Abstract

Background and Purpose: Enlarged perivascular spaces in the brain are common but generally overlooked and of uncertain pathophysiology. They may reflect underlying cerebral small vessel disease. We determined whether enlarged perivascular spaces were associated with lacunar stroke subtype and white matter hyperintensities, markers of established small vessel disease. Materials and Methods: We prospectively recruited patients with acute ischemic lacunar or cortical stroke. Age-matched non-stroke controls were also recruited. We rated basal ganglia and centrum semiovale enlarged perivascular spaces 0-4 (0=none, 4=>40) on T2-MRI, and white matter hyperintensities. We compared enlarged perivascular spaces between stroke subtypes and controls and assessed associations with vascular risk factors and white matter hyperintensities.Results: We recruited 350 patients, 129 lacunar, 124 cortical stroke and 97 age-matched controls. Adjusting for vascular risk factors and white matter hyperintensities, total enlarged perivascular spaces were associated with lacunar stroke subtype (p=0.04) in the acute stroke group (n=253); basal ganglia enlarged perivascular spaces were associated with lacunar stroke subtype (p=0.003), deep (p=0.02) and periventricular white matter hyperintensities (p=0.01); in all 350 subjects, total enlarged perivascular spaces were associated with deep (P<0.001) and periventricular (P<0.001) white matter hyperintensities. Conclusions— Although prevalent in patients with vascular risk factors and stroke, enlarged perivascular spaces are specifically associated with lacunar ischemic stroke and white matter hyperintensities. Further studies should determine the mechanism of this association while including adequate controls to account for stroke and vascular risk factors. Enlarged perivascular spaces should not be overlooked in studies of small vessel disease.
Original languageEnglish
Pages (from-to)450-454
Number of pages5
JournalStroke
Volume41
Issue number3
DOIs
Publication statusPublished - Mar 2010

Keywords

  • Lacunar infarcts
  • white matter disease
  • small vessel disease
  • enlarged perivascular spaces

Fingerprint Dive into the research topics of 'Enlarged perivascular spaces on MRI are a feature of cerebral small vessel disease'. Together they form a unique fingerprint.

Cite this