Clinical, radiological and pathological correlates of leukoaraiosis

Auriel, Eitan; Bornstein, Natan M.; Berényi, Ervin; Varkonyi, Ildiko; M, Gábor; Majtenyi, K; Szepesi, Rita; Goldberg, Iris; Lampé, Rudolf; Csiba, László

doi:10.1111/j.1600-0404.2010.01341.x

Cited by 37 publications

(32 citation statements)

References 39 publications

(42 reference statements)

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“…12,13,26 Furthermore, there is pathologic evidence linking age and WMH lesions. 27 Proposed mechanisms of association between leukoaraiosis and advancing age include the following: 1) alteration of blood supply to the white matter due to arteriosclerosis, tortuosity, and elongation of the vessels that result from the aging process 23,[28][29][30][31][32][33] ; and 2) age-related changes to the periventricular white matter regions that are in the arterial borderzone and easily susceptible to systemic or focal decreases in cerebral blood flow. 34 Besides age, HTN is the most common risk factor for WMH.…”

Section: Discussionmentioning

confidence: 99%

Severity of Leukoaraiosis in Large Vessel Atherosclerotic Disease

Chutinet

Biffi

Kanakis

et al. 2012

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The severity of white matter hyperintensity, or leukoaraiosis, is a marker of cerebrovascular disease. In stroke, WMH burden is strongly linked to lacunar infarction; however, impaired cerebral perfusion due to extracranial or intracranial atherosclerosis may also contribute to WMH burden. We sought to determine whether WMH burden is associated with extracranial or intracranial stenosis in patients with AIS.

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Section: Discussionmentioning

confidence: 99%

Severity of Leukoaraiosis in Large Vessel Atherosclerotic Disease

Chutinet

Biffi

Kanakis

et al. 2012

AJNR Am J Neuroradiol

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“…In support of this, recent evidence suggests that PLA is primarily associated with diminished cerebral vasomotor reactivity and subsequent cerebral hypoperfusion, 21 whereas SLA is associated with microangiopathy. 22 The exact mechanism by which leukoaraiosis confers increased risk of short-term stroke recurrence is not known. The severity of leukoaraiosis is, in part, influenced by vascular risk factors, such as hypertension, advanced age, diabetes mellitus, and smoking.…”

Section: Discussionmentioning

confidence: 99%

Extensive Leukoaraiosis Is Associated With High Early Risk of Recurrence After Ischemic Stroke

Kim

Park

Avery

et al. 2014

Stroke

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Background and Purpose-The integrity of white matter tracts connecting different parts of the brain is important for rapid compensation for the lost function from ischemic stroke. Impaired white matter reserve capacity secondary to leukoaraiosis may facilitate detection of new symptomatic ischemic events that would otherwise remain inconspicuous after an initial ischemic stroke. We sought to identify whether the extent of leukoaraiosis was a predictor of risk of early stroke recurrence. Methods-We used Cox regression analysis in consecutive patients with ischemic stroke to determine the relationship between leukoaraiosis burden and symptomatic stroke recurrence within 90 days. We graded total leukoaraiosis, periventricular leukoaraiosis, and subcortical leukoaraiosis using the Fazekas scale as mild (<2) and extensive (≥2) on fluid-attenuated inversion recovery images obtained within 72 hours of stroke onset in the hemisphere contralateral to acute stroke. Results-There were 106 recurrent events in 2378 patients. The cumulative incidence of recurrence was 5.9% at 90 days.Kaplan-Meier estimate of recurrence-free survival rate was lower in patients with extensive leukoaraiosis (P=0.04) and extensive periventricular leukoaraiosis (P=0.02) but not in extensive subcortical leukoaraiosis (P=0.09). Multivariable Cox regression analysis revealed a hazard ratio of 1.50 (95% confidence interval, 1.00-2.25) for extensive leukoaraiosis, 1.67 (95% confidence interval, 1.11-2.51) for extensive periventricular leukoaraiosis, and 1.42 (95% confidence interval, 0.94-2.12) for extensive subcortical leukoaraiosis. Conclusions-The extent of leukoaraiosis independently predicts 90-day recurrent stroke risk after ischemic stroke. This suggests that leukoaraiosis may be used for risk stratification in ischemic stroke.

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“…[2][3][4][5][6] Moreover, LA represents an independent risk factor that can be used to predict future stroke. [7][8][9] This condition is probably caused by chronic cerebral ischemia, but its pathogenesis and clinical significance are incompletely understood. 10 Several articles suggested an association between carotid atherosclerosis and LA.…”

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confidence: 99%