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Intracranial arterial dolichoectasia and its relation with atherosclerosis and stroke subtype

From the Department of Neurology (Dr. Pico), Versailles Hospital, France; and the Department of Neurology and Stroke Centre, Bichat University Hospital and Medical School, Denis Diderot University–Paris VII, and ‘Formation de Recherche en Neurologie Vasculaire’ (Association Claude Bernard) (J. Labreuche and Drs. Touboul and Amarenco), Paris, France.

Address correspondence and reprint requests to Professor Pierre Amarenco, Department of Neurology and Stroke Centre, Bichat University Hospital and Medical School, 46 rue Henri Huchard, 75018 Paris, France; e-mail: pierre.amarenco{at}bch.ap-hop-paris.fr

Objective: To investigate the relationship between intracranial arterial dolichoectasia (IADE) and vascular risk factors, atherosclerosis of the carotid arteries as measured by ultrasound scan, and stroke subtypes.

Methods: The sample consists of 510 consecutively recruited patients with brain infarction confirmed by MRI. The diagnosis of IADE was made by consensus between two neurologists based on MRI results. An independent reading of the 510 scans was made, with measurement of the diameter of the seven main intracranial arteries with a 16-diopter lens to validate the consensus and to better characterize patients with IADE.

Results: Sixty-three IADE(+) patients were identified by consensus (12%), of whom 59 (94%) had at least one intracranial artery in the fourth quartile of the distribution of diameters of intracranial arteries. Multivariate analyses found an association between IADE(+) and age (OR [95% CI] 1.04 [1.01–1.08]), male sex (3.31 [1.67–6.55]), hypertension (1.94 [1.01–3.72]), and previous myocardial infarction (2.68 [1.33–5.38]). There was no association between IADE and carotid atherosclerosis markers such as plaque or intima-media thickening. Lacunar infarct was more frequent in patients with IADE (36% versus 19%), with an adjusted OR of 2.89 (95% CI 1.29–6.46) compared with atherothrombotic infarct.

Conclusions: IADE was associated with vascular risk factors such as age, male sex, hypertension, previous history of myocardial infarction, and lacunar infarct, but not with carotid atherosclerosis.

Received February 7, 2003. Accepted in final form August 27, 2003.

*A list of the GENIC Investigators and their institutions is available at http://www.ccr.jussieu.fr/GENIC/welcome.html

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