Cerebral white matter hyperintensities on MRI: Current concepts and therapeutic implications

Cerebrovasc Dis. 2006;22(2-3):83-90. doi: 10.1159/000093235. Epub 2006 May 9.


Background: White matter hyperintensities (WMH) are commonly observed MRI abnormalities in the elderly, which generally reflect covert vascular brain injury. WMH cumulatively produce substantial neurologic, psychiatric, and medical morbidity. This review provides an overview of current knowledge on vascular WMH, and describes some pharmacological agents that may have a role in mitigating this condition.

Summary of review: This review has two main focus areas. The first is a discussion of currently available knowledge regarding the public health burden, pathogenesis, and various risk factors associated with the presence of vascular white matter lesions noted on brain MRI. The second section of the article details the mechanistic and clinical basis for promising pharmacological treatment modalities that could potentially prevent progression of ischemic cerebral white matter brain injury. Many of these therapies are already of proven efficacy in preventing recurrent stroke.

Conclusions: Individuals with vascular white matter lesions on MRI may represent a potential target population likely to benefit from secondary stroke prevention therapies.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Atherosclerosis / complications
  • Brain / pathology*
  • Clinical Trials as Topic
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypertension / complications
  • Leukoaraiosis / drug therapy
  • Leukoaraiosis / etiology
  • Leukoaraiosis / pathology*
  • Magnetic Resonance Imaging* / methods
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Risk Factors
  • Stroke / pathology*
  • Stroke / prevention & control


  • Antihypertensive Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Platelet Aggregation Inhibitors