Distribution of lacunes in cerebral amyloid angiopathy and hypertensive small vessel disease.

Abstract:

OBJECTIVE:To evaluate whether the burden of deep and lobar lacunes differs between patients with intracerebral hemorrhage (ICH) with definite/probable cerebral amyloid angiopathy (CAA) per the Boston criteria and hypertensive small vessel disease (HTN-SVD; ICH in basal ganglia, thalami, brainstem). METHODS:We defined lobar and deep lacunes similar to the topographic distribution used for ICH and cerebral microbleeds (CMBs). We then compared their distribution between patients with CAA-ICH and those with strictly deep CMB and ICH (HTN-ICH). The independent associations of lacune location with the diagnosis of CAA-ICH and HTN-ICH were evaluated with multivariable models. The relationship between lobar lacunes and white matter hyperintensity (WMH) volume was evaluated by means of partial correlation analyses adjusted for age and a validated visual scale. RESULTS:In our final cohort of 316 patients with ICH, lacunes were frequent (24.7%), with similar rates in 191 patients with CAA and 125 with HTN-ICH (23% vs 27.2%, p = 0.4). Lobar lacunes were more commonly present in CAA (20.4% vs 5.7%, p < 0.001), while deep lacunes were more frequent in HTN-ICH (15.2% vs 2.1%, p < 0.001). After correction for demographics and clinical and neuroimaging markers of SVD, lobar lacunes were associated with CAA (p = 0.003) and deep lacunes with HTN-ICH (p < 0.001). Lobar lacunes in 80% of the cases were at least in contact with WMH, and after adjustment for age, they were highly correlated to WMH volume (r = 0.42, p < 0.001). CONCLUSIONS:Lobar lacunes are associated with CAA, whereas deep lacunes are more frequent in HTN-SVD. Lobar lacunes seem to have a close relationship with WMH, suggesting a possible common origin.

journal_name

Neurology

journal_title

Neurology

authors

Pasi M,Boulouis G,Fotiadis P,Auriel E,Charidimou A,Haley K,Ayres A,Schwab KM,Goldstein JN,Rosand J,Viswanathan A,Pantoni L,Greenberg SM,Gurol ME

doi

10.1212/WNL.0000000000004007

subject

Has Abstract

pub_date

2017-06-06 00:00:00

pages

2162-2168

issue

23

eissn

0028-3878

issn

1526-632X

pii

WNL.0000000000004007

journal_volume

88

pub_type

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