Vertebrobasilar dolichoectasia as a risk factor for cerebral microbleeds

Area of Science:

• Neurology
• Vascular Neurology
• Neuroimaging

Background:

• Vertebrobasilar dolichoectasia (VBD) and cerebral microbleeds (CMBs) are associated with intracerebral hemorrhage risk.
• Understanding the relationship between VBD and CMBs is crucial for stroke patient management.

Purpose of the Study:

• To investigate the association between VBD and CMBs in patients with ischemic stroke or transient ischemic attack (TIA).

Main Methods:

• Retrospective analysis of 182 ischemic stroke/TIA patients using gradient echo brain MRI.
• CMB locations categorized into anterior and posterior circulation.
• VBD defined by basilar artery diameter, bifurcation level, or position relative to surrounding structures.
• Logistic regression models used to analyze VBD association with CMBs in different territories.

Main Results:

• VBD present in 13.2% and CMBs in 26.4% of patients.
• CMBs were significantly more frequent in patients with VBD (66.7% vs. 20.3%).
• VBD showed a strong association with CMBs in any location, posterior circulation only, and both territories, but not anterior circulation only.
• Associations remained significant after adjusting for age, gender, hypertension, leukoaraiosis, and stroke subtype.

Conclusions:

• Vertebrobasilar dolichoectasia is independently associated with cerebral microbleeds in ischemic stroke/TIA patients.
• The association is particularly pronounced in the posterior circulation territory.