Dolichoectasia and Small Vessel Disease in Young Patients with Transient Ischemic Attack and Stroke

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Background and Purpose - We evaluated whether basilar dolichoectasia is associated with markers of cerebral small vessel disease in younger transient ischemic attack and ischemic stroke patients. Methods - We used data from the SIFAP1 study (Stroke in Young Fabry Patients), a large prospective, hospital-based, screening study for Fabry disease in young (<55 years) transient ischemic attack/stroke patients in whom detailed clinical data and brain MRI were obtained, and stroke subtyping with TOAST classification (Trial of ORG 10172 in Acute Stroke Treatment) was performed. Results - Dolichoectasia was found in 508 of 3850 (13.2%) of patients. Dolichoectasia was associated with older age (odds ratio per decade, 1.26; 95% confidence interval, 1.09-1.44), male sex (odds ratio, 1.96; 95% confidence interval, 1.59-2.42), and hypertension (odds ratio, 1.39; 95% confidence interval, 1.13-1.70). Dolichoectasia was more common in patients with small infarctions (33.9% versus 29.8% for acute lesions, P=0.065; 29.1% versus 16.5% for old lesions, P<0.001), infarct location in the brain stem (12.4% versus 6.9%, P<0.001), and in white matter (27.8% versus 21.1%, P=0.001). Microbleeds (16.3% versus 4.7%, P=0.001), higher grades of white matter hyperintensities (P<0.001), and small vessel disease subtype (18.1% versus 12.4%, overall P for differences in TOAST (P=0.018) were more often present in patients with dolichoectasia. Conclusions - Dolichoectasia is associated with imaging markers of small vessel disease and brain stem localization of acute and old infarcts in younger patients with transient ischemic attack and ischemic stroke.


  • Vincent Thijs
  • Ulrike Grittner
  • Franz Fazekas
  • Dominick J H McCabe
  • Anne-Katrin Giese
  • Christof Kessler
  • Peter Martus
  • Bo Norrving
  • Erich Bernd Ringelstein
  • Reinhold Schmidt
  • Christian Tanislav
  • Jukka Putaala
  • Turgut Tatlisumak
  • Bettina von Sarnowski
  • Arndt Rolfs
  • Christian Enzinger
  • Stroke in Fabry (SIFAP1) Investigators
Enheter & grupper
Externa organisationer
  • University of Melbourne
  • Austin Health
  • Charité Universitätsmedizin Berlin
  • Medical University of Graz
  • Trinity College Dublin
  • University College London
  • University of Rostock
  • Ernst-Moritz-Arndt University Greifswald
  • Justus Liebig University Giessen
  • Helsinki University Central Hospital
  • University of Helsinki
  • Sahlgrenska Academy
  • Sahlgrenska University Hospital
  • University of Tübingen
  • University of Münster

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Neurologi


Sidor (från-till)2361-2367
Antal sidor7
Utgåva nummer9
StatusPublished - 2017 sep 1
Peer review utfördJa