What Is the Significance of Leukoaraiosis in Patients With Acute Ischemic Stroke?

Arch Neurol. 2000 Jul;57(7):967-73. doi: 10.1001/archneur.57.7.967.

Abstract

Background: Leukoaraiosis (LA) may have specific clinical correlates in patients with stroke, but this is not well investigated, so that the significance of LA in patients with stroke remains unclear.

Methods: In a study of 2289 patients with a first-ever acute ischemic stroke, LA was noted in 149 by the use of baseline computed tomography of the brain. These patients were compared with the non-LA group. Statistical tests, including Fisher exact test or a chi(2) test, were used to compare variables, and a multivariate approach using stepwise logistic regression was performed.

Results: Patients with LA were significantly older (73.7 vs 62.7 years; P<. 001), and had a higher incidence of hypertension (72.5% vs 47.1%; P<. 001) and subcortical or lacunar infarction (40.3% vs 25.4% and 21.5% vs 8.0%, respectively; P<.001) on neuroimaging studies, compared with the non-LA group. The most common cause of stroke in the LA group was presumed to be small-artery disease associated with hypertension (46% vs 13.5% in the non-LA group). Age and hypertension were very strongly associated with LA (respective odds ratios [95% confidence intervals], 1.06 [1.04-1.08] and 2.33 [1.60-3. 39]). In addition to these risk factors, a close relationship was found between LA and nonsevere stenosis (<50%) of the internal carotid artery (odds ratio, 2.23 [95% confidence interval, 1.32-3. 76]), although the significance of this association remains speculative. The outcome at 1 month after stroke was similar in both groups.

Conclusion: Our results provide further evidence that LA is related primarily to small-vessel disease.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Ataxia / epidemiology
  • Brain / blood supply
  • Brain / pathology
  • Cardiovascular Diseases / epidemiology
  • Carotid Artery, Internal / diagnostic imaging
  • Carotid Stenosis / diagnostic imaging
  • Comorbidity
  • Female
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neurodegenerative Diseases / diagnosis
  • Neurodegenerative Diseases / epidemiology*
  • Odds Ratio
  • Paresis / epidemiology
  • Prognosis
  • Risk Factors
  • Sex Distribution
  • Stroke / diagnosis
  • Stroke / epidemiology*
  • Ultrasonography
  • Vertebral Artery / diagnostic imaging