Intracranial artery dolichoecstasia is recognised as an underdiagnosed yet potentially treatable stroke mechanism. A prospective analysis of patients in the Durban Cerebrovascular Data Bank (n=762) was undertaken over a 4 year period and 32 patients identified as meeting established criteria. No significant difference was found between those patients presenting with stroke as opposed to transient ischaemic attacks. There was a trend to a preponderance in males and most patients had hypertension and presented with posterior circulation ischaemia or infarction. All patients were identified by first tier investigation with conventional brain scanning (MRI or CT) but contemporary imaging modalities such as MRA and transcranial Doppler sonography aided in the diagnosis. Six patients were treated with anticoagulation after failing antiaggregant therapy with aspirin with no recurrent events over a 15.6 mean month follow up period.

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