Characteristics and clinical significance of magnetic resonance imaging manifestations of cerebral small vessel disease in acute period of ischemic stroke

Abstract

Aim. To characterize magnetic-resonance imaging manifestations of cerebral small vessel disease in patients in acute period of ischemic stroke and to study their clinical significance.

Methods. 56 patients in acute period of ischemic stroke and 10 subjects without stroke and cognitive impairment were examined. Magnetic-resonance tomography of the brain was performed to all patients and healthy subjects to assess the quantity of lacunes, perivascular spaces, leukoaraiosis and cerebral microbleeds. Based on analysis of 4 neurovisual markers of cerebral small vessel disease, an integral scale was developed. The obtained results were evaluated in association with a wide spectrum of clinical data.

Results. Patients in acute period of ischemic stroke are characterized by higher quantitative expression of certain markers of cerebral small vessel disease in comparison with healthy age-matched subjects. A correlation between neuroimaging markers of cerebral small vessel disease and patients` age, severity and etiology of the stroke was observed. Total expression of cerebral small vessel disease, assessed using the integral score turned out to be higher in the group of stroke than in healthy elderly persons. High rates of certain markers of cerebral small vessel disease and integral scale score are associated with low mobility of patients, neurological deficiency and dependence in daily activities on discharge.

Conclusion. In patients in acute period of ischemic stroke, higher expression of certain markers of cerebral small vessel disease and their total evidence were revealed in comparison with healthy people; total indicator of cerebral small vessel disease expression is associated with neurological and functional outcome of acute period of stroke.

Keywords

stroke / cerebral small vessel disease / scale

References

[1] Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol. 2010; 9 (7): 689-670. DOI: 10.1016/S1474-4422(10)70104-6.

[2] Wardlaw J.M., Smith C., Dichgans M. Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol. 2013; 12 (5): 483-497. DOI: 10.1016/S1474-4422(13)70060-7.

[3] The LADIS Study Group, Poggesi A., Pantoni L. et al. 2001-2011: A decade of the LADIS (Leukoaraiosis And DISability) Study: What have we learned about white matter changes and small-vessel disease? Cerebrovasc. Dis. 2011; 32 (6): 577-588. DOI: 10.1159/000334498.

[4] Staals J., Makin S.D., Doubal F.N. et al. Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden. Neurology. 2014; 83 (14): 1228-1234. DOI: 10.1212/WNL.0000000000000837.

[5] Wardlaw J.M., Smith E.E., Biessels G.J. et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013; 12 (8): 822-838. DOI: 10.1016/S1474-4422(13)70124-8.

[6] Kim B.J., Lee S.H. Cerebral microbleeds: their associated factors, radiologic findings, and clinical implications. Stroke. 2013; 15 (3): 153-163. DOI: 10.5853/jos.2013.15.3.153.

[7] Caunca M.R., Del Brutto V., Gardener H. et al. Cerebral microbleeds, vascular risk factors, and magnetic resonance imaging markers: The Northern Manhattan Study. J. Am. Heart Assoc. 2016; 5 (9): pii: e003477. DOI: 10.1161/JAHA.116.003477.

[8] Wilson D., Charidimou A., Ambler G. et al. Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA: A meta-analysis. Neurology. 2016; 87: 1-10. DOI: 10.1212/WNL.0000000000003183.

[9] Charidimou A., Martinez-Ramirez S., Shoamanesh A. et al. Cerebral amyloid angiopathy with and without hemorrhage: evidence for different disease phenotypes. Neurology. 2015; 84 (12): 1206-1212. DOI: 10.1212/WNL.0000000000001398.

[10] Hart R.G., Diener H.C., Coutts S.B. et al. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol. 2014; 13 (4): 429-438. DOI: 10.1016/S1474-4422(13)70310-7.

[11] Kim B.J., Lee S.H. Prognostic impact of cerebral small vessel disease on stroke outcome. J. Stroke. 2015; 17 (2): 101-110. DOI: 10.5853/jos.2015.17.2.101.

RIGHTS & PERMISSIONS

Kayleva N.A., Kulesh A.A., Gorst N.K., Bykova A.Y., Drobakha V.E., Shestakov V.V.