Dilated Virchow-Robin Spaces in First-Ever Lacunar Stroke Patients: Topography and Clinical Correlations

Background and purpose: Dilated Virchow-Robin spaces (dVRSs) were regarded as a phenotype of cerebral small-vessel disease (SVD). However, the clinical correlations of dVRS were still unclear. In this study, we aimed to investigate the topography and clinical correlations of dVRS in first-ever lacunar stroke patients.

Methods: Patients with first-ever lacunar stroke were recruited and had magnetic resonance scans to identify the presence and degree of dVRS in the basal ganglia (BG-dVRS), dVRS in the central semiovale (CSO-dVRS), leukoaraiosis, and silent brain infarction (SBI). The neurological deficits after stroke onset and functional outcome after 1 year were evaluated using National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale, respectively. Clinical and radiological features were compared between patients with high and low degrees of dVRS, and between patients with favorable and unfavorable outcomes. Logistic regression models were constructed to identify the risk factors of unfavorable outcome.

Results: The NIHSS scores were not statistically different between patients with high and low degrees of dVRS. More patients with high degrees of BG-dVRS had unfavorable outcomes than those with low degrees of BG-dVRS. Logistic regression showed that the degrees of BG-dVRS, leukoaraiosis, and SBIs were not independent risk factors for the unfavorable outcome, whereas the total burden of SVD was an independent risk factor for the unfavorable outcome.

Conclusion: The degrees of either BG-dVRS or CSO-dVRS were not associated with the severity of first lacunar stroke. BG-dVRS was related to the unfavorable 1-year outcome. This association might be based on the total severity of SVD.