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
. 2011 Jul 5;77(1):55-61.
doi: 10.1212/WNL.0b013e318221ad02. Epub 2011 Jun 22.

Severity of leukoaraiosis determines clinical phenotype after brain infarction

E M Arsava  1 , A Bayrlee, M Vangel, N S Rost, J Rosand, K L Furie, A G Sorensen, H Ay
Affiliations

Severity of leukoaraiosis determines clinical phenotype after brain infarction

E M Arsava et al. Neurology. .

Abstract

Objective: To determine whether the extent of leukoaraiosis, a composite marker of baseline brain integrity, differed between patients with TIA with diffusion-weighted imaging (DWI) evidence of infarction (transient symptoms with infarction [TSI]) and patients with ischemic stroke.

Methods: Leukoaraiosis volume on MRI was quantified in a consecutive series of 153 TSI and 354 ischemic stroke patients with comparable infarct volumes on DWI. We explored the relationship between leukoaraiosis volume and clinical phenotype (TIA or ischemic stroke) using a logistic regression model.

Results: Patients with TSI tended to be younger (median age 66 vs 69 years, p = 0.062) and had smaller median normalized leukoaraiosis volume (1.2 mL, interquartile range [IQR] 0.2-4.7 mL vs 3.5 mL, IQR 1.2-8.6 mL, p < 0.001). In multivariable analysis controlling for age, stroke risk factors, etiologic stroke mechanism, infarct volume, and infarct location, increasing leukoaraiosis volume remained associated with ischemic stroke (odds ratio 1.05 per mL, 95%confidence interval 1.02-1.09, p = 0.004), along with infarct volume and infarct location.

Conclusion: The probability of ischemic stroke rather than TSI increases with increasing leukoaraiosis volume, independent of infarct size and location. Our findings support the concept that the integrity of white matter tracts connecting different parts of the brain could contribute to whether or not patients develop TSI or ischemic stroke in an event of brain infarction.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Probability of transient symptoms with infarction (TSI) decreases as diffusion-weighted imaging (DWI) volume increases
Circles represent individual data points. Lines represent the probability curve and 95% confidence interval. The area left to the vertical dotted line (DWI volume = 13.7 mL) represents the region of overlapping infarct volumes in subjects with TSI and ischemic stroke.
Figure 2
Figure 2. Probability of transient symptoms with infarction (TSI) decreases as leukoaraiosis volume increases
The circles represent individual data points. Lines represent the probability curve and 95% confidence interval. DWI = diffusion-weighted imaging.
See this image and copyright information in PMC

References

    1. Giles MF, Albers GW, Amarenco P, et al. Addition of brain infarction to the ABCD2 score (ABCD2I): a collaborative analysis of unpublished data on 4574 patients. Stroke 2010;41:1907–1913 - PubMed
    1. Ay H, Koroshetz WJ, Benner T, et al. Transient ischemic attack with infarction: a unique syndrome? Ann Neurol 2005;57:679–686 - PubMed
    1. Cramer SC, Nelles G, Benson RR, et al. A functional MRI study of subjects recovered from hemiparetic stroke. Stroke 1997;28:2518–2527 - PubMed
    1. Wall PD, Egger MD. Formation of new connexions in adult rat brains after partial deafferentation. Nature 1971;232:542–545 - PubMed
    1. Cao Y, D'Olhaberriague L, Vikingstad EM, Levine SR, Welch KM. Pilot study of functional MRI to assess cerebral activation of motor function after poststroke hemiparesis. Stroke 1998;29:112–122 - PubMed

Publication types