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Leukoaraiosis is a chronic atherosclerotic disease.

Ben-Assayag E, Mijajlovic M, Shenhar-Tsarfaty S, Bova I, Shopin L, Bornstein NM - ScientificWorldJournal (2012)

Bottom Line: Seventy-two patients (42.4%) were found to have white matter lesions, of whom 28.8% had advanced LA.In multivariate logistic regression analysis, including all vascular risk factors, LA was found to be associated with age and IMT.We conclude that a chronic atherosclerotic disease underlies the pathophysiology of leukoaraiosis and its progression.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 64239 Tel Aviv, Israel.

ABSTRACT

Background and purpose: White matter changes (WMCs), or leukoaraiosis (LA), are associated with increased age, hypertension, diabetes mellitus, and history of stroke. Although several lines of evidence suggest a role of atherosclerosis in atherothrombotic vascular events, their involvement in LA remains to be determined. Our study examines this association in ischemic stroke patients.

Methods: One hundred and seventy consecutive ischemic stroke or transient ischemic attack (TIA) patients were included. All patients underwent brain computed tomography (CT) with assessment of the extension and severity of WMCs, carotid arteries duplex scan with measurements of intima-media thickness (IMT) and plaques.

Results: Seventy-two patients (42.4%) were found to have white matter lesions, of whom 28.8% had advanced LA. Mean IMT was significantly higher in patients with LA and with advanced LA (P = 0.002, P = 0.003, resp.). In addition, LA and LA severity were associated with existence of carotid plaque (P = 0.007, P = 0.004, resp.). In multivariate logistic regression analysis, including all vascular risk factors, LA was found to be associated with age and IMT.

Conclusion: This study reinforces the tight association between LA and carotid atherosclerosis in ischemic stroke patients. We conclude that a chronic atherosclerotic disease underlies the pathophysiology of leukoaraiosis and its progression.

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Related in: MedlinePlus

Two examples illustrating degrees of LA in CT scan.
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fig1: Two examples illustrating degrees of LA in CT scan.

Mentions: Of the 170 acute stroke patients enrolled (mean ± SD age 66.4 ± 13.4 years, 104 men and 66 women), 94 had lacunar stroke, 32 had large-artery atherosclerotic stroke, 12 had cardioembolic stroke, 1 had stroke of undetermined etiology, and 31 had transient ischemic attack (TIA). In addition to stroke, 28.2% of the patients had diabetes mellitus, 46.7% had hyperlipidemia, 62.7% had hypertension, and 26.2% are current smokers. Seventy-two patients (42.4%) were found to have 1 or more white-matter lesions or leukoaraiosis (LA) on CT images located in frontal, parietal, or occipital region. Of the acute stroke patients, 49 patients (28.8%) were recorded to have advanced LA. Figure 1 illustrates examples of an image from a patient suffering from LA in one region (Figure 1(a)) and a patient suffering from advanced LA (Figure 1(b)). The characteristics of stroke patients with and without LA are summarized in Table 1. Stroke patients with LA differed significantly from stroke patients without LA in their age (71.4 ± 11.3 versus 62.6 ± 13.7 years, P < 0.001) and the prevalence of hypertension (74.6% versus 54.1%, P = 0.006) and diabetes mellitus (36.1% versus 22.4%, P = 0.051) (Table 1).


Leukoaraiosis is a chronic atherosclerotic disease.

Ben-Assayag E, Mijajlovic M, Shenhar-Tsarfaty S, Bova I, Shopin L, Bornstein NM - ScientificWorldJournal (2012)

Two examples illustrating degrees of LA in CT scan.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3362036&req=5

fig1: Two examples illustrating degrees of LA in CT scan.
Mentions: Of the 170 acute stroke patients enrolled (mean ± SD age 66.4 ± 13.4 years, 104 men and 66 women), 94 had lacunar stroke, 32 had large-artery atherosclerotic stroke, 12 had cardioembolic stroke, 1 had stroke of undetermined etiology, and 31 had transient ischemic attack (TIA). In addition to stroke, 28.2% of the patients had diabetes mellitus, 46.7% had hyperlipidemia, 62.7% had hypertension, and 26.2% are current smokers. Seventy-two patients (42.4%) were found to have 1 or more white-matter lesions or leukoaraiosis (LA) on CT images located in frontal, parietal, or occipital region. Of the acute stroke patients, 49 patients (28.8%) were recorded to have advanced LA. Figure 1 illustrates examples of an image from a patient suffering from LA in one region (Figure 1(a)) and a patient suffering from advanced LA (Figure 1(b)). The characteristics of stroke patients with and without LA are summarized in Table 1. Stroke patients with LA differed significantly from stroke patients without LA in their age (71.4 ± 11.3 versus 62.6 ± 13.7 years, P < 0.001) and the prevalence of hypertension (74.6% versus 54.1%, P = 0.006) and diabetes mellitus (36.1% versus 22.4%, P = 0.051) (Table 1).

Bottom Line: Seventy-two patients (42.4%) were found to have white matter lesions, of whom 28.8% had advanced LA.In multivariate logistic regression analysis, including all vascular risk factors, LA was found to be associated with age and IMT.We conclude that a chronic atherosclerotic disease underlies the pathophysiology of leukoaraiosis and its progression.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 64239 Tel Aviv, Israel.

ABSTRACT

Background and purpose: White matter changes (WMCs), or leukoaraiosis (LA), are associated with increased age, hypertension, diabetes mellitus, and history of stroke. Although several lines of evidence suggest a role of atherosclerosis in atherothrombotic vascular events, their involvement in LA remains to be determined. Our study examines this association in ischemic stroke patients.

Methods: One hundred and seventy consecutive ischemic stroke or transient ischemic attack (TIA) patients were included. All patients underwent brain computed tomography (CT) with assessment of the extension and severity of WMCs, carotid arteries duplex scan with measurements of intima-media thickness (IMT) and plaques.

Results: Seventy-two patients (42.4%) were found to have white matter lesions, of whom 28.8% had advanced LA. Mean IMT was significantly higher in patients with LA and with advanced LA (P = 0.002, P = 0.003, resp.). In addition, LA and LA severity were associated with existence of carotid plaque (P = 0.007, P = 0.004, resp.). In multivariate logistic regression analysis, including all vascular risk factors, LA was found to be associated with age and IMT.

Conclusion: This study reinforces the tight association between LA and carotid atherosclerosis in ischemic stroke patients. We conclude that a chronic atherosclerotic disease underlies the pathophysiology of leukoaraiosis and its progression.

Show MeSH
Related in: MedlinePlus