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. 2010 Dec;41(12):2807-11.
doi: 10.1161/STROKEAHA.110.595355. Epub 2010 Oct 14.

White matter hyperintensity burden and susceptibility to cerebral ischemia

Natalia S Rost  1 , Kaitlin Fitzpatrick, Alessandro Biffi, Allison Kanakis, William Devan, Christopher D Anderson, Lynelle Cortellini, Karen L Furie, Jonathan Rosand
Affiliations

White matter hyperintensity burden and susceptibility to cerebral ischemia

Natalia S Rost et al. Stroke. 2010 Dec.

Abstract

Background and purpose: White matter hyperintensity (WMH) burden increases risk of ischemic stroke; furthermore, it predicts infarct growth in acute cerebral ischemia. We hypothesized that WMH would be less severe in patients with TIA as compared to those with acute ischemic stroke and completed infarct.

Methods: Cases (TIA, n = 30) and controls (acute ischemic stroke, n = 120) were selected from an ongoing longitudinal cohort study of patients with stroke and matched for age, gender, and race/ethnicity. All subjects had brain MRI within 48 hours of presentation to evaluate for evidence of acute cerebral ischemia. WMH burden on MRI was quantified using a validated computer-assisted program with high inter-rater reliability.

Results: Median WMH volume in individuals with TIA was 3.7 cm³ (interquartile range, 1.5 - 8.33 cm³) compared to 6.9 cm³ (interquartile range, 3.1-11.9 cm³) in acute ischemic stroke (P < 0.04). In multivariable analysis, the odds of completed infarct were higher (OR, 2.19; 95% CI, 1.27-3.77; P < 0.005) in subjects with larger volumes of WMH.

Conclusions: WMH burden was significantly less in subjects with TIA as opposed to those with ischemic stroke. These data provide further evidence to support a detrimental role of WMH burden on the capacity of cerebral tissue to survive acute ischemia.

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Figures

Figure
Figure. Severity of white matter hyperintensity burden in patients with transient ischemic attack vs. acute ischemic stroke
Burden of leukoaraiosis measured as WMH volume in patients with TIA is significantly less as compared to those with AIS (Panel A). Greater WMH volume measured on admission brain MRI increases the probability of a cerebrovascular infarct (AIS) over that of transient ischemia (TIA) (Panel B).
See this image and copyright information in PMC

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