Relationship Between White Matter Hyperintensities Penumbra and Cavity Formation

Area of Science:

• Neurology
• Neuroimaging
• Cerebrovascular Disease

Background:

• White matter hyperintensities (WMH) are associated with a penumbra effect at their edges.
• The impact of this penumbra on acute lacunar infarcts requires further investigation.

Purpose of the Study:

• To compare cavity formation in acute lacunar infarcts located at the edge of WMH versus those distant from WMH.
• To identify risk factors associated with cavity formation in lacunar infarcts.

Main Methods:

• Ninety-six subjects with acute lacunar infarcts (≤25 mm) were categorized into Edge Group (contacting WMH) and Non-edge Group.
• Vascular risk factors, clinical data, infarct characteristics, and WMH severity were recorded.
• Cavity formation was assessed via follow-up MR imaging; risk factors were analyzed using logistic regression.

Main Results:

• Infarcts at the edge of WMH demonstrated a significantly higher rate of cavity formation (78.4%) compared to those not at the edge (44.1%).
• Larger infarct size and location in subcortical white matter were associated with cavity formation in univariate analysis.
• Diffusion-weighted imaging (DWI) infarct size and proximity to WMH were independent predictors of cavity formation.

Conclusions:

• Acute lacunar infarcts adjacent to WMH are more prone to developing cavities.
• The findings suggest that the WMH penumbra plays a role in the process of cavity formation post-infarction.