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Lacune stroke

Wei Ling Lau, Branko N Huisa, Mark Fisher
Chronic kidney disease (CKD) is an independent risk factor for the development of cerebrovascular disease, particularly small vessel disease which can manifest in a variety of phenotypes ranging from lacunes to microbleeds. Small vessel disease likely contributes to cognitive dysfunction in the CKD population. Non-traditional risk factors for vascular injury in uremia include loss of calcification inhibitors, hyperphosphatemia, increased blood pressure variability, elastinolysis, platelet dysfunction, and chronic inflammation...
September 14, 2016: Translational Stroke Research
Kyeong Joon Kim, Jong-Min Kim, Yun Jung Bae, Hee Joon Bae, Beomseok Jeon, Jae Hyung Kim, Jeong Ho Han, Chang Wan Oh
BACKGROUND: Hemifacial spasm (HFS) is frequently caused by vascular compression of the facial nerve. Vertebrobasilar dolichoectasia (VBDE) may cause vascular crowding in the limited space of the posterior fossa, increasing the chance of vascular compression of the facial nerve. We investigated the prevalence of VBDE in HFS. METHODS: We analyzed the presence of VBDE on 3.0 T magnetic resonance images in patients with HFS and control subjects; age, sex and hypertension were matched...
August 20, 2016: Parkinsonism & related Disorders
Francesco Arba, Terence J Quinn, Graeme J Hankey, Kennedy R Lees, Joanna M Wardlaw, Myzoon Ali, Domenico Inzitari
BACKGROUND: Previous studies suggested that enlarged perivascular spaces are neuroimaging markers of cerebral small vessel disease. However, it is not clear whether enlarged perivascular spaces are associated with cognitive impairment. We aimed to determine the cross-sectional relationship between enlarged perivascular spaces and small vessel disease, and to investigate the relationship between enlarged perivascular spaces and subsequent cognitive impairment in patients with recent cerebral ischemic event...
August 19, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Zhaolu Wang, Susanne J van Veluw, Adrian Wong, Wenyan Liu, Lin Shi, Jie Yang, Yunyun Xiong, Alexander Lau, Geert Jan Biessels, Vincent C T Mok
BACKGROUND AND PURPOSE: It was recently demonstrated that cerebral microinfarcts (CMIs) can be detected in vivo using 3.0 tesla (T) magnetic resonance imaging. We investigated the prevalence, risk factors, and the longitudinal cognitive consequence of cortical CMIs on 3.0T magnetic resonance imaging, in patients with ischemic stroke or transient ischemic attack. METHODS: A total of 231 patients undergoing 3.0T magnetic resonance imaging were included. Montreal Cognitive Assessment was used to evaluate global cognitive functions and cognitive domains (memory, language, and attention visuospatial and executive functions)...
October 2016: Stroke; a Journal of Cerebral Circulation
Renate M Arntz, Steffen M A van den Broek, Inge W M van Uden, Mohsen Ghafoorian, Bram Platel, Loes C A Rutten-Jacobs, Noortje A M Maaijwee, Pauline Schaapsmeerders, Hennie C Schoonderwaldt, Ewoud J van Dijk, Frank-Erik de Leeuw
OBJECTIVE: To study the long-term prevalence of small vessel disease after young stroke and to compare this to healthy controls. METHODS: This prospective cohort study comprises 337 patients with an ischemic stroke or TIA, aged 18-50 years, without a history of TIA or stroke. In addition, 90 age- and sex-matched controls were included. At follow-up, lacunes, microbleeds, and white matter hyperintensity (WMH) volume were assessed using MRI. To investigate the relation between risk factors and small vessel disease, logistic and linear regression were used...
September 20, 2016: Neurology
Xiangliang Chen, Lihui Duan, Yunfei Han, Ling Tian, Qiliang Dai, Shang Wang, Ying Lin, Yunyun Xiong, Xinfeng Liu
BACKGROUND: Around two thirds stroke patients may suffer from vascular cognitive impairment (VCI). Our previous study has validated the NINDS-CSN harmonization standard for VCI diagnosis in Chinese. In this study, we aimed to investigate the predictors for VCI in Chinese post-stroke patients. METHODS: We compared epidemiological, clinical, and neuroimaging data (number, size and location of acute infarcts and lacunes, severities of white matter hyperintensities and brain atrophy) between stroke patients with and without VCI...
2016: BMC Neurology
Vincent C T Mok, Bonnie Y K Lam, Zhaolu Wang, Wenyan Liu, Lisa Au, Eric Y L Leung, Sirong Chen, Jie Yang, Winnie C W Chu, Alexander Y L Lau, Anne Y Y Chan, Lin Shi, Florence Fan, Sze H Ma, Vincent Ip, Yannie O Y Soo, Thomas W H Leung, Timothy C Y Kwok, Chi L Ho, Lawrence K S Wong, Adrian Wong
INTRODUCTION: Patients surviving stroke without immediate dementia are at high risk of delayed-onset dementia. Mechanisms underlying delayed-onset dementia are complex and may involve vascular and/or neurodegenerative diseases. METHODS: Dementia-free patients with stroke and/or transient ischemic attack (TIA; n = 919) were studied for 3 years prospectively, excluding those who developed dementia 3 to 6 months after stroke and/or TIA. RESULTS: Forty subjects (4...
