Intracranial Arterial Dolichoectasia: A Comprehensive Review

Intracranial arterial dolichoectasia (IADE) is a vascular condition defined by the abnormal widening, lengthening, and twisting of arteries within the brain, most frequently affecting the basilar artery. This review explores how the disease stems from structural arterial wall damage caused by genetic factors, hemodynamic stress, and enzyme imbalances. Patients may remain asymptomatic or suffer from severe complications such as ischemic strokes, brain hemorrhages, or nerve compression. Doctors typically diagnose the condition using MRI and MRA scans, often applying the Smoker’s criteria to measure vessel distortion. Because there is currently no specific cure to stop arterial expansion, medical management centers on controlling blood pressure and using antithrombotic medications. For high-risk cases involving rapid growth or physical pressure on brain structures, surgical or endovascular procedures may be considered despite a lack of robust clinical evidence.