arterioscler. Thromb. Vasc. Biol. 20, E120–E126 (2000).

    CAS  PubMed  Google Scholar 

  44. Sho, E. et al. Arterial enlargement in response to high flow requires early expression of matrix metalloproteinases to degrade extracellular matrix. Exp. Mol. Pathol. 73, 142–153 (2002).

    CAS  PubMed  Google Scholar 

  45. Sho, E. et al. Arterial enlargement, tortuosity, and intimal thickening in response to sequential exposure to high and low wall shear stress. J. Vasc. Surg. 39, 601–612 (2004).

    PubMed  Google Scholar 

  46. Meng, H. et al. Complex hemodynamics at the apex of an arterial bifurcation induces vascular remodeling resembling cerebral aneurysm initiation. Stroke 38, 1924–1931 (2007).

    PubMed  PubMed Central  Google Scholar 

  47. Hoi, Y. et al. In vivo assessment of rapid cerebrovascular morphological adaptation following acute blood flow increase. J. Neurosurg. 109, 1141–1147 (2008).

    PubMed  PubMed Central  Google Scholar 

  48. Cines, D. B. et al. Endothelial cells in physiology and in the pathophysiology of vascular disorders. Blood 91, 3527–3561 (1998).

    CAS  PubMed  Google Scholar 

  49. Lehoux, S., Castier, Y. & Tedgui, A. Molecular mechanisms of the vascular responses to haemodynamic forces. J. Intern. Med. 259, 381–392 (2006).

    CAS  PubMed  Google Scholar 

  50. Chen, K. D. et al. Mechanotransduction in response to shear stress. Roles of receptor tyrosine kinases, integrins, and Shc. J. Biol. Chem. 274, 18393–18400 (1999).

    CAS  PubMed  Google Scholar 

  51. Ogawa, A., Suzuki, M., Shirane, R. & Yoshimoto, T. Repositioning of the tortuous vertebrobasilar artery for trigeminal neuralgia: a technical note. Surg. Neurol. 38, 232–235 (1992).

    CAS  PubMed  Google Scholar 

  52. Mercurius, K. O. & Morla, A. O. Inhibition of vascular smooth muscle cell growth by inhibition of fibronectin matrix assembly. Circ. Res. 82, 548–556 (1998).

    CAS  PubMed  Google Scholar 

  53. Gibbons, G. H. & Dzau, V. J. The emerging concept of vascular remodeling. N. Engl. J. Med. 330, 1431–1438 (1994).

    CAS  PubMed  Google Scholar 

  54. Nakatomi, H. et al. Clinicopathological study of intracranial fusiform and dolichoectatic aneurysms: insight on the mechanism of growth. Stroke 31, 896–900 (2000).

    CAS  PubMed  Google Scholar 

  55. Dziewasa, R. et al. Treatment options in vertebrobasilar dolichoectasia—case report and review of the literature. Eur. Neurol. 49, 245–247 (2003).

    PubMed  Google Scholar 

  56. Hegedus, K. Ectasia of the basilar artery with special reference to possible pathogenesis. Surg. Neurol. 24, 463–469 (1985).

    CAS  PubMed  Google Scholar 

  57. Hassan, A. et al. Markers of endothelial dysfunction in lacunar infarction and ischaemic leukoaraiosis. Brain 126, 424–432 (2003).

    PubMed  Google Scholar 

  58. Amano, T. et al. Ruptured saccular aneurysm of a dolichoectatic internal carotid artery in a patient with agenesis of the contralateral internal carotid artery—case report. Neurol. Med. Chir. (Tokyo) 44, 20–23 (2004).

    Google Scholar 

  59. Keeling, W. B., Armstrong, P. A., Stone, P. A., Bandyk, D. F. & Shames, M. L. An overview of matrix metalloproteinases in the pathogenesis and treatment of abdominal aortic aneurysms. Vasc. Endovascular Surg. 39, 457–464 (2005).

    PubMed  Google Scholar 

  60. Aziz, F. & Kuivaniemi, H. Role of matrix metalloproteinase inhibitors in preventing abdominal aortic aneurysm. Ann. Vasc. Surg. 21, 392–401 (2007).

    PubMed  PubMed Central  Google Scholar 

  61. Rosenberg, G. A., Sullivan, N. & Esiri, M. M. White matter damage is associated with matrix metalloproteinases in vascular dementia. Stroke 32, 1162–1168 (2001).

    CAS  PubMed  Google Scholar 

  62. Pfefferkorn, T. & Rosenberg, G. A. Closure of the blood-brain barrier by matrix metalloproteinase inhibition reduces rtPA-mediated mortality in cerebral ischemia with delayed reperfusion. Stroke 34, 2025–2030 (2003).