June 18, 2016: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
Søren Due Andersen, Flemming Skjøth, Yousef Yavarian, Flemming W Bach, Gregory Y H Lip, Torben Bjerregaard Larsen
BACKGROUND: Silent lacunes are a common finding on brain imaging in ischemic stroke patients, but the prognostic significance of these lesions is uncertain. We aimed at investigating the association of silent lacunes and the risk of ischemic stroke recurrence, death, and cardiovascular events in a cohort of patients with incident ischemic stroke and no atrial fibrillation (AF). METHODS: We included 786 patients (mean age 59.5 (SD 14.0); 42.9% females) in a registry-based, observational cohort study on patients with first-ever ischemic stroke...
2016: Cerebrovascular Diseases
Shanshan Duan, Shan Zhang, Liang Li, Chuancheng Ren, Juan Xieb
BACKGROUND AND PURPOSE: Small deep brain infarcts are often caused by two different vascular pathologies: branch atheromatous disease (BAD) and lipohyalinotic degeneration (LD). In the present study༌ we compare the clinical characteristics of BAD and LD and investigate the role of C-reactive protein (CRP), homocysteine (Hcy), and carotid artery intima-media thickness (IMT) in the prognosis of patients with BAD and LD. METHODS: Of 262 adult patients with small deep infarcts, 104 were considered BAD and 158 were considered LD...
April 6, 2016: International Journal of Neuroscience
Andrea Vilar-Bergua, Iolanda Riba-Llena, Natalia Ramos, Xavier Mundet, Eugenia Espinel, Antonio López-Rueda, Elena Ostos, Daniel Seron, Joan Montaner, Pilar Delgado
BACKGROUND: Kidney function has been related to the presence of individual markers of cerebral small vessel disease (CSVD), as lacunes, white matter hyperintensities (WMH) or microbleeds. We aimed at studying the relationship of kidney dysfunction with the combination of several markers of CSVD. METHODS: Subjects are those included in the ISSYS cohort (Investigating Silent Strokes in hypertensives: a magnetic resonance imaging study). A scale ranging from 0 to 4 points was applied based on the presence (one point each) of lacunes, deep microbleeds, moderate to extensive basal ganglia enlarged perivascular spaces (EPVS), and periventricular or deep WMH...
2016: Cerebrovascular Diseases
I Riba-Llena, C Nafría, X Mundet, A López-Rueda, I Fernández-Cortiñas, C I Jarca, J Jiménez-Balado, M Domingo, J L Tovar, F Orfila, F Pujadas, J Álvarez-Sabín, O Maisterra, J Montaner, P Delgado
BACKGROUND AND PURPOSE: Enlarged perivascular spaces (EPVS) have been recently considered a feature of cerebral small vessel disease. They have been related to aging, hypertension and dementia but their relationship with hypertension related variables (i.e. target organ damage, treatment compliance) and mild cognitive impairment (MCI) is not fully elucidated. Our aims were to investigate the relation between basal ganglia (BG) and centrum semiovale (CSO) EPVS with vascular risk factors, hypertension related variables and MCI...
June 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Laura K Wilson, Lesly A Pearce, Antonio Arauz, David C Anderson, Jorge Tapia, Carlos Bazan, Oscar R Benavente, Thalia S Field
BACKGROUND: Pontine infarcts are common and often attributed to small vessel disease ("small deep infarcts") or basilar branch atherosclerosis ("wedge shaped"). A well-described morphological differentiation using magnetic resonance images has not been reported. Furthermore, whether risk factors and outcomes differ by morphology, or whether infarct morphology should guide secondary prevention strategy, is not well characterized. METHODS: All participants in the Secondary Prevention of Small Subcortical Strokes Study with magnetic resonance imaging -proven pontine infarcts were included...
June 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Eric Jouvent, Zhong Yi Sun, François De Guio, Edouard Duchesnay, Marco Duering, Stefan Ropele, Martin Dichgans, Jean-François Mangin, Hugues Chabriat
BACKGROUND AND PURPOSE: Both brain and cognitive reserves modulate the clinical impact of chronic brain diseases. Whether a motor reserve also modulates the relationships between stroke and disability is unknown. We aimed to determine whether the shape of the central sulcus, a marker of the development of underlying motor connections, is independently associated with disability in patients with a positive history of small subcortical ischemic stroke. METHODS: Shapes of central sulci were reconstructed from high-resolution magnetic resonance imaging and ordered without supervision according to a validated algorithm in 166 patients with a positive history of small subcortical ischemic stroke caused by CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy), a severe monogenic cerebral small vessel disease affecting young patients...
