BACKGROUND AND PURPOSE: Few and conflicting data exist on the case fatality rate in stroke patients with basilar artery dolichoectasia. We analyzed basilar artery characteristics (diameter, height of bifurcation, transverse position) and 5-year mortality (all-cause, nonstroke vascular, and stroke) in patients with brain infarction. METHODS: The basilar artery diameter was measured with a 16-diopter lens in 466 consecutively recruited patients with brain infarction confirmed by magnetic resonance imaging. The height of the bifurcation and the transverse position of the basilar artery were assessed on semiquantitative scales. Patients were followed up for a median of 5.3 years (range, 1.5 to 6.6) and were classified as having had stroke, nonstroke vascular, and nonvascular death according to the French national registry of death certificates. RESULTS: Of the 157 deaths, 88 were vascular (including 54 stroke deaths). Basilar artery diameter was associated with an increased 5-year stroke mortality rate but not with all-cause or nonstroke vascular mortality. The adjusted hazard ratio (HR) of stroke mortality per 1-mm increase in basilar artery diameter was 1.23 (95% confidence interval [CI], 1.07 to 1.41). A higher risk of stroke death was associated with basilar artery diameter at the 95th percentile (diameter >4.3 mm; adjusted HR 3.69; 95% CI, 1.63 to 8.38) and the height of bifurcation (adjusted HR for score >1, 2.08; 95% CI, 0.93 to 4.68) but not with transverse position. CONCLUSIONS: Basilar artery diameter was independently associated with cerebrovascular mortality. A diameter >4.3 mm may be a marker for a high risk of fatal stroke.
BACKGROUND AND PURPOSE: Few and conflicting data exist on the case fatality rate in strokepatients with basilar artery dolichoectasia. We analyzed basilar artery characteristics (diameter, height of bifurcation, transverse position) and 5-year mortality (all-cause, nonstroke vascular, and stroke) in patients with brain infarction. METHODS: The basilar artery diameter was measured with a 16-diopter lens in 466 consecutively recruited patients with brain infarction confirmed by magnetic resonance imaging. The height of the bifurcation and the transverse position of the basilar artery were assessed on semiquantitative scales. Patients were followed up for a median of 5.3 years (range, 1.5 to 6.6) and were classified as having had stroke, nonstroke vascular, and nonvascular death according to the French national registry of death certificates. RESULTS: Of the 157 deaths, 88 were vascular (including 54 stroke deaths). Basilar artery diameter was associated with an increased 5-year stroke mortality rate but not with all-cause or nonstroke vascular mortality. The adjusted hazard ratio (HR) of stroke mortality per 1-mm increase in basilar artery diameter was 1.23 (95% confidence interval [CI], 1.07 to 1.41). A higher risk of stroke death was associated with basilar artery diameter at the 95th percentile (diameter >4.3 mm; adjusted HR 3.69; 95% CI, 1.63 to 8.38) and the height of bifurcation (adjusted HR for score >1, 2.08; 95% CI, 0.93 to 4.68) but not with transverse position. CONCLUSIONS: Basilar artery diameter was independently associated with cerebrovascular mortality. A diameter >4.3 mm may be a marker for a high risk of fatal stroke.
Authors: Makoto Nakajima; Lesly A Pearce; Nobuyuki Ohara; Thalia S Field; Carlos Bazan; David C Anderson; Robert G Hart; Oscar R Benavente Journal: J Stroke Cerebrovasc Dis Date: 2015-03-25 Impact factor: 2.136
Authors: Jennifer Bracken; Ian Robinson; Aisling Snow; Rosemarie Watson; Alan D Irvine; David Rea; Ethna Phelan Journal: Pediatr Radiol Date: 2011-06-15
Authors: Jose Gutierrez; James Goldman; Lawrence S Honig; Mitchell S V Elkind; Susan Morgello; Randolph S Marshall Journal: Atherosclerosis Date: 2014-05-29 Impact factor: 5.162
Authors: Setareh Salehi Omran; Farid Khasiyev; Cen Zhang; Tatjana Rundek; Ralph L Sacco; Clinton B Wright; Mitchell S V Elkind; Jose Gutierrez Journal: J Neuroimaging Date: 2022-01-26 Impact factor: 2.324
Authors: Jose Gutierrez; Mitchell S V Elkind; Carol Petito; David Y Chung; Andrew J Dwork; Randolph S Marshall Journal: Neuropathology Date: 2012-10-15 Impact factor: 1.906
Authors: A Pichiecchio; S Sacco; P De Filippi; E Caverzasi; S Ravaglia; S Bastianello; C Danesino Journal: J Neurol Date: 2017-08-30 Impact factor: 4.849