Widening of arteries, not stenosis, 'strongly linked' with lacunar stroke

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By Emma Wilkinson

A study has challenged long-held assumptions about the role of stenosis in arteries in lacunar stroke - which also may explain why routinely used treatments may not work.

The careful analysis of MRI scans at the time of the stroke and a year later in patients with small vessel disease showed that the build up of fatty deposits in large arteries appeared "unrelated" to lacunar ischaemic stroke.

Instead, the team led by the University of Edinburgh reported that different vascular abnormalities related to enlargement and widening of arteries in the brain appear strongly linked to the condition.

The study which tracked 229 patients, found that lacunar stroke was associated with dolichoectasia and wider arteries. In fact, patients with this feature were more than four times as likely to have lacunar stroke, the researchers reported in Circulation.

Arterial widening was also found to be associated with a greater burden of small vessel disease, faster worsening of brain damage, and a higher risk of developing new “silent” strokes.