Dear Editor,The pathogenesis of intracranial arterial dolichoectasia is controversial. The fact that dolichoectasia and atherosclerosis share risk factors has led us to consider a common underlying pathophysiology for both conditions. Furthermore, atheromatous changes have been found in a sizable proportion of intracranial ectatic arteries. Nevertheless, increasing evidence suggests that dolichoectasia differs from atherosclerosis because it predominantly affects the internal elastic lamina, as opposed to the endothelial injury and plaque formation characteristics of atherosclerosis. This is supported by studies showing a lack of association between extracranial atherosclerosis and intracranial dolichoectasia. However, the relevance of intracranial atherosclerosis in patients with dolichoectasia has not been investigated at the population level.We documented a relationship between pulse pressure (PP) levels and intracranial atherosclerosis in older Amerindians living in rural Ecuador. This might be related to the exposure of major intracranial vessels to the stretch caused by increases in pulsatile components of blood pressure that, in turn, enhance arterial stiffness and lead to atherosclerotic abnormalities. As posterior circulation is most often involved in individuals with intracranial dolichoectasia, we evaluated the correlation between the PP and the basilar artery (BA) diameter to assess the role of this reliable biomarker of intracranial atherosclerosis in the pathogenesis of
Geriatrics & Gerontology International – Wiley
Published: Jan 1, 2018
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