Characteristics of White Matter Lesion Severity and Age in Patients with Lacunar Ischemic Stroke Diagnosed by Magnetic Resonance Imaging

Introduction: Lacunar ischemic stroke is a manifestation of small vessel disease (SVD), characterized by small subcortical infarctions caused by perforating artery occlusion. White Matter Hyperintensities (WMH) are imaging findings that reflect degenerative changes due to chronic ischemia and can be assessed using the Fazekas scale. Objective: To determine the correlation between age and Fazekas grade in patients with lacunar ischemic stroke based on MRI findings at Dr. Saiful Anwar Regional General Hospital, Malang. Methods: This retrospective observational analytical study used medical records and brain MRI data from patients with lacunar ischemic stroke between January 2023 and January 2024. MRI scans were interpreted by two radiologists, and inter-rater agreement was assessed using the Kappa test. The correlation between age and WMH severity was analyzed using Spearman’s rank correlation test. Results: A total of 59 patients were included: 1 (1.7%) aged 18–40 years, 27 (45.8%) aged 41–60 years, and 31 (52.5%) aged over 60 years. All patients aged 18–40 years had Fazekas grade I. Among those aged 41–60 years, 10 (37%) had grade I, 14 (51.9%) grade II, and 3 (11.1%) grade III. Among patients aged over 60 years, 4 (12.9%) had grade I, 23 (74.2%) grade II, and 4 (12.9%) grade III. Spearman’s test showed a significant, weak positive correlation between age and WMH severity (r = 0.269; p = 0.039). Conclusion: Age is significantly associated with WMH severity in patients with lacunar ischemic stroke.