[Diffuse intracranial arterectasias: megadolichocarotids, megadolichovertebrals]

Intracranial diffuse arteriectasis may be located to the carotid and vertebral arteries and their branches separately or concomitantly and associated with saccular aneurysms and generalized arteriectasis. The principle clinical aspects of intracranial arteriectasis are cranial nerve palsies, particularly of the cerebellopontine region in association or not with cerebellar disorders and transient or permanent motor deficiencies. Arterial hypertension exists in a high proportion of cases. The some times complex clinical picture may be due to pressure of nervous structures by the ectatic vessels, ischemia or hemorrhagy. Mostly affected are men over 50 years of age although arteriectasis has been observed in younger patients including children and infants. The disease can be suspected clinically but is generally diagnosed after neuroradiological studies, mostly angiography and/or computerized tomography. Initially arteriectasis was supposed to be the result of arteriosclerosis but histopathology has shown that it may be independent of arteriosclerosis and appears to be the result of a congenital abnormality in the elastic component of the vessel wall. On the basis of our six observations and those already published it becomes apparent that diffuse intracranial arteriectasis represents a specific disease.