ABSTRACT NUMBER: ESOC2026A1914 LACUNAR INFARCTS IN PATIENTS WITH PROBABLE CEREBRAL AMYLOID ANGIOPATHY AND HYPERTENSIVE CEREBRAL MICROANGIOPATHY

Abstract Background and aims Cerebral Amyloid Angiopathy (CAA) and Hypertensive Cerebral Microangiopathy (hCMA) as causes of Lacunar Infarcts (LI) is an important task because both of these diseases lead to cerebral vascular damage and have a number of similar manifestations. Methods We analyzed the examination results of 40 patients aged 55 years and older with acute supratentorial LI with MRI and Frontal Assesment Battery test. The MRI protocol included specialized pulse sequences to visualize paramagnetic, iron-containing blood breakdown products. Probable CAA and hCMA, according to the Boston criteria, was diagnosed by our team in 12 out of the 40 patients who were potentially eligible for these pathologies (Group 1). Isolated hCMA was identified as the cause of LI in the remaining 28 patients (Group 2). Results The proportion of patients with severe diffuse involvement of the deep white matter of the brain (Fazekas scale score of 3) was statistically significantly higher in Group 1 (10 out of 12, or 83% of patients) than in Group 2 (4 out of 28, or 14.2%), p < 0.001. Analysis of contingency tables for the degree of white matter changes in the brain (according to the Fazekas scale) and the severity of regulatory dysfunction (according to the FAB scale) across the entire cohort of examined patients (40 individuals) indicated a statistically significant association between the specified parameters. Conclusions Patients with acute lacunar stroke who have a combination of probable CAA and hCMA differ from patients with isolated hCMA by having more pronounced cognitive impairments and greater white matter hyperintensity on neuroimaging. Conflict of interest Saydaliev Saidaziz: nothing to disclose