抄録
Objective: Lacunar infarction and intracerebral hemorrhage (ICH) have common characteristics of cerebral small-vessel disease (CSVD) although they are classified as different stroke subtypes. Previous studies showed a positive correlation of CSVD with physiological parameters such as pulse wave velocity (PWV) or with radiographical findings such as leukoaraiosis; however, the role of these parameters remains controversial. Therefore, we assessed whether there is a relationship between stroke subtypes and these potential CSVD-related parameters.
Methods: In a multicenter, retrospective study from 8 hospitals, we enrolled 874 patients with a history of cerebral infarction or ICH who underwent both carotid ultrasound and MRI examination between June 2008 and May 2010. We evaluated the values of PWV, ultrasonographic parameters and MRI findings, and compared them between the stroke subtypes.
Results: Of patients, 331 (38%) were classified into the large artery atherosclerosis (LAA) group, 387 (44%) into the small vessel occlusion (SVO) group, and 156 (18%) into the ICH group. Lower max intima media thickness (IMT) and lower plaque score, and higher PWV were shown in SVO and ICH groups than those in LAA groups. Higher pulsatility index (PI) of common carotid artery (CCA) in SVO group, higher PI of ICA and higher prevalence of cerebral micro-bleeds (CMB) in ICH group were also shown than those in LAA group. After adjustment for vascular risk factors, the following parameters in both SVO and ICH groups were significantly different from those in the LAA group: lower max IMT, lower plaque score, higher periventricular hyper-intensity (PVH) grade, and higher prevalence of CMB. PIs of CCA and internal carotid artery (ICA) were higher in ICH group than those in LAA group.
Conclusions: The similar trends of some physiological and radiographical parameters were shown in ICH and SVO group compared with LAA group, which reflected the underlying pathophysiology of CSVD.