    PubMed  Google Scholar 

  63. Wardlaw, J. M., Sandercock, P. A., Dennis, M. S. & Starr, J. Is breakdown of the blood–brain barrier responsible for lacunar stroke, leukoaraiosis, and dementia? Stroke 34, 806–812 (2003).

    CAS  PubMed  Google Scholar 

  64. Young, V. G., Halliday, G. M. & Kril, J. J. Neuropathologic correlates of white matter hyperintensities. Neurology 71, 804–811 (2008).

    PubMed  Google Scholar 

  65. Ince, B. et al. Dolichoectasia of the intracranial arteries in patients with first ischemic stroke: a population-based study. Neurology 50, 1694–1698 (1998).

    CAS  PubMed  Google Scholar 

  66. Nijensohn, D. E., Saez, R. J. & Reagan, T. J. Clinical significance of basilar artery aneurysms. Neurology 24, 301–305 (1974).

    CAS  PubMed  Google Scholar 

  67. Milandre, L. et al. Vertebrobasilar arterial dolichoectasia. Complications and prognosis. [French] Rev. Neurol. (Paris) 147, 714–722 (1991).

    CAS  Google Scholar 

  68. Pico, F., Biron, Y., Bousser, M. G. & Amarenco, P. Concurrent dolichoectasia of basilar and coronary arteries. Neurology 65, 1503–1504 (2005).

    PubMed  Google Scholar 

  69. Edvinsson, L. & Owman, C. Sympathetic innervation and adrenergic receptors in intraparenchymal cerebral arterioles of baboon. Acta Physiol. Scand. Suppl. 452, 57–59 (1977).

    CAS  PubMed  Google Scholar 

  70. Edvinsson, L. & MacKenzie, E. T. Amine mechanisms in the cerebral circulation. Pharmacol. Rev. 28, 275–348 (1976).

    CAS  PubMed  Google Scholar 

  71. Edvinsson, L., Hardebo, J. E. & Owman, C. Role of perivascular sympathetic nerves in autoregulation of cerebral blood flow and in blood–brain barrier functions. Acta Neurol. Scand. Suppl. 64, 50–51 (1977).

    CAS  PubMed  Google Scholar 

  72. El-Barhoun, E. N., Gledhill, S. R. & Pitman, A. G. Circle of Willis artery diameters on MR angiography: an Australian reference database. J. Med. Imaging Radiat. Oncol. 53, 248–260 (2009).

    CAS  PubMed  Google Scholar 

  73. Beausang-Linder, M. & Bill, A. Cerebral circulation in acute arterial hypertension—protective effects of sympathetic nervous activity. Acta Physiol. Scand. 111, 193–199 (1981).

    CAS  PubMed  Google Scholar 

  74. Krabbe-Hartkamp, M. J. et al. Circle of Willis: morphologic variation on three-dimensional time-of-flight MR angiograms. Radiology 207, 103–111 (1998).

    CAS  PubMed  Google Scholar 

  75. Ichikawa, H. et al. Dilative arterial remodeling of the brain with different effects on the anterior and posterior circulation: an MRI study. J. Neurol. Sci. 287, 236–240 (2009).

    PubMed  Google Scholar 

  76. Borota, L. & Jonasson, P. Basilar and bilateral carotid dolichoectasia with spontaneous dissection of C2 segment of the internal carotid artery. AJNR Am. J. Neuroradiol. 27, 1241–1244 (2006).

    CAS  PubMed  PubMed Central  Google Scholar 

  77. Giray, S., Pelit, A., Kizilkilic, O. & Karatas, M. Isolated abducens nerve palsy caused by contralateral vertebral artery dolichoectasia. Neurol. India 53, 246–247 (2005).

    PubMed  Google Scholar 

  78. Rautenberg, W., Aulich, A., Rother, J., Wentz, K. U. & Hennerici, M. Stroke and dolichoectatic intracranial arteries. Neurol. Res. 14, 201–203 (1992).

    CAS  PubMed  Google Scholar 

  79. Gutierrez, J., Adams, D., Tornes, L., Isaacson, R. & Wright, C. B. Dolichoectasia and multifocal simultaneous intracranial haemorrhages. BMJ Case Reports 2010 doi:10.1136/bcr.10.2009.2325.

    Google Scholar 

  80. Jacobson, D. M. & Corbett, J. J. Downbeat nystagmus associated with dolichoectasia of the vertebrobasilar artery. Arch. Neurol. 46, 1005–1008 (1989).

