Smoker’s criteria use three quantitative measures of basilar artery morphology to diagnose dolichoectasia:
laterality
bifurcation height as a surrogate measure for tortuosity and elongation
basilar artery diameter represents the degree of dilatation
The application of Smoker’s criteria provides a means to diagnose dolichoectasia of the basilar artery 1,2. Elongation is indicated by abnormal laterality or height, ectasia is indicated by abnormal diameter, and doliechoectasia is indicated by the presence of both elongation and ectasia 6.
Classification
Basilar artery diameter
Score of 1 is abnormal:
0: 1.9–4.5 mm
1: >4.5 mm
Laterality
Score ≥2 is abnormal:
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: in the cerebellopontine angle cistern
Height of bifurcation
Score ≥2 is abnormal:
0: at or below the dorsum sellae
1: within the suprasellar cistern (one cut above dorsum)
2: at the 3rd ventricle floor (one cut above suprasellar cistern)
3: indenting and elevating the floor of the 3rd ventricle (two or more cuts above suprasellar cistern)
The above criteria were defined on 5 mm thick slices 1.
History and etymology
Wendy R K Smoker (fl. 2022) is a retired American neuroradiologist who developed her eponymous criteria in the mid-1980s 1,2.
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