Imaging of the permeability of the blood brain barrier with use off contrast enhanced magnetic resonance in people with a first even lacunar stroke

A lacunar infarct is a small brain infarct located deeply in the brain which is
caused by local pathology in one of the small, perforating arteries (so called
cerebral small vessel disease). The two distinguished forms of small vessel
disease can be differentiated during life; patients with one single lacunar
infarct have atheromatosis, whereas patients with multiple infarct especially
when accompanied by extensive white matter disease do have arteriolosclerosis.
Recent studies showed evidence for involvement of endothelial dysfunction due
to arteriolosclerosis. This dysfuction might result in an increased
permeability of the blood brain barrier. This permeability can be investigated
in vivo using magnetic resonance imaging by estimating the degree of leakage of
contrast across the blood brain barrier. We hypothezised that leakage of
contrast across the blood brain barrier especially seen in patients with a
first ever lacuanr stroke and concomittant ischemic white matter lesions.

Determine if there is a difference in permeability of the blood brain barrier
between the twodifferent types of cerebral small vessel disease.

Observational, experimental imaging study

Participants will be intravenously injected with a small amount of a
paramagnetic contrast agent and magnetic resonance images of their brains will
be made. The discomfort of these procedures is minimal. Theoretically, one
might react allergic to the contrast medium, although this chance is minimal. A
recently recognized risk of MR contrast agents is the development of nefrogenic
systemic fibrosis which only develops in patients with an impaired kidney
function. However, participants are not at risk for this complication as an
impaired kidney function is an exclusion criteria for this study.