scholarly journals Hemoglobin is Associated with Periventricular but Not Deep White Matter Hyperintensities in Lacunar Ischemic Stroke

2013 ◽  
Vol 19 (8) ◽  
pp. 632-634 ◽  
Author(s):  
Jie Pan ◽  
Bo Yin ◽  
Zi-Qi Xu ◽  
Hai-Yan Lou ◽  
Hui Liang
2019 ◽  
Author(s):  
Nicola J Armstrong ◽  
Karen A Mather ◽  
Muralidharan Sargurupremraj ◽  
Maria J Knol ◽  
Rainer Malik ◽  
...  

AbstractWe conducted a genome-wide association meta-analysis of two ischemic white matter disease subtypes in the brain, periventricular and deep white matter hyperintensities (PVWMH and DWMH). In 26,654 participants, we found 10 independent genome-wide significant loci only associated with PVWMH, four of which have not been described previously for total WMH burden (16q24.2, 17q21.31, 10q23.1, 7q36.1). Additionally, in both PVWMH and DWMH we observed the previous association of the 17q25.1 locus with total WMH. We found that both phenotypes have shared but also distinct genetic architectures, consistent with both different underlying and related pathophysiology. PVWMH had more extensive genetic overlap with small vessel ischemic stroke, and unique associations with several loci implicated in ischemic stroke. DWMH were characterized by associations with loci previously implicated in vascular as well as astrocytic and neuronal function. Our study confirms the utility of these phenotypes and identifies new candidate genes associated only with PVWMH.


2019 ◽  
Vol 9 (1) ◽  
pp. 16 ◽  
Author(s):  
Imama Naqvi ◽  
Emi Hitomi ◽  
Richard Leigh

Objective: To report a patient in whom an acute ischemic stroke precipitated chronic blood-brain barrier (BBB) disruption and expansion of vascular white matter hyperintensities (WMH) into regions of normal appearing white matter (NAWM) during the following year. Background: WMH are a common finding in patients with vascular risk factors such as a history of stroke. The pathophysiology of WMH is not fully understood; however, there is growing evidence to suggest that the development of WMH may be preceded by the BBB disruption in the NAWM. Methods: We studied a patient enrolled in the National Institutes of Health Natural History of Stroke Study who was scanned with magnetic resonance imaging (MRI) after presenting to the emergency room with an acute stroke. After a treatment with IV tPA, she underwent further MRI scanning at 2 h, 24 h, 5 days, 30 days, 90 days, 6 months, and 1-year post stroke. BBB permeability images were generated from the perfusion weighted imaging (PWI) source images. MRIs from each time point were co-registered to track changes in BBB disruption and WMH over time. Results: An 84-year-old woman presented after acute onset right hemiparesis, right-sided numbness and aphasia with an initial NIHSS of 13. MRI showed diffusion restriction in the left frontal lobe and decreased blood flow on perfusion imaging. Fluid attenuated inversion recovery (FLAIR) imaging showed bilateral confluent WMH involving the deep white matter and periventricular regions. She was treated with IV tPA without complication and her NIHSS improved initially to 3 and ultimately to 0. Permeability maps identified multiple regions of chronic BBB disruption remote from the acute stroke, predominantly spanning the junction of WMH and NAWM. The severity of BBB disruption was greatest at 24 h after the stroke but persisted on subsequent MRI scans. Progression of WMH into NAWM over the year of observation was detected bilaterally but was most dramatic in the regions adjacent to the initial stroke. Conclusions: WMH-associated BBB disruption may be exacerbated by an acute stroke, even in the contralateral hemisphere, and can persist for months after the initial event. Transformation of NAWM to WMH may be evident in areas of BBB disruption within a year after the stroke. Further studies are needed to investigate the relationship between chronic BBB disruption and progressive WMH in patients with a history of cerebrovascular disease and the potential for acute stroke to trigger or exacerbate the process leading to the development of WMH.


2012 ◽  
Vol 33 (7) ◽  
pp. 1156-1167.e1 ◽  
Author(s):  
Sang Won Seo ◽  
Jong-Min Lee ◽  
Kiho Im ◽  
Jun-Sung Park ◽  
Sook-Hui Kim ◽  
...  

