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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
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Recurrent cerebrovascular events after recent small subcortical infarction
Melanie Haidegger1, Nina Klock1, Markus Kneihsl1,2
1Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8036, Graz, Austria.
Journal of Neurology
|May 27, 2024
Summary
Recent small subcortical infarcts (RSSI) indicate a high risk of recurrent cerebrovascular events, primarily due to small vessel disease (SVD). Key SVD features on MRI predict these future events, emphasizing the need for early detection and management.
Area of Science:
- Neurology
- Neuroimaging
- Vascular Neurology
Background:
- Recent small subcortical infarcts (RSSI) are characteristic of small vessel disease (SVD)-related lacunar stroke.
- Long-term data on recurrent cerebrovascular events and their causes following RSSI are limited.
Purpose of the Study:
- To investigate the long-term risk of recurrent cerebrovascular events after RSSI.
- To identify clinical and MRI-based SVD features associated with recurrent ischaemic and haemorrhagic events.
Main Methods:
- Retrospective analysis of 332 consecutive ischaemic stroke patients with MRI-confirmed RSSI (2008-2013).
- Utilized multivariable Cox regression, adjusting for age, sex, vascular risk factors, and MRI parameters.
- Assessed associations between baseline SVD features (STRIVE criteria) and recurrent events over a median 12-year follow-up.
Main Results:
- A total of 70 patients (21.1%) experienced recurrent ischaemic events (54 strokes, 22 TIAs), predominantly linked to SVD (68%).
- 26 patients (7.8%) had intracranial haemorrhage. Diabetes, severe white matter hyperintensities, and cerebral microbleeds predicted recurrent ischaemic events.
- Cerebral microbleeds also increased the risk of intracranial haemorrhage. An SVD summary score indicated elevated risks for both recurrent ischaemic and haemorrhagic events.
Conclusions:
- Patients with RSSI face a significant risk of recurrent cerebrovascular events.
- The presence of chronic SVD features on baseline MRI substantially increases this risk.
- Recurrent events, both ischaemic and haemorrhagic, are largely attributable to underlying SVD.
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