Temporal changes in blood–brain barrier permeability and cerebral perfusion in lacunar/subcortical ischemic stroke. Issue 1 (December 2015)

• Record Type: Journal Article
• Authors: Yang, Jun; d'Esterre, Christopher; Ceruti, Stefano; Roversi, Gloria; Saletti, Andrea; Fainardi, Enrico; Lee, Ting
• Is Part Of: BMC neurology. Volume 15:Issue 1(2015)
• Page Start: 1
• Page End: 6
• Publication Date: 2015-12
• Subjects: Blood–brain barrier -- Cerebral blood flow -- Lacunar/subcortical infarct -- CT perfusion -- Cerebral small vessel disease; Neurology -- Periodicals; 616.8005
• DOI: 10.1186/s12883-015-0468-0
• Languages: English
• ISSNs: 1471-2377

Abstract

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.