title: Enlarged perivascular spaces and small diffusion-weighted lesions in intracerebral hemorrhage.
abstract: OBJECTIVE
  To examine the association between enlarged perivascular spaces (EPVS) and the prevalence and extent of small acute diffusion-weighted imaging (DWI) lesions (SA-DWIL) in patients with spontaneous supratentorial intracerebral hemorrhage (ICH).
  
  
  METHODS
  We conducted a retrospective review of a consecutive cohort of 201 patients with spontaneous supratentorial ICH who had brain MRI with DWI within 1 month of ICH onset. We compared the clinical and imaging characteristics, including EPVS, of patients with and without SA-DWIL. We used univariate and multivariate logistic regression analyses to determine the variables associated with SA-DWIL.
  
  
  RESULTS
  Small acute DWI lesions were detected in 27.9% (n = 56) of patients. Intraventricular and subarachnoid extension of ICH (p ≤ 0.001), high centrum semiovale (CSO)-EPVS (p < 0.001), high basal ganglia-EPVS (p = 0.007), overall extent of white matter hyperintensity (p = 0.018), initial ICH volume (p < 0.001), and mean change in mean arterial blood pressure (δ MAP = MAP at admission - the lowest MAP before MRI scan) (p = 0.027) were associated with SA-DWIL on univariate analyses. On multivariate logistic regression analyses, larger ICH volume (odds ratio [OR] 1.03; 95% confidence interval [CI] 1.01-1.06; p = 0.006) and high CSO-EPVS (OR 12.56; 95% CI 4.40-35.85; p < 0.001) were independently associated with the presence of SA-DWIL.
  
  
  CONCLUSIONS
  In our cohort, high EPVS, in particular CSO-EPVS, and larger hematoma volume emerged as independent predictors for SA-DWIL after ICH. Our findings might provide a new explanation for the pathophysiologic mechanisms predisposing to SA-DWIL after ICH.
authors.affiliation: From the Center of Cerebrovascular Diseases (B.W., C.L., M.L.), Department of Neurology, West China Hospital, Sichuan University, Chengdu, China; Stroke Division (B.W., X.Y., M.H.S.), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and the Department of Neurology (X.Y.), Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Wu
authors.affiliation: From the Center of Cerebrovascular Diseases (B.W., C.L., M.L.), Department of Neurology, West China Hospital, Sichuan University, Chengdu, China; Stroke Division (B.W., X.Y., M.H.S.), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and the Department of Neurology (X.Y.), Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, China.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Yao
authors.affiliation: From the Center of Cerebrovascular Diseases (B.W., C.L., M.L.), Department of Neurology, West China Hospital, Sichuan University, Chengdu, China; Stroke Division (B.W., X.Y., M.H.S.), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and the Department of Neurology (X.Y.), Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, China.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Lei
authors.affiliation: From the Center of Cerebrovascular Diseases (B.W., C.L., M.L.), Department of Neurology, West China Hospital, Sichuan University, Chengdu, China; Stroke Division (B.W., X.Y., M.H.S.), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and the Department of Neurology (X.Y.), Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.affiliation: From the Center of Cerebrovascular Diseases (B.W., C.L., M.L.), Department of Neurology, West China Hospital, Sichuan University, Chengdu, China; Stroke Division (B.W., X.Y., M.H.S.), Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and the Department of Neurology (X.Y.), Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, China. mselim@bidmc.harvard.edu.
authors.forename: Magdy H
authors.initials: MH
authors.lastname: Selim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000378:metabolism*; D015331:Cohort Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013346:Subarachnoid Space / Q000378:metabolism* / Q000473:pathology*