Dolichoectatic cervical arteries (carotid and vertebral arteries) heralded by recurrent cerebral ischemia: case illustration.

A case of a 61-year-old man with recurrent episodes of cerebral transient ischemic attacks is reported. The patient had a history of cigarette smoking, hypertension, hypercholesterolemia, and diabetes mellitus. Before these episodes, the patient had no clinical symptoms and signs of cerebral pathology. Brain magnetic resonance imaging revealed microvascular lesions in the white matter of the cerebral hemispheres. Digital subtraction arteriogram revealed the aortic arch dolichoic shape and course of the great vessels originating from it, whereas there were no pathological findings from the intracranial vessels. This study describes a case of the existence of distal dolichoectasia of the vertebral and carotid arteries without intracranial dolichoectasia. It seems that such a type of dolichoectasia does not influence the performance status of a patient, but when a critical point is crossed, patients suffer from cerebrovascular disease.