Intracranial Arterial Dolichoectasia And Posterior Circulation Cerebral Infarction

Purpose : Intracranial arterial dolichoectasia(IADE)is a dilated arteriopathy characterized by abnormal dilation,tortuosity,elongation,or angulation of the cerebral arteries.It is divided into VBD and ICDA.The incidence of the disease is low,and the prevalence of IADE is approximately 0.05%-18%.Little is known about the natural course of the disease,its prognosis and how to prevent its complications.There is no effective quantitative standard.The probability of misdiagnosis and misdiagnosis due to missed diagnosis is high,and its disability rate and mortality rate are high,and the prognosis is poor.The purpose of this study was to gain a deeper understanding of IADE and to explore the relationship between IADE and posterior circulation cerebral infarction through clinical cases.We hope to deepen the understanding of intracranial arteries dolichoectasia and provide a evidence for early diagnosis and treatment.Methods:72 patients were chosen from the imaging diagnosis of posterior cerebral infarction patients at the neurology department of the Tianjin Medical University General Hospital from October 2014 to June 2017.The enrolled patients were in line with the diagnostic criteria established in the 1996 Conference on Cerebrovascular Diseases and the expert consensus of post-circulatory ischemia in China in 2006.We have excluded patients with cerebral embolism,lacunar infarct and organic disease.All selected cases were divided into IADE group and non-IADE group.The clinical symptoms and signs,imaging findings(including the specific site of infarct,diameter of dilated artery,bifurcation height,and degree of deviation)and treatment of IADE group were recorded and used SPSS 19.0 Software performed a statistical analysis of the general conditions(age,sex),risk factors(smoking and alcohol addiction,hypertension,diabetes,hyperlipidemia,history of TIA,cerebral hemorrhage,and nerve compression)in both groups.Results:1?A total of 72 patients with posterior circulation cerebral infarction were enrolled,12 patients with IADE accounted for 16.67%(12/72),which including 2 patients with ICDA and 10 patients with VBD.2 ? Age ranged from 45-83 years with IADE,and the average age was(69.50±10.10)years old.Compared with non-IADE,there were statistically significant differences in age,hypertension,history of previous TIA,and symptoms of nerve compression(P<0.05).There was no significant difference in gender,smoking history,drinking history,coronary heart disease,hyperlipidemia,hyperglycemia,and cerebral hemorrhage.3?In the posterior circulation cerebral infarction caused by IADE,VBD patients accounted for 83.33%(10/12).Compared with ICDA patients,VBD is more prone to posterior circulation cerebral infarction.4?In the posterior circulation cerebral infarction caused by IADE,pontine infarction(n=4)accounted for 33.33% and posterior cerebral artery(n=4)infarction accounted for 33.33%,which were higher probability of occurrence.Conclusion:1?IADE is closely associated with posterior circulation cerebral infarction,especially those caused by VBD.2?Age,high blood pressure,past TIA,and neurological stress may be risk factors for IADE patients.3?The proportion of infarcts in the pons and the posterior cerebral artery is greatest in posterior circulation cerebral infarction caused by IADE.4?the use of multiple inspection methods can raised the findings rate of the disease,missed diagnosis and misdiagnosis rate will be reduced.