title: Cerebral white matter hyperintensities predict functional stroke outcome.
abstract: BACKGROUND
  Growing evidence suggests that white matter hyperintensities (WMHs) are implicated in stroke recurrence and mortality, and their location can be a critical factor. This study evaluated the impact of periventricular WMHs (PVWMHs) and subcortical WMHs (SWMHs) on poststroke functional outcomes.
  
  
  METHODS
  Brain MRI was performed on 187 acute ischemic stroke patients (57.8% male; mean age = 64.3 years) recruited from the Kaohsiung Municipal Hsiao-Kang Hospital from February 2007 to January 2008. A Fazekas score >or=2 in the periventrcular or subcortical white matter was taken as presence of WMHs. Demographic data and risk factors for stroke were assessed. Functional stroke outcomes were evaluated 30 days after stroke using the Barthel Index (BI) and the modifiedRankin Scale (mRS).
  
  
  RESULTS
  WMHs were inversely linked to favorable functional outcome measured by mRS (p = 0.001) and BI (p = 0.003). Evaluating different locations, PVWMHs were associated with unfavorable functional outcomes (p = 0.002, mRS; p = 0.001, BI). SWMHs were related to mRS (p = 0.026) but not BI (p = 0.069). After controlling other stroke risk factors, infarct volumes and initial stroke severity, PVWMHs were a significant indicator for both mRS (OR = 2.76; 95% CI = 1.03-7.40) and BI (OR = 3.07; 95% CI = 1.13-8.40), but SWMHs were not.
  
  
  CONCLUSIONS
  Unfavorable functional stroke outcome is associated with MRI WMHs. In terms of location, PVWMHs but not SWMHs are related to functional stroke outcome.
authors.affiliation: Department of Neurology, Kaohsiung Municipal Hsiaokang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Liou
authors.forename: Chien-Fu
authors.initials: CF
authors.lastname: Chen
authors.forename: Yuh-Cherng
authors.initials: YC
authors.lastname: Guo
authors.forename: Hsiu-Ling
authors.initials: HL
authors.lastname: Cheng
authors.forename: Hui-Lin
authors.initials: HL
authors.lastname: Lee
authors.forename: Jui-Sheng
authors.initials: JS
authors.lastname: Hsu
authors.forename: Ruey-Tay
authors.initials: RT
authors.lastname: Lin
authors.forename: Hsiu-Fen
authors.initials: HF
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000473:pathology* / Q000503:physiopathology; D013997:Time Factors; D055815:Young Adult