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Increased arterial diameters in the posterior cerebral circulation in men with Fabry disease.
[fabry disease]
A
high
load
of
white
matter
lesions
and
enlarged
basilar
arteries
have
been
shown
in
selected
patients
with
Fabry
disease
,
a
disorder
associated
with
an
increased
stroke
risk
.
We
studied
a
large
cohort
of
patients
with
Fabry
disease
to
differentially
investigate
white
matter
lesion
load
and
cerebral
artery
diameters
.
We
retrospectively
analyzed
cranial
magnetic
resonance
imaging
scans
of
87
consecutive
Fabry
patients
,
20
patients
with
ischemic
stroke
,
and
36
controls
.
We
determined
the
white
matter
lesion
load
applying
the
Fazekas
score
on
fluid-attenuated
inversion
recovery
sequences
and
measured
the
diameters
of
cerebral
arteries
on
3
D-
reconstructions
of
the
time-of-flight-
MR-angiography
scans
.
Data
of
different
Fabry
patient
subgroups
(
males-females
;
normal-
impaired
renal
function
)
were
compared
with
data
of
patients
with
stroke
and
controls
.
A
history
of
stroke
or
transient
ischemic
attacks
was
present
in
4
/
30
males
(
13
%
)
and
5
/
57
(
9
%
)
females
with
Fabry
disease
,
all
in
the
anterior
circulation
.
Only
one
man
with
Fabry
disease
showed
confluent
cerebral
white
matter
lesions
in
the
Fazekas
score
assessment
(
1
%
)
.
Male
Fabry
patients
had
a
larger
basilar
artery
(
p
<
0
.
01
)
and
posterior
cerebral
artery
diameter
(
p
<
0
.
05
)
compared
to
male
controls
.
This
was
independent
of
disease
severity
as
measured
by
renal
function
and
did
not
lead
to
changes
in
arterial
blood
flow
properties
.
A
basilar
artery
diameter
of
>
3
.
2
mm
distinguished
between
men
with
Fabry
disease
and
controls
(
sensitivity
:
87
%
,
specificity
:
86
%
,
p
<
0
.
001
)
,
but
not
from
stroke
patients
.
Enlarged
arterial
diameters
of
the
posterior
circulation
are
present
only
in
men
with
Fabry
disease
independent
of
disease
severity
.
Diseases
Validation
Diseases presenting
"increased stroke risk"
symptom
fabry disease
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