RT Journal Article
SR Electronic
T1 Severity of Leukoaraiosis in Large Vessel Atherosclerotic Disease
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A3015
A1 A. Chutinet
A1 A. Biffi
A1 A. Kanakis
A1 K.M. Fitzpatrick
A1 K.L. Furie
A1 N.S. Rost
YR 2012
UL http://www.ajnr.org/content/early/2012/03/15/ajnr.A3015.abstract
AB 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. MATERIALS AND METHODS: Patients with AIS with admission head/neck CTA and brain MR imaging were included in this analysis. “Extracranial stenosis” was defined as >50% stenosis in the extracranial ICA, and “intracranial,” as >50% stenosis in either the middle, anterior, or posterior cerebral arteries on CTA, on either side. WMHV was determined by using a validated semiautomated protocol. Multiple regression was used to assess the relationship between WMHV and extracranial/intracranial atherosclerosis. RESULTS: Of 201 subjects, 51 (25.4%) had extracranial and 63 (31.5%) had intracranial stenosis. Mean age was 62 ± 15 years; 36% were women. Mean WMHV was 12.87 cm3 in the extracranial and 8.59 cm3 in the intracranial stenosis groups. In univariate analysis, age (P < .0001), SBP and DBP (P = .004), and HTN (P = .0003) were associated with WMHV. Extracranial stenosis was associated with greater WMHV after adjustment for intracranial stenosis (P = .04). In multivariate analysis including extracranial stenosis, only age (P < .0001) and HTN (P = .03) demonstrated independent effects on WMHV. CONCLUSIONS: In our cohort of patients with AIS, age and HTN were the strongest determinants of the WMHV severity. Future studies are warranted to unravel further association between WMHV and cerebral vessel atherosclerosis. Abbreviations AFatrial fibrillationAISacute ischemic strokeCADcoronary artery diseaseDBPdiastolic blood pressureDMdiabetes mellitusHTNhypertensionIQRinterquartile rangelnWMHVnatural logarithm-transformed white matter hyperintensity volumeSBPsystolic blood pressureTOASTTrial of Org 10172 in Acute Stroke TreatmentWMHwhite matter hyperintensityWMHVwhite matter hyperintensity volume