Clinical features of leuko-araiosis.

Abstract

Objective-To study the clinical features of leuko-araiosis. Methods-Age matched groups of patients with a CT finding of pure leukoaraiosis (n = 26) and a control group with a normal CT finding (n = 26) were formed (mean ages 78*6 (SD 3.3) v 76 5 (SD 4.6) years; NS).Results-Dementia, vascular dementia, central brain atrophy on CT, disability in activities of daily living and instrumental activities of daily living, urinary incontinence, gait disorder (assistance needed), personality change, and night time confusion were found to be more commonly present in leuko-araiosis positive patients than in controls, whereas focal neurological symptoms and signs were not associated with leuko-araiosis. The occurrences of heart failure and systolic hypotensionbut not hypertension-were higher in the leuko-araiosis positive group than in the controls. Leuko-araiosis was also found to be related to a less sudden onset of symptoms and a lower Hachinski score than true brain infarction(s). Conclusions-Leuko-araiosis on CT in these elderly patients seems to be a vascular disorder aetiologically different from brain infarction, with clinical manifestations of subtle onset and general disabling nature and no prominent focal neurological signs or symptoms.

Symptoms, Vascular Risk Factors and Blood-Brain Barrier Function in Relation to CT White-Matter Changes in Dementia

“…This is in agreement with other clinical studies that have found WMCs to be related to heart failure, atrial fibrillation [26, 27]and hypertension [28, 29]. As both hypotension [30]and low nocturnal BP [31]have also been found to be related to WMCs, the relationship between BP and WMCs appears to be complex.…”

Usefulness of Primitive Reflexes in Demented and Non-Demented Cerebrovascular Patients in Daily Clinical Practice

“…The extent of vascular damage has been related to VaD [28]and may play a pivotal role in the reemergence of PRs by a direct or indirect disconnection of subcortical brain structures and deep nuclei from cortical control. White matter lesions have been associated with lower scores in cognitive function tests and with subjective mental decline [29], but their relevance in both degenerative and vascular dementia has yet to be fully elucidated [30]. Leukoaraiosis is reported to be associated with cortical hypometabolism [31]as well as with the reappearance of some primitive reflexes [32], both of which have been considered to result from diffuse corticofugal fiber damage.…”

Poststroke Dementia

“…They are frequent in VaD and are also found in AD, especially with late onset. In healthy elderly subjects they are associated with subtle neuropsychological [68, 69] and behavioral changes [70]. WMC may contribute to dementia in stroke patients because they indicate an increased risk of stroke recurrence[71], and they lead to a subtle cognitive decline with the possible consequences of stroke lesions and even associated Alzheimer pathology [72].…”