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Cerebral small vessel disease characteristics associate with domain-specific impairments during Intracerebral

Karim Borei1, Abdulaziz T Bako2, Alan P Pan3

  • 1Department of Neurosurgery, Houston Methodist, Houston, TX, USA.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|December 12, 2025
PubMed

Insights

Cerebral small vessel disease (CSVD) markers, particularly severe white matter hyperintensities (WMH), significantly increase the likelihood of moderate-severe stroke and neurological deficits in patients with intracerebral hemorrhage (ICH).

Area of Science:

  • Neurology
  • Radiology
  • Public Health

Background:

  • Cerebral Small Vessel Disease (CSVD) is linked to cognitive issues post-intracerebral hemorrhage (ICH).
  • Limited data exist on the association between CSVD and admission National Institutes of Health Stroke Scale (NIHSS) scores.

Purpose of the Study:

  • To investigate the relationship between CSVD burden and admission NIHSS scores in primary ICH patients.
  • To determine if specific CSVD markers predict neurological deficits after ICH.

Main Methods:

  • Retrieved electronic medical records for adult ICH patients with NIHSS and CSVD assessments.
  • Graded CSVD burden (0-4) using MRI criteria including Fazekas scores, microbleeds, lacunes, and perivascular spaces.
  • Used multivariable logistic regression to analyze associations between CSVD and outcomes like moderate-severe stroke, motor deficit, aphasia, and cortical deficit.

Main Results:

  • The study included 1024 patients; 47% had moderate-severe NIHSS scores and 26% had severe CSVD.
  • Periventricular white matter hyperintensity (WMH) burden independently correlated with moderate-severe NIHSS scores (aOR: 1.54).
  • Deep WMH burden was independently associated with aphasia (aOR: 2.02) and motor deficit (aOR: 3.64).

Conclusions:

  • Severe white matter hyperintensities (WMH) independently elevate the risk of neurological deficits in primary ICH patients.
  • CSVD assessment, particularly WMH, is crucial for predicting stroke severity and outcomes in ICH.
Abstract

Keywords:
NIHSSSmall vessel diseaseStrokeWhite matter hyperintensitymRS

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