    CAS  PubMed  Google Scholar 

  81. Passero, S. G., Calchetti, B. & Bartalini, S. Intracranial bleeding in patients with vertebrobasilar dolichoectasia. Stroke 36, 1421–1425 (2005).

    PubMed  Google Scholar 

  82. Kawasaki, A. & Purvin, V. Isolated IVth (trochlear) nerve palsy due to basilar artery dolichoectasia. Klin. Monbl. Augenheilkd. 223, 459–461 (2006).

    CAS  PubMed  Google Scholar 

  83. Campos, C. R., Doria-Netto, H. L., Souza-Filho, A. M. & Silva Junior, H. M. Oligosymptomatic and giant basilar artery dolichoectasia discovered after a stroke: case report. Arq. Neuropsiquiatr. 65, 345–347 (2007).

    PubMed  Google Scholar 

  84. Titlic, M. et al. Tinnitus caused by vertebrobasilar dolichoectasia. Bratisl. Lek. Listy 108, 455–457 (2007).

    CAS  PubMed  Google Scholar 

  85. Krespi, Y., Verstichel, P., Masson, C. & Cambier, J. Downbeat nystagmus and vertebrobasilar arterial dolichoectasia. [French] Rev. Neurol. (Paris) 151, 196–197 (1995).

    CAS  Google Scholar 

  86. Papapetropoulos, S. et al. Hemifacial spasm and pontine compression caused by a giant vertebrobasilar dolichoectasia. Cerebrovasc. Dis. 27, 413–414 (2009).

    PubMed  Google Scholar 

  87. Durand, J. R. & Samples, J. R. Dolichoectasia and cranial nerve palsies. A case report. J. Clin. Neuroophthalmol. 9, 249–253 (1989).

    CAS  PubMed  Google Scholar 

  88. Egido, J. A., Carod, J., Cuadrado, M. L. & Gonzalez, J. L. Dolichoectasia of multiple cranial arteries. Findings on neuroimaging and transcranial Doppler. [Spanish] Rev. Neurol. 25, 872–874 (1997).

    CAS  PubMed  Google Scholar 

  89. Davous, P., Tillier, J. N. & Torrent, J. Total deafness after multiple pontine infarctions. Dolichoectasia of the basilar trunk. [French] Rev. Neurol. (Paris) 147, 234–237 (1991).

    CAS  Google Scholar 

  90. Siddiqui, A., Chew, N. S. & Miszkiel, K. Vertebrobasilar dolichoectasia: a rare cause of obstructive hydrocephalus: case report. Br. J. Radiol. 81, e123–e126 (2008).

    CAS  PubMed  Google Scholar 

  91. Huang, C., Chan, Y. W. & Wang, R. Senile dementia and hydrocephalus due to carotid dolichoectasia. Clin. Exp. Neurol. 19, 171–176 (1983).

    CAS  PubMed  Google Scholar 

  92. Doran, S. E., Deveikis, J. P. & Chandler, W. F. Dolichoectasia of the anterior cerebral arteries in an adolescent. AJNR Am. J. Neuroradiol. 16, 1548–1550 (1995).

    CAS  PubMed  PubMed Central  Google Scholar 

  93. Thompson, J. R., Weinstein, P. R. & Simmons, C. R. Cerebral arterial dolichoectasia with seizure. Case report. J. Neurosurg. 44, 509–512 (1976).

    CAS  PubMed  Google Scholar 

  94. Guirgis, M. F., Lam, B. L. & Falcone, S. F. Optic tract compression from dolichoectatic basilar artery. Am. J. Ophthalmol. 132, 283–286 (2001).

    CAS  PubMed  Google Scholar 

  95. Slavin, M. L. Bitemporal hemianopia associated with dolichoectasia of the intracranial carotid arteries. J. Clin. Neuroophthalmol. 10, 80–81 (1990).

    CAS  PubMed  Google Scholar 

  96. Kwon, H. M. et al. Basilar artery dolichoectasia is associated with paramedian pontine infarction. Cerebrovasc. Dis. 27, 114–118 (2009).

    PubMed  Google Scholar 

  97. Tsutsumi, S., Yasumoto, Y. & Ito, M. Atypical megadolichoectasia manifesting as brain infarction rapidly followed by fatal subarachnoid hemorrhage. J. Neuroimaging doi:10.1111/j.1552-65692009.00363.x.

  98. Rabb, C. H. & Barnwell, S. L. Catastrophic subarachnoid hemorrhage resulting from ruptured vertebrobasilar dolichoectasia: case report. Neurosurgery 42, 379–382 (1998).

    CAS  PubMed  Google Scholar 

  99. Pico, F., Labreuche, J., Gourfinkel-An, I. & Amarenco, P. Basilar artery diameter and 5-year mortality in patients with stroke. Stroke 37, 2342–2347 (2006).

