Prevalence of Cerebral Small-Vessel Disease in Long-Term Breast Cancer Survivors Exposed to Both Adjuvant Radiotherapy and Chemotherapy

2015 ◽  
Vol 26 (4) ◽  
pp. 353 ◽  
Author(s):  
S.R. Kesler
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Adjuvant Radiotherapy ◽  
Breast Cancer Survivors ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease

Prevalence of Cerebral Small-Vessel Disease in Long-Term Breast Cancer Survivors Exposed to Both Adjuvant Radiotherapy and Chemotherapy

2015 ◽  
Vol 33 (6) ◽  
pp. 588-593 ◽  
Author(s):  
Vincent Koppelmans ◽  
Meike W. Vernooij ◽  
Willem Boogerd ◽  
Caroline Seynaeve ◽  
M. Arfan Ikram ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Carotid Artery ◽  
Cancer Survivors ◽  
Adjuvant Radiotherapy ◽  
Breast Cancer Survivors ◽  
Small Vessel Disease ◽  
Reference Group ◽  
Population Based ◽  
Cerebral Small Vessel Disease ◽  
Vessel Disease

Purpose Adjuvant radiotherapy and chemotherapy for breast cancer have been related to transient ischemic attacks and stroke. To date, no studies have investigated the relationship between these adjuvant therapies and subclinical cerebral small-vessel disease in survivors of breast cancer. We compared white matter lesion (WML) volume and prevalence of brain infarctions and cerebral microbleeds (CMBs) between breast cancer survivors exposed to adjuvant radiotherapy and chemotherapy (aRCeBCSs) for primary disease and a population-based reference group. Patients and Methods Multimodal magnetic resonance imaging (1.5 T) was performed in 187 aRCeBCSs who received primary breast cancer treatment on average more than 20 years before this study and 374 age-matched reference women without a history of cancer. WML volume was segmented using fully automated software. Experienced raters reviewed all scans for cortical infarctions, lacunar infarctions, strictly lobar CMBs, and deep/infratentorial CMBs with or without lobar CMBs. Within the aRCeBCS group, we also analyzed the association between relative radiotherapy exposure to the carotid artery and prevalence of WML volume and CMBs. Results The aRCeBCS group had a higher prevalence of both total CMBs and CMBs in a deep/infratentorial region than the reference group. No between-group differences were observed in the prevalence of infarctions or WML volume. Exposure of the carotid artery to radiation was not associated with WML volume or CMBs. Conclusion More CMBs were found in the aRCeBCS group than in the population-based controls. These vascular lesions potentially mark cerebrovascular frailty that could partially explain the well-documented association between chemotherapy and cognitive dysfunction. No support was found for a radiotherapy-related origin of CMBs.

scholarly journals Cerebral Small Vessel Disease and Kidney Function Predict Long-Term Survival in Patients With Acute Stroke

Stroke ◽  
2010 ◽  
Vol 41 (9) ◽  
pp. 1914-1920 ◽  
Author(s):  
Niku K.J. Oksala ◽  
Tapani Salonen ◽  
Timo Strandberg ◽  
Anni Oksala ◽  
Tarja Pohjasvaara ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Kidney Function ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Term Survival ◽  
Long Term Survival ◽  
Vessel Disease

scholarly journals Cognitive reserve moderates long-term cognitive and functional outcome in cerebral small vessel disease

2016 ◽  
Vol 87 (12) ◽  
pp. 1296-1302 ◽  
Author(s):  
Hanna Jokinen ◽  
Susanna Melkas ◽  
Sofia Madureira ◽  
Ana Verdelho ◽  
José M Ferro ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Cognitive Reserve ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease

Abstract TP39: Long-term Imaging Outcomes in Cerebral Small Vessel Disease

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Yan Chen ◽  
Renyuan Liu ◽  
Wu Xu ◽  
Yuanyuan Gao ◽  
Xin Xu ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Lacunar Stroke ◽  
Vessel Disease ◽  
Drum Tower Hospital ◽  
The Relationship

