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. 2015 Jan;17(1):60-6.
doi: 10.5853/jos.2015.17.1.60. Epub 2015 Jan 30.

White matter hyperintensity in ischemic stroke patients: it may regress over time

A-Hyun Cho  1 , Hyeong-Ryul Kim  2 , Woojun Kim  1 , Dong Won Yang  3
Affiliations

White matter hyperintensity in ischemic stroke patients: it may regress over time

A-Hyun Cho et al. J Stroke. 2015 Jan.

Abstract

Background and purpose: White matter hyperintensities (WMH) are frequently observed on MRI in ischemic stroke patients as well as in normal elderly individuals. Besides the progression of WMH, the regression of WMH has been rarely reported. Thus, we aimed to investigate how WMH change over time in patients with ischemic stroke, particularly focusing on regression.

Methods: We enrolled ischemic stroke patients who underwent brain MRI more than twice with at least a 6 month time-interval. Based on T2-weighted or FLAIR MRI, WMH were visually assessed, followed by semiautomatic volume measurement. Progression or regression of WMH change was defined when 0.25 cc increase or decrease was observed and it was also combined with visible change. A statistical analysis was performed on the pattern of WMH change over time and factors associated with change.

Results: A total of 100 patients were enrolled. Their age (mean±SD) was 67.5±11.8 years and 63 were male. The imaging time-interval (mean) was 28.0 months. WMH progressed in 27, regressed in 9 and progressed in distinctive regions and regressed in others in 5 patients. A multiple logistic regression model showed that age (odds ratio[OR] 2.51, 90% confidence interval[CI] 1.056-5.958), male gender (OR 2.957, 95% CI 1.051-9.037), large vessel disease (OR 1.955, 95% CI 1.171-3.366), and renal dysfunction (OR 2.900, 90% CI 1.045-8.046) were associated with progression. Regarding regression, no significant factor was found in the multivariate analysis.

Conclusions: In 21.5% of ischemic stroke patients, regression of WMH was observed. WMH progression was observed in a third of ischemic stroke patients.

Keywords: Ischemic stroke; Leukoaraiosis; MRI, progression; Regression; White matter hyperintensity.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Figure 1
Figure 1
A 77-year-old female presented with left pontine infarction (A). Progression of white matter hyperintensity is observed on FLAIR MRI at 3.5 years of follow-up (B, initial scan; C, follow-up).
Figure 2
Figure 2
A 68-year-old female presented with left MCA territorial infarction (A). Regression of white matter hyperintensity is observed on FLAIR at 21 months of follow-up (B, initial scan; C, follow-up).
Figure 3
Figure 3
A 72-year-old female presented with left pontine infarction (A). Regression of white matter hyperintensity is observed on T2-weighted MRI at 7 months of follow-up (B, initial scan; C, follow-up).
See this image and copyright information in PMC

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