    PubMed  Google Scholar 

  100. Giang, D. W., Perlin, S. J., Monajati, A., Kido, D. J. & Hollander, J. Vertebrobasilar dolichoectasia: assessment using MR. Neuroradiology 30, 518–523 (1988).

    CAS  PubMed  Google Scholar 

  101. Levine, R. L., Turski, P. A. & Grist, T. M. Basilar artery dolichoectasia. Review of the literature and six patients studied with magnetic resonance angiography. J. Neuroimaging 5, 164–170 (1995).

    CAS  PubMed  Google Scholar 

  102. Vieco, P. T., Maurin, E. E. 3rd. & Gross, C. E. Vertebrobasilar dolichoectasia: evaluation with CT angiography. AJNR Am. J. Neuroradiol. 18, 1385–1388 (1997).

    CAS  PubMed  PubMed Central  Google Scholar 

  103. De Georgia, M. et al. Thrombus in vertebrobasilar dolichoectatic artery treated with intravenous urokinase. Cerebrovasc. Dis. 9, 28–33 (1999).

    CAS  PubMed  Google Scholar 

  104. Ubogu, E. E., Chase, C. M., Verrees, M. A., Metzger, A. K. & Zaidat, O. O. Cervicomedullary junction compression caused by vertebral artery dolichoectasia and requiring surgical treatment. Case report. J. Neurosurg. 96, 140–143 (2002).

    PubMed  Google Scholar 

  105. Rawlinson, J. N. & Coakham, H. B. The treatment of hemifacial spasm by sling retraction. Br. J. Neurosurg. 2, 173–178 (1988).

    CAS  PubMed  Google Scholar 

  106. Pereira-Filho, A., Faria, M., Bleil, C. & Kraemer, J. L. Brainstem compression syndrome caused by vertebrobasilar dolichoectasia: microvascular repositioning technique. Arq. Neuropsiquiatr. 66, 408–411 (2008).

    PubMed  Google Scholar 

  107. Laws, E. R. Jr, Kelly, P. J. & Sundt, T. M. Jr. Clip-grafts in microvascular decompression of the posterior fossa. Technical note. J. Neurosurg. 64, 679–681 (1986).

    PubMed  Google Scholar 

  108. Chao, K. H., Riina, H. A., Heier, L., Steig, P. E. & Gobin, Y. P. Endovascular management of dolichoectasia of the posterior cerebral artery report. AJNR Am. J. Neuroradiol. 25, 1790–1791 (2004).

    PubMed  PubMed Central  Google Scholar 

  109. Matsumoto, K. et al. Dolichoectatic basilar artery treated by reducing hemodynamic stress--report of two cases. Neurol. Med. Chir. (Tokyo) 30, 691–694 (1990).

    CAS  Google Scholar 

  110. de los Reyes, R. A. et al. Treatment of dolichoectasia of the middle cerebral artery with bypass and exclusion. N. Y. State J. Med. 89, 629–633 (1989).

    CAS  PubMed  Google Scholar 

  111. Corkill, G., Sarwar, M. & Virapongse, C. Evolution of dolichoectasia of the vertebrobasilar system as evidenced by serial computed tomography. Surg. Neurol. 18, 262–266 (1982).

    CAS  PubMed  Google Scholar 

  112. Mangrum, W. I. et al. Enlarging vertebrobasilar nonsaccular intracranial aneurysms: frequency, predictors, and clinical outcome of growth. J. Neurosurg. 102, 72–79 (2005).

    PubMed  Google Scholar 

Download references

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  1. Department of Neurology, Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1387, Miami, 33136, FL, USA

    Jose Gutierrez, Ralph L. Sacco & Clinton B. Wright

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  1. Jose Gutierrez
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  2. Ralph L. Sacco
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  3. Clinton B. Wright
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Contributions

J. Gutierrez researched the data for the article, provided substantial contributions to discussions of the content, and contributed to writing the article and to review and editing of the manuscript before submission. C. B. Wright provided substantial contributions to discussions of the content, and contributed to writing the article and the review and editing of the manuscript before submission. R. L. Sacco provided substantial contributions to discussions of the content and to review and editing of the manuscript before submission.

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Correspondence to Jose Gutierrez.

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The authors declare no competing financial interests.

Supplementary information

Supplementary Table 1

Patient characteristics of selected studies of dolichoectasia (DOC 105 kb)

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Gutierrez, J., Sacco, R. & Wright, C. Dolichoectasia—an evolving arterial disease. Nat Rev Neurol 7, 41–50 (2011). https://doi.org/10.1038/nrneurol.2010.181

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