Distribution of white matter hyperintensity in cerebral hemorrhage and healthy aging

J Neurol. 2012 Mar;259(3):530-6. doi: 10.1007/s00415-011-6218-3. Epub 2011 Aug 30.


We compared the severity of white matter T2-hyperintensities (WMH) in the frontal lobe and occipital lobe using a visual MRI score in 102 patients with lobar intracerebral hemorrhage (ICH) diagnosed with possible or probable cerebral amyloid angiopathy (CAA), 99 patients with hypertension-related deep ICH, and 159 normal elderly subjects from a population-based cohort. The frontal-occipital (FO) gradient was used to describe the difference in the severity of WMH between the frontal lobe and occipital lobe. A higher proportion of subjects with obvious occipital dominant WMH (FO gradient ≤-2) was found among patients with lobar ICH than among healthy elderly subjects (FO gradient ≤-2: 13.7 vs. 5.7%, p = 0.03). Subjects with obvious occipital dominant WMH were more likely to have more WMH (p = 0.0006) and a significantly higher prevalence of the apolipoprotein E ε4 allele (45.8% vs. 19.4%, p = 0.04) than those who had obvious frontal dominant WMH. This finding is consistent with the relative predilection of CAA for posterior brain regions, and suggests that white matter lesions may preferentially occur in areas of greatest vascular pathology.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / pathology*
  • Cerebral Amyloid Angiopathy / etiology
  • Cerebral Hemorrhage / complications*
  • Cerebral Hemorrhage / pathology
  • Cohort Studies
  • Female
  • Humans
  • Leukoencephalopathies / etiology*
  • Leukoencephalopathies / pathology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Odds Ratio
  • Retrospective Studies