Temporal changes in blood-brain barrier permeability and cerebral perfusion in lacunar/subcortical ischemic stroke.

Abstract

BACKGROUND:

Cerebral microvascular abnormality is frequently associated with lacunar and subcortical ischemic lesions. We performed acute and follow-up CT perfusion scans over the first 3 months after ischemic stroke to investigate disturbances of the blood-brain barrier (BBB) and cerebral perfusion in patients with lacunar/subcortical lesions compared to those with cortical lesions alone.

METHODS:

Thirty-one patients with lacunar/subcortical infarct (n = 14) or with cortical large vessel infarct (n = 17) were recruited and underwent a CT perfusion study at admission, 24 h, 7 days and 3 months after stroke using a two-phase imaging protocol. Functional maps of BBB permeability surface area product (BBB-PS), cerebral blood flow (CBF) and blood volume (CBV) at follow-up were co-registered with those at admission, and the measurements in non-infarcted ipsilateral basal ganglia and thalamus were compared within each group and between the two groups.

RESULTS:

For the lacunar/subcortical group, BBB-PS within non-infarcted ipsilateral basal ganglia and thalamus peaked at day 7 compared to all other time points, and was significantly higher than the cortical group at day 7 and month 3. The CBF and CBV in the same region were significantly lower at admission and transient hyperemia was seen at day 7 in the lacunar/subcortical group.

CONCLUSION:

Disturbed BBB-PS and compromised cerebral perfusion over the first 3 months post stroke were shown in the non-infarcted basal ganglia and thalamus of lacunar/subcortical stroke using CT perfusion. Future studies are required to elucidate the relationship of post-stroke BBB disturbances to chronic cognitive impairment.

• Authors: Jun Yang, Christopher d'Esterre, Stefano Ceruti, Gloria Roversi, Andrea Saletti, Enrico Fainardi, Ting Yim Lee
• Journal: BMC neurology (BMC Neurol) Vol. 15 Pg. 214 (Oct 22 2015) ISSN: 1471-2377 [Electronic] England
• PMID: 26490140 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Aged, 80 and over
• Basal Ganglia (blood supply, metabolism)
• Blood-Brain Barrier (metabolism)
• Capillary Permeability
• Case-Control Studies
• Cerebrovascular Circulation
• Cohort Studies
• Disease Progression
• Female
• Humans
• Male
• Middle Aged
• Perfusion Imaging
• Permeability
• Prospective Studies
• Stroke (metabolism)
• Stroke, Lacunar (metabolism)
• Thalamus (blood supply, metabolism)
• Time Factors
• Tomography, X-Ray Computed