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Spatial Relationship between Acute Lacunar Infarction and White Matter Hyperintensities
Xiaoyu Zhang1, Lingling Ding, Junliang Yuan
1Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
European Neurology
|December 10, 2015
Summary
Half of lacunar infarcts occur at the edge of white matter hyperintensities (WMH). Periventricular and deep WMH predict these edge-localized infarcts, impacting stroke outcomes.
Area of Science:
- Neurology
- Radiology
- Stroke Research
Background:
- White matter hyperintensities (WMH) are known predictors of stroke and lacunes.
- WMH may influence the location of acute infarcts.
- The spatial relationship between WMH and acute lacunar infarction requires further investigation.
Purpose of the Study:
- To examine the spatial relationship between WMH and acute lacunar infarction.
- To define and investigate predictors and outcomes of edge-localized lacunar infarctions.
Main Methods:
- MRI analysis of 590 patients with acute supratentorial lacunar infarction.
- Classification of infarction proximity to WMH: no contact (Grade 0), edge-localized (Grades Ia/Ib), and complete overlap (Grade II).
- Identification of predictors and short-term outcomes for edge-localized infarctions.
Main Results:
- 47.9% of lacunar infarcts were edge-localized (Grades Ia/Ib).
- Edge-localized infarcts were associated with larger infarct size, more severe WMH, higher NIHSS, and lower admission/discharge BI scores.
- Predictors for edge-localized infarction included subcortical location, infarct size, periventricular WMH, and deep WMH.
Conclusions:
- Approximately half of lacunar infarcts occur at the edge of WMH.
- Both periventricular and deep WMH are significant predictors of edge-localized lacunar infarction.
