Intracranial arterial dolichoectasia and small-vessel disease in stroke patients

Two studies found that stroke patients with intracranial arterial dolichoectasia (IADE) had lacunar infarction more often than the control subjects. The relation between IADE and other manifestations of small-vessel disease (multilacunar state, leukoaraiosis, and etat crible) was not investigated. The magnetic resonance images of 510 patients with brain infarction in the Etude du Profil Genetique de l'Infarctus Cerebral (GENIC) study were evaluated for the diagnosis of multilacunar infarction (> 1 lacunar infarct), leukoaralosis (assessed in periventricular and subcortical regions according to Scheltens and colleagues' scale, with severe leukoaraiosis defined as a score > 8), etat crible (using a semiquantitative score ranging from 0-8, with severe EC > 4), and UDE (using the consensus method). By comparison with stroke patients without UDE (n = 447), LADE(+) stroke patients (n = 63) had significantly more frequent multilacunar state (51 vs 33%), severe leukoaraiosis (34 vs 19%), and severe etat crible (32 vs 12%). After adjustment for potential confounding factors, the odds ratios (95% confidence interval) for the presence of LADE were 2.05 (1.08-3.87) for multilacunar state, 2.40 (1.11-5.20) for severe leukoaraiosis, and 3.60 (1.43-9.08) for severe etat crible. The factors significantly associated with etat crible were older age and a familial history of stroke. IADE in stroke patients was independently associated with parenchymal manifestations of small-vessel disease. These conditions may have in common underlying pathophysiological processes.