Logo image
Back
Assessing Changes on Large Cerebral Arteries in CADASIL: Preliminary Insights from a Case-Control Analysis
Journal article   Open access   Peer reviewed

Assessing Changes on Large Cerebral Arteries in CADASIL: Preliminary Insights from a Case-Control Analysis

Edgar R. Lopez-Navarro, Silvia V. Mayer, Brenno R. Barreto, Kevin H. Strobino, Antonio Spagnolo-Allende, Pedro G. Bueno, Kursat Gurel, Khrystyna Kozii, Salwa Rahman, Farid Khasiyev, …
Journal of stroke and cerebrovascular diseases, Vol.34(6), 108294
03/15/2025
DOI: 10.1016/j.jstrokecerebrovasdis.2025.108294
PMCID: PMC12085198
PMID: 40096922
url
https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108294View
Published (Version of record) Open Access

Abstract

Parent large brain arteries are intimately related to their offspring's small arteries. Whether the CADASIL phenotype is confined to small vessels is unclear, and the involvement of large arteries in CADASIL has not been systematically studied. We conducted a retrospective observational study with patients with CADASIL and randomly selected controls with acute lacunar stroke from the New York-Presbyterian Hospital/Columbia University Irving Medical Center Stroke Registry. We measured the diameters of both groups' basilar artery (BA) and intracranial internal carotid artery (ICA) on T2-weighted images. Z-scores of the arteries were calculated to derive a Brain Arterial Remodeling (BAR) score. We rated cervical ICA tortuosity as 0=no tortuosity, 1=45-90° deviation, and 2= >90°. Generalized linear models compared large artery characteristics, adjusting for demographics and clinical variables. We matched 37 patients with CADASIL with 104 controls. Patients with CADASIL were less likely to be Hispanic/Latino (p<0.001), hypertensive (p<0.001), or current smokers (p=0.02) but more likely to have a prior stroke (p<0.001) than controls. In adjusted models, patients with CADASIL had larger BA diameters than controls (p=0.002), but there were no differences in the right and left ICA diameters (p=0.73, p=0.88). There was a statistical trend for higher cervical ICA tortuosity in patients with CADASIL compared to controls (p=0.08). Traditionally considered a small-vessel disease, patients with CADASIL have larger BA diameters and possibly higher cervical ICA tortuosity than controls. Whether these changes are part of the NOTCH-3 mutation phenotype or influence the clinical course is uncertain but should be further investigated.
 Dementia Stroke arterial dilatation NOTCH3 small-vessel-disease

Details

Metrics

13 Record Views
Logo image