Stroke ◽  
2015 ◽  
Vol 46 (2) ◽  
pp. 348-353 ◽  
Author(s):  
Poneh Adib-Samii ◽  
William Devan ◽  
Matthew Traylor ◽  
Silvia Lanfranconi ◽  
Cathy R. Zhang ◽  
...  

2002 ◽  
Vol 59 (9) ◽  
pp. 785 ◽  
Author(s):  
Alan J. Thomas ◽  
John T. O'Brien ◽  
Sue Davis ◽  
Clive Ballard ◽  
Robert Barber ◽  
...  

2019 ◽  
Author(s):  
Hao Yin ◽  
Xiang Wang ◽  
Yuan-yuan Zhao ◽  
Xiao-kang Ji ◽  
Shao-wei Sang ◽  
...  

Abstract Background: Although homocysteine (Hcy) and white matter hyperintensities (WMH) have been proven to be correlated with increased risks of ischemic stroke, there have been few studies addressing the association between serum Hcy and WMH in a population with asymptomatic intracranial arterial stenosis (aICAS). Thus, the aim of the present study is to describe the association between Hcy and WMH in rural-dwelling Chinese people with aICAS. Methods: In this study, 150 participants diagnosed as aICAS by magnetic resonance angiography were recruited from the Kongcun Town Study, which was a population-based study aimed to investigate the prevalence of aICAS in general population aged 40 to 90 years old, free of ischemic stroke history, and living in the Kongcun town, Pingyin county, Shandong, China. Data on demographics, risk factors, and serum Hcy levels were collected via interview, clinical examination, and laboratory tests. The WMH volumes were calculated through the lesion segmentation tool system for the Statistical Parametric Mapping package based on magnetic resonance imaging. The association between Hcy and WMH volume was analyzed using both linear and logistic regression analysis. Results: After adjusting for all confounders, high Hcy (HHcy) (serum Hcy ≥15umol/L) was significantly associated with severe WMH (the highest quartile in WMH volume) (OR: 2.972, 95%CI: 1.017-7.979, P <0.05). However, with changing of WMH volumes, only trends towards association with HHcy were observed in all 3 models (P values only slightly exceeded 0.05). After being stratified by age, sex, or ever smoking, the association between HHcy and WMH became more significant in participants who were ≥60 years old, male, or ever smoker. Conclusions: HHcy is associated with severe WMH in rural-dwelling Chinese people with aICAS, especially in participants ≥60 years old, male participants, or ever smokers, indicating these may be risk factors that contribute to the association between HHcy and severe WMH.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alexander Rau ◽  
Marco Reisert ◽  
Elias Kellner ◽  
Jonas A. Hosp ◽  
Horst Urbach ◽  
...  

AbstractPeriventricular white matter changes are common in patients with idiopathic normal pressure hydrocephalus (iNPH) and considered to represent focally elevated interstitial fluid. We compared diffusion measures in periventricular hyperintensities in patients with imaging features of iNPH to patients without. The hypothesis is that periventricular hyperintensities in patients with presumed iNPH show higher water content than in patients without imaging features of iNPH. 21 patients with iNPH Radscale 7–12 (“high probability of iNPH”) and 10 patients with iNPH Radscale 2–4 (“low probability of iNPH”) were examined with a neurodegeneration imaging protocol including a diffusion microstructure imaging sequence. Periventricular hyperintensities and deep white matter hyperintensities were segmented and diffusion measures were compared. In patients with imaging features of iNPH, the free water content in periventricular hyperintensities was significantly higher compared to the control group (p = 0.005). This effect was also detectable in deep white matter hyperintensities (p = 0.024). Total brain volumes and total gray or white matter volumes did not differ between the groups. Periventricular cap free water fraction was highly discriminative regarding patients with presumed iNPH and controls with an ROC AUC of 0.933. Quantitative diffusion microstructure imaging shows elevated water content in periventricular hyperintensities in patients with imaging features of iNPH, which could be the imaging correlate for pathologic fluid accumulation and may be used as an imaging biomarker in the future.


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