Vertebrobasilar dolichoectasia in patients with cerebrovascular ischemic stroke: does it have a role in cerebral microbleeds?

Abstract

Background: Vertebrobasilar dolichoectasia (VBD) may account for cerebral microbleeds (CMBs) in ischemic cerebrovascular stroke. Objectives: To examine whether VBD is associated with the involvement of CMBs in any region and, if so, whether it is associated with CMBs among ischemic stroke patients located in posterior circulation territory. For patients with VBD, we also studied ischemic stroke subtypes, and checked whether dolichoectasia was linked to vascular risk factors. Methods: Two hundred ischemic stroke patients in whom detailed clinical data and brain MRI sequences were obtained, and stroke subtyping with TOAST classification (Trial of ORG 10172 in Acute Stroke Treatment) was performed. Results: The mean age of patients was (65.22 ± 12.88), male patients were more frequent (67.5%); dyslipidemia was the most frequent risk factor (55%). Cardio-embolic stroke subtype was the most frequent (37%) and (71.5%) of patients had no history of previous use of antithrombotic drugs. Ectasia was found in 28 (14%), dolichosis was found in 50 (25%) and vertebrobasilar dolichoectasia was found in 19 (9.5%) of patients. Cerebral microbleeds were detected in 114 (57%) patients. Mild degree CMBs was the most prevalent among patients 69 (61%) and were located predominantly in both anterior and posterior territories 41 (36%). CMBs were significantly more frequent in hypertensive and older patients. Conclusions: In patients with VBD, severe degree CMBs were more common and were located as a vascular territory supplied by vessels originating from dolichoectatic parent vessels in the posterior region.