Background: About 90% Older people above the age of 65 years present white matter hyperintensities (WMH) of varying severity when undergoing MRI. However, white matter hyperintensities is one of the characteristic in imaging for cerebral small vessel disease (CSVD). The relationship between WMH volume and lacunar stroke is unknown. Patients and Methods: A total of 8475 patients with hypertension and WMH on MRI, which were from Nanjing Drum Tower hospital imaging register center from 2011 to 2015, were studied retrospectively. Age between 60 and 85 years without dementia or parkinsonism. The patients were scanned MRI including DWI, T1W, T2W, FLAIR in 1 time each year, acute lacunar stroke is as an endpoint. Patients with Intracranial atherosclerosis in larger arteries were excluded. Areas of supratentorial WMH were semi-automated segmented on FLAIR sequences using MRIcron software. DWI identificates acute lacunar infarct. Results: Of 8475 patients, 599 got acute lacunar stroke and accound for 7.07%. A percentage of 82.5 acute lacunar infarctions were located beside periventricular WMH and merge into white matter disease abnormalities. In compared with patients that were spared from any vascular incidents, higher periventricular WMH volumes were found among the 599 patients in baseline FLAIR images (p=0.012). Furthermore, by annual MRI scan, about 612 patients were found with increased volumes of periventricular WMH, and 86.5% of the patients ended up with acute lacunar stroke. While in patients with stable WMH volumes, only 0.89% of them ended up with vascular incidents. Logistic regression analysis demonstrated that only periventricular WMH volumes were associated with incidence of acute lacunar stroke (p=0.001), while no association of aging (p=0.275) and hypertension (p=0.146) were found. Conclusion: This study indicates that periventricular WMH volumes on FLAIR are independent predictors for acute lacunar stroke and suggest that therapies aimed at reducing progression of white matter hyperintensities via regulating hyperintensities and end-arteriole damage may protect against acute lacunar stroke in clinic.

scholarly journals Blood–Brain Barrier Permeability and Long-Term Clinical and Imaging Outcomes in Cerebral Small Vessel Disease

Stroke ◽  
2013 ◽  
Vol 44 (2) ◽  
pp. 525-527 ◽  
Author(s):  
Joanna M. Wardlaw ◽  
Fergus N. Doubal ◽  
Maria Valdes-Hernandez ◽  
Xin Wang ◽  
Francesca M. Chappell ◽  
...  
Keyword(s):  
Blood Brain Barrier ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Brain Barrier ◽  
Small Vessel ◽  
Barrier Permeability ◽  
Blood Brain Barrier Permeability ◽  
Vessel Disease ◽  
Brain Barrier Permeability

scholarly journals Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes

2020 ◽  
Vol 5 (2) ◽  
pp. 128-137
Author(s):  
Huimin Chen ◽  
Yuesong Pan ◽  
Lixia Zong ◽  
Jing Jing ◽  
Xia Meng ◽  
...  
Keyword(s):  
Regression Models ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Arterial Stenosis ◽  
Small Vessel ◽  
Minor Stroke ◽  
Bleeding Events ◽  
Stroke Outcomes ◽  
Vessel Disease ◽  
Increased Risk

BackgroundThe effect of cerebral small vessel disease (CSVD) and intracranial arterial stenosis (ICAS) on stroke outcomes remains unclear.MethodsData of 1045 patients with minor stroke or transient ischaemic attack (TIA) were obtained from 45 sites of the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. We assessed the associations of burdens of CSVD and ICAS with new strokes and bleeding events using multivariate Cox regression models and those with modified Rankin Scale (mRS) scores using ordinal logistic regression models.ResultsAmong the 1045 patients, CSVD was present in 830 cases (79.4%) and ICAS in 460 (44.0%). Patients with >1 ICAS segment showed the highest risk of new strokes (HR 2.03, 95% CI 1.15 to 3.56, p=0.01). No association between CSVD and the occurrence of new strokes was found. The presence of severe CSVD (common OR (cOR) 2.01, 95% CI 1.40 to 2.89, p<0.001) and >1 ICAS segment (cOR 2.15, 95% CI 1.57 to 2.93, p<0.001) was associated with higher mRS scores. Severe CSVD (HR 10.70, 95% CI 1.16 to 99.04, p=0.04), but not ICAS, was associated with a higher risk of bleeding events. Six-point modified CSVD score improved the predictive power for bleeding events and disability.InterpretationCSVD is associated with more disability and bleeding events, and ICAS is associated with an increased risk of stroke and disability in patients with minor stroke and TIA at 3 months. CSVD and ICAS may represent different vascular pathologies and play distinct roles in stroke outcomes.Trial registration numberNCT00979589

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