Enlarged Perivascular Spaces on MRI Are a Feature of Cerebral Small Vessel Disease

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,...

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Bibliographic Details
Published in:Stroke (1970) 2010-03, Vol.41 (3), p.450-454
Main Authors: DOUBAL, Fergus N, MACLULLICH, Alasdair M. J, FERGUSON, Karen J, DENNIS, Martin S, WARDLAW, Joanna M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Arterioles - pathology
Arterioles - physiopathology
Biological and medical sciences
Brain Infarction - pathology
Brain Infarction - physiopathology
Cerebral Ventricles - blood supply
Cerebral Ventricles - pathology
Cerebrovascular Disorders - pathology
Cerebrovascular Disorders - physiopathology
Female
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Prospective Studies
Vascular diseases and vascular malformations of the nervous system
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Summary: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. We prospectively recruited patients with acute ischemic lacunar or cortical stroke. Age-matched nonstroke control subjects were also recruited. We rated basal ganglia and centrum semiovale enlarged perivascular spaces 0 to 4 (0=none, 4=>40) on T2-weighted MRI and white matter hyperintensities. We compared enlarged perivascular spaces between stroke subtypes and control subjects and assessed associations with vascular risk factors and white matter hyperintensities. We recruited 350 patients; 129 lacunar, 124 cortical stroke, and 97 age-matched control subjects. 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
ISSN:0039-2499
1524-4628
DOI:10.1161/strokeaha.109.564914