Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2010 Nov 9;75(19):1670-7.
doi: 10.1212/WNL.0b013e3181fc279a.

White matter hyperintensity volume is increased in small vessel stroke subtypes

N S Rost  1 , R M Rahman, A Biffi, E E Smith, A Kanakis, K Fitzpatrick, F Lima, B B Worrall, J F Meschia, R D Brown Jr, T G Brott, A G Sorensen, S M Greenberg, K L Furie, J Rosand
Affiliations
Comparative Study

White matter hyperintensity volume is increased in small vessel stroke subtypes

N S Rost et al. Neurology. .

Abstract

Objective: White matter hyperintensity (WMH) may be a marker of an underlying cerebral microangiopathy. Therefore, we hypothesized that WMH would be most severe in patients with lacunar stroke and intracerebral hemorrhage (ICH), 2 types of stroke in which cerebral small vessel (SV) changes are pathophysiologically relevant.

Methods: We determined WMH volume (WMHV) in cohorts of prospectively ascertained patients with acute ischemic stroke (AIS) (Massachusetts General Hospital [MGH], n = 628, and the Ischemic Stroke Genetics Study [ISGS], n = 263) and ICH (MGH, n = 122).

Results: Median WMHV was 7.5 cm³ (interquartile range 3.4-14.7 cm³) in the MGH AIS cohort (mean age 65 ± 15 years). MGH patients with larger WMHV were more likely to have lacunar stroke compared with cardioembolic (odds ratio [OR] = 1.87 per SD normally transformed WMHV), large artery (OR = 2.25), undetermined (OR = 1.87), or other (OR = 1.85) stroke subtypes (p < 0.03). These associations were replicated in the ISGS cohort (p = 0.03). In a separate analysis, greater WMHV was seen in ICH compared with lacunar stroke (OR = 1.2, p < 0.02) and in ICH compared with all ischemic stroke subtypes combined (OR = 1.34, p < 0.007).

Conclusions: Greater WMH burden was associated with SV stroke compared with other ischemic stroke subtypes and, even more strongly, with ICH. These data, from 2 independent samples, support the model that increasing WMHV is a marker of more severe cerebral SV disease and provide further evidence for links between the biology of WMH and SV stroke.

PubMed Disclaimer

Figures

None
Figure 1 Box plot graphic representation of white matter hyperintensity volume distribution by acute ischemic stroke subtype (combined MGH and ISGS cohorts) and intracerebral hemorrhage AIS = acute ischemic stroke; ICH = intracerebral hemorrhage; ISGS = Ischemic Stroke Genetics Study; MGH = Massachusetts General Hospital; WMH = white matter hyperintensity.
See this image and copyright information in PMC

Comment in

References

    1. O'Sullivan M. Leukoaraiosis. Practical Neurol 2008;8:26–38. - PubMed
    1. de Leeuw FE, de Groot JC, Achten E, et al. Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study—the Rotterdam Scan Study. J Neurol Neurosurg Psychiatry 2001;70:9–14. - PMC - PubMed
    1. de Leeuw F-E, Richard F, de Groot JC, et al. Interaction between hypertension, ApoE, and cerebral white matter lesions. Stroke 2004;35:1057–1060. - PubMed
    1. Rost NS, Rahman R, Sonni S, et al. Determinants of white matter hyperintensity volume in patients with acute ischemic stroke. J Stroke Cerebrovasc Dis 2010;19:230–235. - PubMed
    1. Turner ST, Jack CR, Fornage M, Mosley TH, Boerwinkle E, de Andrade M. Heritability of leukoaraiosis in hypertensive sibships. Hypertension 2004;43:483–487. - PubMed

Publication types

MeSH terms