The Severity of White Matter Lesions Possibly Influences Stroke Recurrence in Patients with Histories of Lacunar Infarctions

Imaizumi, Toshio; Inamura, Shigeru; Nomura, Tatsufumi; Kanno, Aya; Kim, Sang Nyon

doi:10.1016/j.jstrokecerebrovasdis.2015.05.023

Cited by 13 publications

(20 citation statements)

References 29 publications

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“…Given the implications of increased risk of intracerebral hemorrhage in the presence of CMB [5] and some evidence suggesting that CMB are related to antithrombotic-related hemorrhage [9], starting antiplatelet therapy in patients with moderate to severe leukoaraiosis and CMB might not be the ideal therapeutic approach. Under this respect, it has to be emphasized that in our cohort of patients three subjects with Moderate-Severe leukoaraiosis showed incidental subcortical ischemias at follow up.…”

Section: Resultsmentioning

confidence: 99%

“…Presence of CMB often coincides with other radiological features of SVD (lacunar infarction, white matter hyperintensity and asymptomatic microinfarction) and may be regarded as a marker of underlying vasculopathy severity [3,4]. CMB may be deemed as an important prognostic factor since their presence correlates with higher risk of recurrent stroke, both ischemic and hemorrhagic [5]. Up to few months ago there was no prospective evidence about presence of CMB and risk of recurrent ischemic or haemorrhagic stroke, in patients with newly diagnosed lacunar stroke [5].…”

Section: Introduction and Methodsmentioning

confidence: 96%

“…CMB may be deemed as an important prognostic factor since their presence correlates with higher risk of recurrent stroke, both ischemic and hemorrhagic [5]. Up to few months ago there was no prospective evidence about presence of CMB and risk of recurrent ischemic or haemorrhagic stroke, in patients with newly diagnosed lacunar stroke [5]. However there is still lack of neuroimaging correlates.…”

Section: Introduction and Methodsmentioning

confidence: 99%

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Cerebral Microbleeds in a Small Cohort of Patients with First Ever Lacunar Stroke. A 3Tesla MRI Longitudinal Case Series

Gulli¹,

Pizzini²,

Moretto³

et al. 2016

J Neurol Neurol Sci Disord

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Background: High resolution imaging may help detect early development of cerebral microbleeds (CMB) and clarify mechanisms of small vessel disease (SVD).Methods: 19 patients with lacunar stroke were recruited and 3T MRI scan was performed after the acute event and at four months. All patients were started on anti-platelet treatment after the first event. SVD severity was assessed by the age-related white matter changes (ARWMC) scale.Results; First MRI -13 patients had No or Mild SVD (ARWMC 1-2), 6 patients had Moderate to Severe SVD (ARWMC 3-6). 3/13 of NO-MILD patients and 5/6 of MOD-SEV patients have at least 1 CMB in the first scan.Only 2 patients in the MOD-SEV group showed either enlarged or additional CMB at follow up. 3 patients in the MOD-SEV group and no patients in the NO-MILD group had at least one new asymptomatic subcortical ischemic lesion in the follow-up scan.Conclusions: Rapid development of new CMB after starting antiplatelet therapy seems to be confined in patients with severe SVD only. Subclinical vascular events in patients with moderate to severe SVD occur even when antiplatelet treatment is started. Long term effects of antiplatelet treatment in MOD-SEV patients with GRE lesions must be tested.

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Section: Resultsmentioning

confidence: 99%

Section: Introduction and Methodsmentioning

confidence: 96%

Section: Introduction and Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Cerebral Microbleeds in a Small Cohort of Patients with First Ever Lacunar Stroke. A 3Tesla MRI Longitudinal Case Series

Gulli¹,

Pizzini²,

Moretto³

et al. 2016

J Neurol Neurol Sci Disord

View full text Add to dashboard Cite

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“…However, treatment should be based on accurate diagnosis. 8 Once lacunar infarction attacks, lesions with large volume are usually rare; metabolism of brain cells will be affected by ischemia and anoxia of cerebral tissues, which will restrain the functions of sodium and potassium ion pump, increase the concentration of sodium ions in lesions and induce cytotoxic edema of cerebral cells. 9 A study suggested that lesions of lacunar infarction were usually small 10 , which was diagnosed as micro infarction and the maximum diameter of infarcted lesions was smaller than 15 mm.…”

