The perivascular spaces in young and middle-aged stroke: A single-center analysis integrating clinical and Doppler ultrasound findings

Purpose: This research seeks to investigate correlations between enlarged Perivascular Spaces (PVSs) and clinical/imaging data, such as information obtained through Doppler analysis, in a population with young and middle-age stroke. Materials and methods: We retrospectively reviewed demographics, clinical and MRI data, of 163 patients, with MRI confirmed stroke. All patients underwent ECD TSA (Eco-Color-Doppler of the Supra-aortic Trunks) and TCCD (Transcranial Eco-color-Doppler), to study extra or intracranial stenosis, presence and composition of plaques. Severity of PVS was evaluated on T2-weighted images according to the Potter scale. To identify potential predictors of PVSs, an exploratory backward stepwise ordinal regression model was developed, including clinical and Doppler US variables. Results: In the stepwise ordered logistic regression analysis with PVSs at BG (Basal Ganglia) as the outcome, hemodynamically significant stenosis in any vessel ipsilateral to the ischemic lesion displayed a significant positive association with a higher outcome value. Similar results were observed for ESUS (Embolic Stroke of Undetermined Source). Fibrolipid plaques in any vase exhibited a significant negative association. At MB (Midbrain), male patients and subjects with hypertension exhibited a higher value of PVSs. Dyslipidemia demonstrated a significant negative effect. When PVSs were investigated in the CS (Centrum Semiovale), no statistically significant association with the extent of PVSs emerged. Conclusion: These insights not only enhance our understanding of the role of PVSs in cerebrovascular health in a young and middle-age population but also highlight the potential of PVSs as a biomarker in neuroimaging studies, warranting further research to elucidate their clinical implications and underlying pathophysiological mechanisms.