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Updated: Mar 30, 2026
Author Spotlight: Imaging Pericytes Post-Subarachnoid Hemorrhaging in Rodents
Published on: August 18, 2023
Enlarged perivascular spaces and small diffusion-weighted lesions in intracerebral hemorrhage
Bo Wu1, Xiaoying Yao1, Chunyan Lei1
1From the Center of Cerebrovascular Diseases (B.W., C.L., M.L.), Department of Neurology, West China Hospital, Sichuan University, Chengdu, China; Stroke Division (B.W., X.Y., M.H.S.), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and the Department of Neurology (X.Y.), Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, China.
Objective:
To examine the association between enlarged perivascular spaces (EPVS) and the prevalence and extent of small acute diffusion-weighted imaging (DWI) lesions (SA-DWIL) in patients with spontaneous supratentorial intracerebral hemorrhage (ICH).
Methods:
We conducted a retrospective review of a consecutive cohort of 201 patients with spontaneous supratentorial ICH who had brain MRI with DWI within 1 month of ICH onset. We compared the clinical and imaging characteristics, including EPVS, of patients with and without SA-DWIL. We used univariate and multivariate logistic regression analyses to determine the variables associated with SA-DWIL.
Results:
Small acute DWI lesions were detected in 27.9% (n = 56) of patients. Intraventricular and subarachnoid extension of ICH (p ≤ 0.001), high centrum semiovale (CSO)-EPVS (p < 0.001), high basal ganglia-EPVS (p = 0.007), overall extent of white matter hyperintensity (p = 0.018), initial ICH volume (p < 0.001), and mean change in mean arterial blood pressure (δ MAP = MAP at admission - the lowest MAP before MRI scan) (p = 0.027) were associated with SA-DWIL on univariate analyses. On multivariate logistic regression analyses, larger ICH volume (odds ratio [OR] 1.03; 95% confidence interval [CI] 1.01-1.06; p = 0.006) and high CSO-EPVS (OR 12.56; 95% CI 4.40-35.85; p < 0.001) were independently associated with the presence of SA-DWIL.
Conclusions:
In our cohort, high EPVS, in particular CSO-EPVS, and larger hematoma volume emerged as independent predictors for SA-DWIL after ICH. Our findings might provide a new explanation for the pathophysiologic mechanisms predisposing to SA-DWIL after ICH.
