title: Enlarged perivascular spaces and cerebral small vessel disease.
abstract: OBJECTIVE
  Enlarged perivascular spaces (also known as Virchow-Robin spaces) on T2-weighted brain magnetic resonance imaging are common, but their etiology, and specificity to small vessel as opposed to general cerebrovascular disease or ageing, is unclear. We tested the association between enlarged perivascular spaces and ischemic stroke subtype, other markers of small vessel disease, and common vascular risk factors.
  
  
  METHODS
  We prospectively recruited patients with acute stroke, diagnosed and subtyped by a stroke physician using clinical features and brain magnetic resonance imaging. A neuroradiologist rated basal ganglia and centrum semiovale enlarged perivascular spaces on a five-point scale, white matter lesions, recent and old infarcts, and cerebral atrophy. We assessed associations between basal ganglia-, centrum semiovale- and total (combined basal ganglia and centrum semiovale) enlarged perivascular spaces, stroke subtype, white matter lesions, atrophy, and vascular risk factors.
  
  
  RESULTS
  Among 298 patients (mean age 68 years), after adjusting for vascular risk factors and white matter lesions, basal ganglia-enlarged perivascular spaces were associated with increasing age (P = 0.001), centrum semiovale-enlarged perivascular spaces (P < 0.001), cerebral atrophy (P = 0.03), and lacunar stroke subtype (P = 0.04). Centrum semiovale-enlarged perivascular spaces were associated mainly with basal ganglia-enlarged perivascular spaces. Total enlarged perivascular spaces were associated with increasing age (P = 0.01), deep white matter lesions (P = 0.005), and previous stroke (P = 0.006).
  
  
  CONCLUSIONS
  Enlarged perivascular spaces are associated with age, lacunar stroke subtype and white matter lesions and should be considered as another magnetic resonance imaging marker of cerebral small vessel disease. Further evaluation of enlarged perivascular spaces in studies of ageing, stroke, and dementia is needed to determine their pathophysiological importance.
authors.affiliation: Division of Clinical Neurosciences and SINAPSE Collaboration, University of Edinburgh, Western General Hospital, Edinburgh, UK.
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Potter
authors.forename: Fergus N
authors.initials: FN
authors.lastname: Doubal
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Jackson
authors.forename: Francesca M
authors.initials: FM
authors.lastname: Chappell
authors.forename: Cathie L
authors.initials: CL
authors.lastname: Sudlow
authors.forename: Martin S
authors.initials: MS
authors.lastname: Dennis
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Wardlaw
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D059345:Cerebral Small Vessel Diseases / Q000150:complications*; D002552:Cerebral Ventricles / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012189:Retrospective Studies
keywords: MRI; brain; cerebral infarction; leukoaraiosis; stroke; stroke subtypes