Journal List > Dement Neurocogn Disord > v.13(4) > 1120736

Dement Neurocogn Disord. 2014 Dec;13(4):112-116. Korean.
Published online Dec 31, 2014.  https://doi.org/10.12779/dnd.2014.13.4.112
© 2014 Korean Dementia Association
Topographical Distribution of Lacunes and Cerebral Microbleeds in CADASIL Affected by Hypertension
Jung Seok Lee, M.D., Jung-Hwan Oh, M.D., Sook Keun Song, M.D., Jay Chol Choi, M.D., Sa-Yoon Kang, M.D. and Ji-Hoon Kang, M.D.
Department of Neurology, Jeju National University Hospital, Jeju, Korea.

Address for correspondence: Jung Seok Lee, M.D. Department of Neurology, Jeju National University Hospital, 15 Aran 13-gil, Jeju 690-756, Korea. Tel: +82-64-717-8178, Fax: +82-64-717-1630, Email: nrlee71@naver.com
Received Aug 29, 2014; Revised Nov 26, 2014; Accepted Nov 26, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Background

Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited small vessel disease caused by mutations in the Notch3 gene. Lacunes may reflect occlusive type microangiopathy. However, cerebral microbleeds (CMBs) may reflect bleeding-prone microangiopathy. In the present study, we aimed to determine whether hypertension influence the distribution and severity of lacunes and CMBs in patients with CADASIL.

Methods

The study population comprised 85 patients who underwent brain MRI, including T1-weighted image, susceptibility weighted image (SWI), and fluid attenuated inversion recovery (FLAIR) image. The patients were divided into two groups depending on the presence or absence of hypertension. In the first, demographic factors, and MRI findings were compared between CADASIL patients with and without hypertension. In the second, we undertook a region by region comparison of number of patients with lacunes or CMBs.

Results

The hypertensive group showed a higher incidence of CMBs in lobar area (p<0.001) and basal ganglia (p=0.014). CMBs tend to be observed more frequently in the thalamus (p=0.058), brainstem (p=0.057), and cerebellum (p=0.052) in the hypertensive group. However, hypertensive group demonstrated a higher incidence of lacunes just in lobar area (p=0.040).

Conclusions

Our findings suggest that CMBs may be a more sensitive neuroimaging marker of hypertensive arteriopathy in patients with CADASIL.

Keywords: Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL); Hypertension; Lacunes; Cerebral microbleeds (CMBs)

Figures


Fig. 1
A 63 year-old man who had one stroke (mild left-sided weakness). Susceptibility Weighted Image (SWI) showing multiple CMBs in brain (A, B). 3D-T1 weighted image and Fluid-attenuated inversion recovery (FLAIR) image showing multiple lacunes in brain (C, D). Arrowhead indicates cerebral microbleeds. Arrow points to lacunes.
Click for larger image

Tables


Table 1
Demographics and clinical characteristics of CADASIL patients with or without HTN
Click for larger image


Table 2
Topographical distribution of lacunes and CMBs of CADASIL patients depending on HTN
Click for larger image

Notes

This research was supported by the 2014 scientific promotion program funded by Jeju National University.

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