Physicians have long been puzzled by a condition called intracranial arterial dolichoectasia, in which the larger arteries of the brain become elongated and misshapen. Typically, it has been considered a complication of atherosclerosis ("hardening of the arteries"), and not directly life-threatening. However, there is recent evidence that people with dolichoectasia are more likely to have aortic aneurysms, a potentially fatal weakening of the main artery that carries blood out from the heart. In an article published online February 28, 2005 in the Annals of Neurology the same French researchers who linked dolichoectasia with aortic aneurysm reveal new evidence that links the disorder with small vessel disease, a significant cause of lacunar or "mini" strokes that can damage small areas of the brain.
Depending on which area of the brain is affected, the strokes can impair functions such as movement, physical control of speech, or coordination. Multiple lacunar strokes can also cause cognitive and memory deficits that resemble Alzheimer’s disease.
According to the authors, physicians who encounter patients with small vessel disease should look for evidence of dolichoectasia. "If dolichoectasia is present, you should look for an associated abdominal aortic aneurysm and carefully search for associated cardiac symptoms," said author Pierre Amarenco, M.D., of Bichat University Hospital in Paris.
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