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

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. 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. 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. 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.