Question 2696
{"accessible":true,"alternatives":[{"id":13192,"text":"white matter hyperintensity of presumed vascular origin"},{"id":13193,"text":"perivascular space"},{"id":13194,"text":"recent subcortical infarct"},{"id":13195,"text":"lacune of presumed vascular origin"},{"id":13196,"text":"cerebral microbleed"}],"archived":false,"correctAlternativeId":13195,"explanation":"\u003cp\u003eThe finding is a subcortical fluid signal intensity cavity, measuring between 3 mm and 15 mm, with a surrounding rim of FLAIR hyperintensity. This finding represents a lacune of presumed vascular origin. It is most likely an old small infarct, but a old hemorrhage is also possible (a susceptibility weighted sequence could distinguish by detecting hemosiderin deposition consistent with chronic blood products).\u003c/p\u003e\u003cp\u003eA white matter hyperintensity would appear hyperintense on FLAIR rather than suppress like as cerebrospinal fluid in the center.\u003c/p\u003e\u003cp\u003eA perivascular space in this location would be smaller (less than 3 mm diameter), even if prominent/dilated, and have a punctate or linear shape depending on the plane of imaging.\u003c/p\u003e\u003cp\u003eA cerebral microbleed is usually not evident on T2WI. If it is, it would appear as a tiny hypointense focus, reflecting chronic blood products.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e","id":2696,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/1054/lacune_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":26436},"imageAttributionCaseInfo":{"title":"Dilated Virchow-Robin spaces - idiopathic","contributor_name":"Ahmed Abdrabou","contributor_param":"drabdrabou","case_rid":26436,"case_param":"dilated-virchow-robin-spaces-idiopathic"},"firstQuestionPath":"/questions/2696","nextQuestionPath":"/articles/cerebral-microhaemorrhage/questions/1023","relatedArticles":[{"id":6160,"title":"Lacunar infarct","link":"/articles/lacunar-infarct?lang=us"},{"id":1863,"title":"Perivascular spaces","link":"/articles/perivascular-spaces?lang=us"},{"id":16200,"title":"Cerebral small vessel disease","link":"/articles/cerebral-small-vessel-disease?lang=us"},{"id":28684,"title":"Hypertensive microangiopathy","link":"/articles/hypertensive-microangiopathy?lang=us"}],"alsoUsedIn":[{"id":1903,"kind":"Course","title":"Radiopaedia 2024 - Virtual Conference - page 1903","link":"https://radiopaedia.org/courses/radiopaedia-2024-virtual-conference/pages/1903"},{"id":1903,"kind":"Course","title":"2024 Virtual Conference Private Use - page 1903","link":"https://radiopaedia.org/courses/2024-virtual-conference-private-use/pages/1903"},{"id":1468,"kind":"Course","title":"2023 Virtual Conference Private Use - page 1468","link":"https://radiopaedia.org/courses/2023-virtual-conference-private-use/pages/1468"},{"id":1468,"kind":"Course","title":"Neuroradiology Lectures - page 1468","link":"https://radiopaedia.org/courses/neuroradiology-lectures/pages/1468"},{"id":1468,"kind":"Course","title":"New test course - page 1468","link":"https://radiopaedia.org/courses/new-test-course/pages/1468"}],"stem":"\u003cp\u003eWhat is the best imaging descriptor for the marker of cerebral small vessel disease indicated by the arrow?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2696"}],"attemptsPercentages":[{"alternativeId":"13196","percentage":2},{"alternativeId":"13195","percentage":59},{"alternativeId":"13193","percentage":14},{"alternativeId":"13192","percentage":18},{"alternativeId":"13194","percentage":7}],"promptToLogin":false,"questionManager":false,"articleId":"cerebral-microhemorrhage"}