Dolichoectasia of the intracranial arteries in patients with first ischemic stroke: a population-based study.
OBJECTIVE
The objective of this study was to estimate the frequency of intracranial arterial dolichoectasia among patients with first ischemic stroke and to compare clinical characteristics, survival, and recurrence in those with and without the abnormality.


BACKGROUND
Dolichoectasia may cause cerebral infarction by thrombosis, embolism, stenosis, or occlusion of deep penetrating arteries.


METHODS
The chi-square, Fisher's exact, and logrank tests were used to compare clinical characteristics, survival, and recurrence for patients with and without dolichoectasia among the 387 residents of Rochester, MN, who had brain CT or MRI for first cerebral infarction from 1985 through 1989.


RESULTS
Twelve patients (3.1%) had dolichoectasia. Patients with dolichoectasia were more likely to have had stroke fitting a clinical and radiographic pattern of lacunar infarction than those without (42% and 17% respectively; p=0.04). Dolichoectasia was detected in the vertebrobasilar system in eight patients (66.7%), in the carotid system in two patients (16.7%), and in both circulatory systems in two patients (16.7%). There were no significant differences in the following characteristics among those with and without dolichoectasia: age, sex, hypertension, diabetes, smoking, and preceding transient ischemic attack. Patients with dolichoectasia had better survival (relative risk [RR] for death, 0.26; p=0.04) after first cerebral infarction but higher rates of stroke recurrence (RR, 2.4; p=0.02).


CONCLUSIONS
Dolichoectasia is detected in 38 of patients with first cerebral infarction and is associated with better survival but higher rates of stroke recurrence.
Ince
B
B
Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
Petty
G W
GW
Brown
R D
RD
Chu
C P
CP
Sicks
J D
JD
Whisnant
J P
JP
D000368:Aged; D000369:Aged, 80 and over; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000473:pathology; D002545:Brain Ischemia / Q000150:complications* / Q000175:diagnosis; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D002533:Cerebral Angiography; D002539:Cerebral Arterial Diseases / Q000150:complications* / Q000175:diagnosis; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology