Study / Study design (population number) / Diagnostic methods / Study period / Prevalence (%) / Sample characteristics (%)
Kwon et al.(2009)1 / Prospective study of patients with isolated pontine stroke without vertebrobasilar stenosis or embolic sources atSeoulNationalUniversityBoramaeHospital(96) / Smoker’s criteria applied to MRI / 2002–2007 / 18.7 / Not applicable / Not applicable
Pico et al.(2007)2 / Retrospective review of the Multiple Atherosclerosis Site in Stroke autopsy database of patients seen at La Salpetriere Hospital, Francewho died of neurological disease(381) / Visual inspection ofBA diameter / 1982–1989 / 6.0 / Age (years)
Male sex
Hypertension
DM
Smoking
Dyslipidemia
MI / 78.0
52.0
65.0
0.0
4.4
7.4
44.0
Passsero et al.(2005)3* / Prospective cohort study of patients seen in the Department of Neurology, Neurosurgery or Otorhinolaryngology of the University of Sienna, Italy who were screened for vertebrobasilar dolichoectasia; average patient follow-up 9.35years(156) / Smoker’s criteria applied toICA, MCA and VA / 1980–2003 / Not applicable / Age (years)
Male sex
Hypertension
DM
Smoking
CAD or MI
Dyslipidemia
Alcoholabuse / 60.5
75.0
64.0
37.0
28.0
10.0
28.0
10.0
Flemming et al.(2004)4* / A retrospective hospital-based cohort study of Mayo Clinic (Rochester, MN, USA) patients withradiographically based diagnosis of dolichoectasia, fusiform aneurysm or enlarged or tortuous VA or BA (159) / Visual assessment by the radiologist / 1989–2001 / Not applicable / Age (years)
Male sex
Hypertension
DM
Smoking
CAD or MI
Dyslipidemia
PAD
Family history‡ / 64.8
74.0
69.0
10.0
52.0
28.0
40.0
7.0
9.0
Ubogu et al.(2004)5* / A retrospective review of all MRI and MRAsperformedat DukeUniversityMedicalCenter,Durham,NC, USA(1,440) / Smoker’s criteria— anatomical landmarks applied to MRA source images / 1995–1997 / 4.4 / Age(years)
Male sex
Hypertension
DM
Smoking
CAD or MI
Dyslipidemia
Family history‡ / 73.4
29.0
71.0
18.0
47.0
29.0
31.0
26.0
Pico et al.(2003)6* / Review of multicenter French database of patients presenting with stroke; inclusion criteria were presence of clinical symptoms of stroke, absence of hemorrhage on brain CT, presence of brain infarction proven by MRI, aged 18–85 years and having both parents of Caucasian origin (510) / Visual inspection—arterial diameters on MRI; Smoker’s criteria applied to MRI / 1995–unknown / 12.0 / Age(years)
Male sex
Hypertension
DM
Smoking
CAD or MI / 70.5
79.0
76.0
10.0
23.0
24.0
Nakatomi et al.(2000)7 / Retrospective review of cases with the diagnosis of fusiform aneurysm seen at multiple Japanese hospitals (16) / Visual inspection / 1993–1998 / Not applicable / Age (years)
Male sex / 53.7
50.0
Ince et al.(1998)8 / A retrospective review of patients with stroke and available neurological imaging taken from Mayo Clinic (Rochester, MN, USA) city-wide epidemiological database(387) / Visual inspection / 1985–1989 / 3.1 / Age (years)
Male sex
Hypertension
DM
Smoking / 75.0
58.3
92.0
17.0
67.0
Passero et al.(1998)9 / Case–control study of patients with stroke and dolichoectasiacompared with patients with stroke but no dolichoectasiaat the University of Sienna, Italy(40 cases and 40 controls) / Smoker’s criteria / Not applicable / Not applicable / Male sex
Hypertension
DM
Smoking
CAD or MI
Dyslipidemia
Alcohol abuse / 77.0
72.0
15.0
42.5
15.0
50.0
20.0
Drake et al.(1997)10 / Retrospective review of operated fusiform aneurysms in the posterior and anterior circulation at the University of Western Ontario, ON, Canada and Mercy Neuroscience Institute, Miami, FL, USA(120) / Visual inspection / 1965–1992 / 3.0 / Not applicable / Not applicable
Anson et al.(1996)11 / Retrospective review of patients diagnosedwithdolichoectatic aneurysm who were treated at Barrow Neurological Institute, Phoenix, Arizona and University of New Mexico, Albuquerque, NM, USAdemographic and clinical variables were analyzed(40) / Visual inspection / 1986–1994 / Not applicable / Age (years)
Male sex
Hypertension / 46.0
62.0
27.0
Rautenberg et al.(1992)12 / Case series of patients withdolichoectasia collected during a 6 year period at University of Heidelberg and University of Dusseldorf, Germany(45) / Smoker’s criteria—arterial diameters (as per Yu et al.) / Not applicable / Not applicable / Age (years)
Male sex / 60.4
86.6
Milandre etal.(1991)13 / Retrospective review of patients with
vertebrobasilar dolichoectasiaseenat TimoneUniversityHospitalCenter, Marseille, France(23) / Smoker’s criteria / 1975–1989 / Not applicable / Age (years)
Male sex
Hypertension / 62.2
69.0
86.0
Smoker et al.(1986)14 / Retrospective review of patients referred to University of Iowa Neurology or Neuro-ophtalmology departments, Iowa City, IA, USA with vertebrobasilar dolichoectasia(20) / Smoker’s criteria / Not applicable / Not applicable / Age (years)
Male sex
Hypertension / 65.3
75.0
55.0
Resta et al.(1984)15 / Retrospective review of vertebral angiographies from patients with vertebrobasilar dolichoectasiacarried outat University of Bari, Italy(132) / Visual inspection—tortuosity / Not applicable / 5.8 / Not applicable / Not applicable
Yu et al.(1982)16 / Retrospective review and case–control study of angiographies performed at NationalHospital, London, UK; the normal arterial diameters were obtained from 50 controls (50,000) / Visual inspection—arterial diameters / 1959–1980 / 0.058 / Age (years)
Male sex
HypertensionDM
CAD or MI
Dyslipidemia
Smoking
Family history‡ / 60.0
83.0
64.0
9.6
35.0
3.1
74.0
23.0
Deeb et al.(1979)17 / Retrospective review of patients that presented with cranial nerve dysfunction at University of Pittsburgh, Pittsburgh, Pennsylvania and Duke University, North Carolina, USA(250) / Visual inspection / Not applicable / 4.8 / Age (years)
Male sex / 57.3
50.0
Nijensohn et al.(1974)18 / Retrospective review of postmortem examinations of patients with BA fusiform aneurysm from Mayo Clinic, Rochester, MN, USA(23) / Visual inspection / 1952–1972 / Not applicable / Age (years)
Male sex
HypertensionDM
CAD or MI
Dyslipidemia / 65.0
65.0
52.0
4.3
54.0
8.6
Housepian et al.(1958)19 / A retrospective review of brain autopsies (adult and children) carried out from 1914 to 1956 at Columbia University, New York, NY, USA(8,762) / Visual inspection / 1914–1956 / 0.008 / Not applicable / Not applicable
*Year of first publication. ‡Familyhistory of stroke or aneurysm. Abbreviations: BA, basilar artery;CAD,coronary artery disease;DM,diabetes mellitus;ICA, internal carotid artery; MCA, middle cerebral artery;MI, myocardial infarction;MRA, Magnetic resonance angiogram; PAD,peripheral artery disease;VA, vertebral artery.
1.Kwon, H.M. et al. Basilar artery dolichoectasia is associated with paramedian pontine infarction. Cerebrovasc. Dis.27, 114–118 (2009).
2.Pico, F. et al. Association of small-vessel disease with dilatative arteriopathy of the brain: neuropathologic evidence. Stroke 38, 1197–1202 (2007).
3.Passero, S.G., Calchetti, B. & Bartalini, S. Intracranial bleeding in patients with vertebrobasilar dolichoectasia. Stroke36, 1421–1425 (2005).
4.Flemming, K.D. et al. Prospective risk of hemorrhage in patients with vertebrobasilar nonsaccular intracranial aneurysm. J. Neurosurg.101, 82–87 (2004).
5.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. Psychiatry75, 22–26 (2004).
6.Pico, F., Labreuche, J., Touboul, P.J. & Amarenco, P. Intracranial arterial dolichoectasia and its relation with atherosclerosis and stroke subtype. Neurology61, 1736–1742 (2003).
7.Nakatomi, H. et al. Clinicopathological study of intracranial fusiform and dolichoectatic aneurysms : insight on the mechanism of growth. Stroke31, 896–900 (2000).
8.Ince, B. et al. Dolichoectasia of the intracranial arteries in patients with first ischemic stroke: a population-based study. Neurology50, 1694–1698 (1998).
9.Passero, S. & Filosomi, G. Posterior circulation infarcts in patients with vertebrobasilar dolichoectasia. Stroke 29, 653–659 (1998).
10.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).
11.Anson, J.A., Lawton, M.T. & Spetzler, R.F. Characteristics and surgical treatment of dolichoectatic and fusiform aneurysms. J. Neurosurg.84, 185–193 (1996).
12.Rautenberg, W., Aulich, A., Rother, J., Wentz, K.U. & Hennerici, M. Stroke and dolichoectatic intracranial arteries. Neurol. Res.14, 201–203 (1992).
13.Milandre, L. et al. Vertebrobasilar arterial dolichoectasia. Complications and prognosis. [French] Rev. Neurol. (Paris)147, 714–722 (1991).
14.Smoker, W.R. et al. High-resolution computed tomography of the basilar artery: 2. Vertebrobasilar dolichoectasia: clinical-pathologic correlation and review. AJNRAm. J. Neuroradiol.7, 61–72 (1986).
15.Resta, M. et al. Clinical-angiographic correlations in 132 patients with megadolichovertebrobasilar anomaly. Neuroradiology26, 213–216 (1984).
16.Yu, Y.L., Moseley, I.F., Pullicino, P. & McDonald, W.I. The clinical picture of ectasia of the intracerebral arteries. J. Neurol. Neurosurg. Psychiatry45, 29–36 (1982).
17.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).
18.Nijensohn, D.E., Saez, R.J. & Reagan, T.J. Clinical significance of basilar artery aneurysms. Neurology 24, 301–305 (1974).
19.Housepian, E.M. & Pool, J.L. A systematic analysis of intracranial aneurysms from the autopsy file of the PresbyterianHospital, 1914 to 1956. J. Neuropathol. Exp. Neurol.17, 409–423 (1958).
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