Objectives: We aimed to investigate the correlation between an overall cerebral small vessel disease (CSVD) burden and outcomes after endovascular treatment (EVT) for patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO).
Methods: In a multicenter registry study, we enrolled patients with EVT for anterior-circulation LVO-stroke. In 3.0-T MR imaging, we assessed 4 CSVD imaging markers, lacunes, white matter hyperintensities, cerebral microbleeds, and enlarged perivascular spaces, each assigned a score of 0 or 1 and summed up to an overall CSVD burden score of 0-4. We dichotomized the overall CSVD severity as none to mild (score 0-2) and moderate to severe (3-4). Primary outcome was 90-day functional dependence or death (modified Rankin Scale (mRS) 3-6). Secondary outcomes included increase in NIH Stroke Scale ≥ 4 within 24 h (early neurological deterioration (END)) and within 7 days, symptomatic intracranial hemorrhage, 90-day mRS 2-6, and 90-day mortality.
Results: Among 311 patients (63.0% male; mean age 65.1 ± 12.7 years), 260 (83.6%) had none-to-mild and 51 (16.4%) had moderate-to-severe overall CSVD burden. Moderate-to-severe CSVD burden was not significantly associated with the primary outcome (47.1% versus 45.4%; p > 0.05 in univariate and multivariate logistic regression), or the secondary outcomes except for a higher risk of END (11.8% versus 3.1%; p < 0.05 in multivariate analyses). Sensitivity analyses with 0-1 versus 2-4 of the CSVD burden score, and the score as an ordinal variable, showed similar results.
Conclusions: An overall moderate-to-severe CSVD burden was not associated with 90-day functional dependence or death, after EVT for anterior-circulation LVO.
Trial Registration: ChiCTR1900022154 KEY POINTS: • Moderate-to-severe cerebral small vessel disease burden on MRI should not be an exclusion indicator in determining the eligibility of an acute ischemic stroke patient for endovascular treatment.
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Cerebral small vessel disease (CSVD) is a common factor in age-related diseases such as stroke and dementia, and about half of dementia patients worldwide are caused by CSVD. CSVD-related cognitive impairment (CSVD-CI) affects more and more elderly people, resulting in economic losses and burdens on families and society. In recent years, circulating biomarkers have made breakthroughs and played an increasingly important role in the diagnosis, progression, and prognosis of CSVD-associated cognitive impairment, and are expected to be applied to the early clinical detection, diagnosis, and treatment of patients with cerebral small vessel disease.
View Article and Find Full Text PDFWhite matter hyperintensities regress at a high rate at three months after minor ischemic stroke or transient ischemic attack.
J Neuroradiol
January 2025
Soochow Medical college of Soochow University, Suzhou, PR China; Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, PR China. Electronic address:
Background: The potential for early white matter hyperintensities(WMH) regression and associated contributory factors remains uncertain. The purpose of this study is to investigate whether WMH regress at early time of three months after minor ischemic stroke (MIS) or transient ischemic attack (TIA), while also identifying factors that may influence this outcome.
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Time to consider health services dedicated for adults living with cerebral small vessel disease: Report of a ESO scientific seminar.
Eur Stroke J
January 2025
Row Fogo Centre for Research into Ageing and the Brain, and UK Dementia Research Institute, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Purpose: Cerebral small vessel disease (cSVD) is a highly prevalent disorder leading to physical, cognitive and functional decline. We report key barriers in the management of individuals with cSVD, the potential benefit of cSVD-dedicated health services, and evidence from existing models of care for adults with cSVD.
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Structure-function coupling alterations in cognitively normal individuals with white matter hyperintensities.
J Alzheimers Dis
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Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Background: White matter hyperintensities (WMH) are prominent neuroimaging markers of cerebral small vessel disease (CSVD) linked to cognitive decline. Nevertheless, the pathophysiological mechanisms underlying WMH remain unclear.
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Association of lymphocyte-to-C-reactive protein ratio with cerebral small vessel disease: a cross-sectional study based on dose-response analysis.
Front Neurol
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Department of Neurology, The First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, Fujian, China.
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