Vertebrobasilar dilatative arteriopathy (dolichoectasia)

Ann N Y Acad Sci. 2010 Jan;1184:121-33. doi: 10.1111/j.1749-6632.2009.05114.x.


Dolichoectasia (dilatative arteriopathy) describes marked elongation, widening, and tortuosity of arteries. The intracranial vertebral and basilar arteries are preferentially involved. Dolichoectatic arteries usually have an abnormally large external diameter and a thin arterial wall, with degeneration of the internal elastic lamina, multiple gaps in the internal elastica, thinning of the media secondary to reticular fiber deficiency, and smooth muscle atrophy. The most important clinical presentations of dilatative arteriopathy include acute brain ischemia; a progressive course related to compression of cranial nerves, the brain stem, or the third ventricle; and catastrophic outcome caused by vascular rupture. Flow in dilated arteries can become bidirectional, resulting in reduced antegrade flow and thrombus formation. Elongation and angulation of arteries can stretch and distort the orifices of arterial branches, leading to decreased blood flow, especially in penetrating branches.

Publication types

  • Review

MeSH terms

  • Basilar Artery / diagnostic imaging
  • Basilar Artery / pathology
  • Blood Flow Velocity
  • Brain / diagnostic imaging
  • Brain Ischemia / diagnostic imaging
  • Cerebral Arteries / diagnostic imaging
  • Cerebral Arteries / pathology*
  • Cranial Nerves / pathology
  • Humans
  • Magnetic Resonance Angiography
  • Magnetic Resonance Imaging
  • Nerve Compression Syndromes / diagnostic imaging
  • Nerve Compression Syndromes / pathology
  • Nerve Fibers / pathology
  • Radiography
  • Vertebral Artery Dissection / complications
  • Vertebral Artery Dissection / diagnostic imaging
  • Vertebrobasilar Insufficiency / complications
  • Vertebrobasilar Insufficiency / diagnostic imaging
  • Vertebrobasilar Insufficiency / pathology
  • Vertebrobasilar Insufficiency / physiopathology*