Cavitation of symptomatic acute single small subcortical infarctions.

Abstract

To investigate cavitation of symptomatic acute single small subcortical infarctions (SSSI). Acute SSSI were diagnosed with magnetic resonance (MR) diffusion-weighted imaging (DWI) combined with apparent diffusion coefficient (ADC) sequence on follow-up MR imaging. Cavitation of the acute SSSI was comprehensively viewed on FLAIR, T2-, and T1-weighted sequences. We enrolled 123 patients with acute SSSI. The follow-up median interval was 303 (125-390) days. The lesions of SSSI evolved into cavitation in 93 patients (75.6%), evolved into WMHs in nine patients (7.3%), and were no visible in 21 patients (17.1%). Cavitation was independently associated with larger infarct diameter on baseline DWI [odds ratio (OR), 1.250, 95% CI (1.078-1.451), P= 0.003], higher score of baseline old lacunar infarct [OR 3.44, 95% CI (1.49-7.91), P= 0.004], and lower rate of dyslipidemia [OR 0.30, 95% CI (0.10-0.76), P= 0.013]. Cavitation occurred more in the setting of small vessel diseased brain and less in the SSSI of possible atherosclerotic etiology. This suggested that the etiology of infarct was associated with cavitation after acute SSSI.