April 2016: Stroke; a Journal of Cerebral Circulation
Christian Lambert, Philip Benjamin, Eva Zeestraten, Andrew J Lawrence, Thomas R Barrick, Hugh S Markus
Cerebral small vessel disease is a common condition associated with lacunar stroke, cognitive impairment and significant functional morbidity. White matter hyperintensities and brain atrophy, seen on magnetic resonance imaging, are correlated with increasing disease severity. However, how the two are related remains an open question. To better define the relationship between white matter hyperintensity growth and brain atrophy, we applied a semi-automated magnetic resonance imaging segmentation analysis pipeline to a 3-year longitudinal cohort of 99 subjects with symptomatic small vessel disease, who were followed-up for ≥1 years...
April 2016: Brain: a Journal of Neurology
Eun Bin Cho, Hee-Young Shin, Sang Eon Park, Phillip Chun, Hye Ryoun Jang, Jin-ju Yang, Hee Jin Kim, Yeo Jin Kim, Na-Yeon Jung, Jin San Lee, Juyoun Lee, Young Kyoung Jang, Eun Young Jang, Mira Kang, Jong-Min Lee, Changsoo Kim, Ju-Hong Min, Seungho Ryu, Duk L Na, Sang Won Seo
We tested the hypothesis that decreased glomerular filtration rate and albuminuria have different roles in brain structure alterations. We enrolled 1,215 cognitively normal individuals, all of whom underwent high-resolution T1-weighted volumetric magnetic resonance imaging scans. The cerebral small vessel disease burdens were assessed with white matter hyperintensities (WMH), lacunes, and microbleeds. Subjects were considered to have an abnormally elevated urine albumin creatinine ratio if the value was ≥17 mg/g for men and ≥25 mg/g for women...
2016: Scientific Reports
Maria Del C Valdés Hernández, Paul A Armitage, Michael J Thrippleton, Francesca Chappell, Elaine Sandeman, Susana Muñoz Maniega, Kirsten Shuler, Joanna M Wardlaw
RATIONALE: Cerebral small vessel disease (SVD) is common in ageing and patients with dementia and stroke. Its manifestations on magnetic resonance imaging (MRI) include white matter hyperintensities, lacunes, microbleeds, perivascular spaces, small subcortical infarcts, and brain atrophy. Many studies focus only on one of these manifestations. A protocol for the differential assessment of all these features is, therefore, needed. AIMS: To identify ways of quantifying imaging markers in research of patients with SVD and operationalize the recommendations from the STandards for ReportIng Vascular changes on nEuroimaging guidelines...
December 2015: Brain and Behavior
Francesco Arba, Vanessa Palumbo, Jean-Martin Boulanger, Giovanni Pracucci, Domenico Inzitari, Alastair M Buchan, Michael D Hill
BACKGROUND: The effect of preexisting small vessel disease on outcomes of patients with ischemic stroke treated with i.v. thrombolysis is not fully understood. AIM: We aim to investigate the effect of combined leukoaraiosis and lacunes as detected on unenhanced brain computer tomography at baseline on clinical outcomes after i.v. thrombolysis. METHODS: We analyzed data from the Canadian Alteplase for Stroke Effectiveness Study. Small vessel disease was assessed on baseline computer tomography rating for leukoaraiosis and lacunes...
January 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Uma Sundar, Vijay Ghuge
OBJECTIVES: The study aimed to evaluate different imaging localizations of the classical Lacunar syndromes, including multiplicity of lacunes. MATERIALS AND METHODS: This prospective study was conducted in a tertiary care municipal hospital over 2 years. Patients with clinical Lacunar syndromes, confirmed on imaging, were evaluated for etiopathogenetic factors, lesion localization, and presence of multiple simItaneous lacunes. Angiographic data and cognitive evaluation was done in a subset of the cohort...
June 2015: Journal of the Association of Physicians of India
Yong Bum Kim, Kwang-Yeol Park, Pil-Wook Chung, Jeong-Min Kim, Heui-Soo Moon, Young Chul Youn
OBJECTIVE: The aim of this study was to determine the association of brachial-ankle pulse wave velocity (baPWV) with both acute and chronic cerebral small vessel disease (SVD). METHODS: We identified 1282 consecutive patients with acute ischemic stroke or transient ischemic attack. Neuroimaging correlates of chronic lacunes, white matter hyperintensity (WMH), and cerebral microbleed (CMB) were assessed using MR images. Combined SVD score was defined as the number of presence of SVD markers including chronic lacunes, WMH, deep CMB, and acute lacunar infarction...
February 2016: Atherosclerosis
Xiaoyu Zhang, Lingling Ding, Junliang Yuan, Wei Qin, Wenli Hu
BACKGROUND: White matter hyperintensities (WMH) predict incident strokes and new lacunes; moreover, WMH may also affect infarct locations. Our aim in this study was to examine the spatial relationship between WMH and acute lacunar infarction. METHODS: Five hundred and ninety patients with acute lacunar infarction in supratentorial region were included. Four situations between infarction and WMH were assessed by axial and coronal MRI: no contact (Grade 0), contact without overlap (Grade Ia), partial overlap (Grade Ib), and complete overlap (Grade II) with preexisting WMH...
2015: European Neurology
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