Section: Discussionmentioning

confidence: 99%

Comparison of application values of CT and MRI in the diagnosis of early Lacunar Infarction

Wei

2018

Pak J Med Sci

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Objective:To analyze and compare the values of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of early lacunar infarction.Methods:Eighty-eight patients with early lacunar infarction who were admitted to the hospital were selected as research subjects, and all of them underwent MRI and CT. The study was conducted at our hospital between May 2015 to July 2016.Results:Four hundred and forty-one lesions were detected by MRI, and 145 were detected by CT. Most of the lesions were located at the thalamus, frontal lobe and parietal lobe. The detection rate of small lesions with a diameter less than 5 cm using MRI was significantly higher than that with CT, and the difference had statistical significance (P<0.05). Forty-nine cases who reached hospital within six hours were scanned in which no images were observed by CT, while small flake-like or spotted images were observed in 47 cases by MRI. The efficacy of MRI in displaying early lesions and micro lesions was superior to that of CT.Conclusion:In the diagnosis of early lacunar infarction, the detection rate of lesions with MRI is significantly higher than that with CT. MRI can clearly display the specific conditions of lesions, which is worth clinical promotion.

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“…CMBs are commonly found in patients with ischemic or hemorrhagic stroke, AD, and vascular dementia (VaD) [8]. Most studies were done to examine the association of CMBs with increased risk of stroke recurrence and intracerebral hemorrhage [9,10]. Investigation of their presence in relation to poorer microstructural integrity of brain white matter was done to explain cognitive impairment [11].…”

Section: Introductionmentioning

confidence: 99%

Do cerebral microbleeds affect cognition in patients with symptomatic small vessel disease?

Abdullah

Zakieldin

Bayomy

et al. 2020

Egypt J Neurol Psychiatry Neurosurg

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Background: Dementia and cognitive impairment are becoming increasingly a major health problem, pronounced by increased life expectancy. Cerebral small vessel disease (cSVD) is among the major causes of cognitive deterioration, yet cerebral microbleeds (CMBs) which are a common association of cSVD are still not sure to be related to cognition. Aim of the study: The study aims to determine whether the number and localization of CMBs correlate with cognition in patients with symptomatic small vessel disease (SVD), according to Montreal Cognitive Assessment (MoCA) test. Subjects and methods: This cross-sectional study included 85 Egyptian patients with symptomatic SVD, from the neuropsychiatry clinic of the Main Suez Hospital in Suez City, in the period between February 2017 and February 2018. Subjects were classified according to CMB presence into CMB-positive and CMB-negative groups. Both groups are assessed using MRI imaging and MoCA test for cognitive function. Results: In our study, CMBs recorded a high prevalence rate of SVD patients. Subjects with MBs were mainly males and significantly older, with higher white matter lesion volume and more lacunar infarcts. MoCA test detected significant impairment in visuospatial/executive function, attention, and total scores in CMB-positive group. Both frontal and parietal MBs showed independent association with visuospatial/executive impairment. Deep MBs in the basal ganglia were proved to be independent risk factor for attention affection. Conclusion: Number and localization of MBs proved to be important in determining cognitive consequences. The relations with cognitive performance were mainly driven by frontal, parietal, and deep located MBs in the basal ganglia. Memory affection in frontal MBs was dependent to severe white matter intensities and lacunes.

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The Severity of White Matter Lesions Possibly Influences Stroke Recurrence in Patients with Histories of Lacunar Infarctions

Cited by 13 publications

References 29 publications

Cerebral Microbleeds in a Small Cohort of Patients with First Ever Lacunar Stroke. A 3Tesla MRI Longitudinal Case Series

Cerebral Microbleeds in a Small Cohort of Patients with First Ever Lacunar Stroke. A 3Tesla MRI Longitudinal Case Series

Comparison of application values of CT and MRI in the diagnosis of early Lacunar Infarction

Do cerebral microbleeds affect cognition in patients with symptomatic small vessel disease?

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