Anterior circulation ischemia due to dolichoectatic internal carotid artery

Intracranial dolichoectatic carotid and middle cerebral artery (ICDA) may cause ischemia by multiple mechanisms, including thrombosis, embolism, and occlusion of the involved arteries. We sought clinical and hemodynamic mechanisms in 8 patients with ICDA and stroke, corresponding to 0.4% of our patients with ischemic stroke, and compared these data with those for patients having ICDA without stroke. Hypertension and transient ischemic attack were the significant findings in patients with stroke compared with those without stroke. Patients with stroke were more likely to have an embolism from the stagnated vascular bed and less frequently had compression of the neighboring structure of the elongated arteries.