Related Experiment Videos
[Significance of periventricular hyperintensity on magnetic resonance images in stroke patients]
1Division of Cerebral Circulation, National Cardiovascular Center.
Abstract:
To clarify the significance of periventricular hyperintensity (PVH) on MRI-T2 images in stroke patients, clinical and experimental studies were performed. MRI (1.5 Tesla) was obtained in 153 patients with ischemic stroke. The PVH was observed in all the patients, although severe PVH was found only in 22% of the cases. Severe PVH was observed mainly in hypertensive elderly patients with multiple infarctions and impaired cognitive function. Regional cerebral blood flow was reduced in majority of these patients. The absence of aqueductal signal flow void, remarkable ventricular enlargement and abnormal RI cisternography+ were observed in 20% of the patients with severe PVH. In Wistar rats and gerbils, chronic low perfusion state was induced by occlusion or narrowing of both common carotid arteries, and histological studies were performed at 1 week, 1 month or 3 months after the surgery. Multiple infarctions, white matter changes and ventricular enlargement were observed in these animals. The results suggest that chronic low perfusion in the brain and/or abnormal cerebrospinal fluid circulation play a role in the development of PVH.
Insights
Periventricular hyperintensity (PVH) on MRI-T2 images is common in stroke patients. Severe PVH is linked to hypertension, cognitive decline, and reduced brain blood flow, suggesting perfusion issues.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Context:
- Periventricular hyperintensity (PVH) on MRI-T2 images is a common finding in stroke patients.
- Understanding PVH significance is crucial for stroke management and prognosis.
Purpose:
- To investigate the clinical significance and potential causes of periventricular hyperintensity (PVH) in ischemic stroke patients.
- To correlate PVH severity with clinical factors and explore underlying mechanisms through experimental models.
Summary:
- MRI-T2 imaging revealed PVH in all 153 ischemic stroke patients; severe PVH occurred in 22%, primarily in hypertensive elderly patients with cognitive impairment and reduced cerebral blood flow.
- Experimental models in rats and gerbils with induced chronic low perfusion showed similar changes, including multiple infarctions and ventricular enlargement.
- Findings suggest chronic cerebral hypoperfusion and/or abnormal cerebrospinal fluid circulation contribute to PVH development.
Impact:
- Provides insights into the pathophysiology of PVH in stroke, potentially improving diagnostic accuracy and patient stratification.
- Highlights the association between PVH, cognitive function, and cerebrovascular health.
- Suggests potential therapeutic targets related to cerebral blood flow and CSF dynamics.