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Differential risk factors for lacunar stroke depending on the MRI (white and red) subtypes of microangiopathy

Jae-Hyun Park1, Sookyung Ryoo, Suk Jae Kim

  • 1Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Plos One
|October 2, 2012
PubMed
Abstract

Insights

Diabetes is linked to leukoaraiosis-predominant cerebral microangiopathy, while smoking and alcohol habits in younger individuals are associated with mild changes in lacunar infarction patients.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Leukoaraiosis and cerebral microbleeds (CMB) are common in acute lacunar stroke, indicating cerebral microangiopathy.
  • Understanding factors differentiating leukoaraiosis-predominant from CMB-predominant microangiopathies is crucial for prognosis and treatment.
  • These microangiopathies may have distinct impacts on stroke outcomes.

Purpose of the Study:

  • To investigate the clinical and laboratory findings associated with different subtypes of cerebral microangiopathy in acute lacunar stroke patients.
  • To compare the risk factor profiles of leukoaraiosis-predominant and CMB-predominant microangiopathies with mild microangiopathy and intracerebral hemorrhage (ICH).

Main Methods:

  • Prospective recruitment of 226 patients with acute lacunar infarction, categorized into mild, red (CMB-predominant), and white (leukoaraiosis-predominant) microangiopathy groups based on Fazekas score and CMB presence.
  • Inclusion of 50 patients with primary intracerebral hemorrhage (ICH) for comparative analysis.
  • Evaluation of clinical and laboratory findings, including age, sex, hypertension, smoking, alcohol habits, and diabetes, to determine risk factor profiles.

Main Results:

  • Distinct risk factor profiles were observed among the microangiopathy groups.
  • White microangiopathy was independently associated with older age and diabetes.
  • Red microangiopathy was independently associated with older age compared to mild microangiopathy.
  • Mild microangiopathy was characterized by younger age, male predominance, less hypertension, and higher rates of smoking and heavy alcohol consumption.

Conclusions:

  • Risk factor profiles differ significantly among patients with acute lacunar infarction based on their microangiopathic findings.
  • Diabetes mellitus appears to be a key determinant of white (leukoaraiosis-predominant) microangiopathy.
  • Smoking and alcohol consumption in younger individuals may be associated with mild microangiopathic changes in lacunar infarction.

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