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March 2011

On Curves, Bends, Blisters, and Strokes

Author Affiliations

Author Affiliations: Department of Neurology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts.


Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011

Arch Neurol. 2011;68(3):292-293. doi:10.1001/archneurol.2011.24

Such knowledge as we have of these steps is derived from casual glimpses afforded when, as the outcome of one of Nature’s experiments, some particular line is interfered with . . .—Archibald E. Garrod, Inborn Errors of Metabolism

Arterial tortuosity and dilatation has usually been called dolichoectasia, a term used to describe marked elongation, widening, and tortuosity of arteries. Because dilatation is the most important feature, the condition is now often referred to as dilatative arteriopathy.1 Approximately 1 patient in 8 who underwent intracranial vascular imaging has some increase in the length and diameter of intracranial arteries.2,3 The prevalence of intracranial dolichoectasia is approximately 0.1% to 5.8% among the general population.46 The intracranial vertebrobasilar arteries are most often and most severely involved. The cervical arteries may also be loopy and dilated. The changes in the brain-supplying cervicocranial arteries are often accompanied by dilatation of the aorta3 and the coronary arteries7 and by abnormalities within the small penetrating arteries within the brain.8

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