Smoker's criteria

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Smoker’s criteria use three quantitative measures of basilar artery morphology to diagnose dolichoectasia:

  • laterality
  • bifurcation height
    • ​surrogate measures for tortuosity and elongation
  • basilar artery diameter represents the degree of dilatation

The application of Smoker’s criteria provides a mean to diagnose dolichoectasia in the posterior circulation. No criteria exist for the diagnosis of anterior circulation dolichoectasia.

Criteria

Basilar artery diameter

Score of 1 is abnormal

  • 0: 1.9 - 4.5 mm
  • 1: ≥ 4.6 mm
Laterality

Score ≥2 indicates abnormality

  • 0: midline throughout
  • 1: medial to the lateral margin of the clivus or dorsum sellae
  • 2: lateral to lateral margin of clivus or dorsum sellae
  • 3: at the cerebellopontine angle
Height of bifurcation

Score ≥2 indicates abnormality

  • 0: at or below the dorsum sellae
  • 1: within the suprasellar cistern (one cut above dorsum)
  • 2: at the 3 ventricle floor (one cut above suprasellar cistern)
  • 3: indenting and elevating the floor of the 3 ventricle (two or more cuts above suprasellar cistern)

History and etymology

Wendy R K Smoker (fl. 2020) is an American neuroradiologist who developed her eponymous criteria in the mid-1980s .