Risk factors and leukoaraiosis in stroke patients.
OBJECTIVE
Although leukoaraosis (LA) is a common CT findings, its pathogenesis remains debated: if small-artery pathology may explain in some cases white matter changes, many other factors, such as hemodynamic perturbations, might also lead to LA. To test these hypothesis, we determined the types of cerebrovascular risk factors associated with leukoaraosis in consecutive patients with acute cerebrovascular event.


METHODS
Using CT-scans, we prospectively studied in 610 patients consecutively admitted for an acute cerebral event, the relation between LA and the following cerebrovascular risk factors: age, sex, arterial hypertension, diabetes mellitus, hyperlipemia, alcohol consumption, birth contraceptive pills, previous transient ischemic attack or stroke, migraine, atrial fibrillation, valvulopathy, coronaropathy, left ventricular hypertrophy, stenosis of the internal carotid artery, by means of a multiple linear regression. Relation with cerebral atrophy was also evaluated.


RESULTS
We found LA scores to depend on increasing age (p = 0.0001), female sex (p = 0.0146), history of stroke or TIA (p = 0.0051), history or current atrial fibrillation (p = 0.0083), increasing cerebral atrophy score (p = 0.0001), absence of hyperlipemia (p = 0.0003) and absence of alcohol consumption higher than 300 g/week (p = 0.0398).


CONCLUSIONS
Our findings do not support the hypothesis that, in stroke patients, LA share similar risk factors than small-vessel disease; other cerebrovascular risk factors may also contribute to LA, perhaps because of decreased cerebral blood flow.
Department of Neurology, University of Lille, France.
H
H
Hénon
O
O
Godefroy
C
C
Lucas
J P
JP
Pruvo
D
D
Leys
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D002545:Brain Ischemia / Q000503:physiopathology*; D016893:Carotid Stenosis / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014057:Tomography, X-Ray Computed