title: Clinical characterization of symptomatic microangiopathic brain lesions.
abstract: BACKGROUND
  Microangiopathic brain lesions can be separated in diffuse lesions - leukoaraiosis - and focal lesions - lacunes. Leukoaraiosis and lacunes are caused by common cerebrovascular risk factors, but whether they represent a common entity is not sufficiently investigated. The present study aimed to determine the clinical profiles associated with the extent of leukoaraiosis and lacunes.
  
  
  METHODS
  Sixty-four consecutive patients with acute microangiopathic stroke were studied. Leukoaraiosis and lacunes were stratified according to their MRI-based extent. Standardized clinical assessment included clinical syndromes, cerebrovascular risk factors, cognitive performance, retinal imaging, ultrasonography, blood, and urine parameters.
  
  
  RESULTS
  Different clinical profiles for leukoaraiosis and lacunes were found. Regarding leukoaraiosis, the cognitive scores (SISCO, mini mental score examination, mental examination) and the presence of hyperlipidemia decreased as the severity of leukoaraiosis increased. Univariate and multivariate analysis revealed that these cognitive score values as well as the presence of hyperlipidemia correlated significantly with no or only mild leukoaraiosis. Regarding lacunes, the percentage of migraine, previous stroke events, hydrocephalus, left ventricular hypertrophy, and a higher National Institutes of Health Stroke Scale increased as the number of lacunar lesions increased. Statistical analysis revealed that these parameters correlated not significantly with the number of lacunes.
  
  
  CONCLUSIONS
  The findings suggests that leukoaraiosis and lacunes are different microangiopathic entities potentially requiering different treatment concepts.
authors.affiliation: Department of Neurology, Charite - University Medicine Berlin Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Leistner
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Koennecke
authors.forename: Jens P
authors.initials: JP
authors.lastname: Dreier
authors.forename: Anne-Katrin
authors.initials: AK
authors.lastname: Strempel
authors.forename: Markus
authors.initials: M
authors.lastname: Kathke
authors.forename: Alexandrina
authors.initials: A
authors.lastname: Nikolova
authors.forename: Peter
authors.initials: P
authors.lastname: Heuschman
authors.forename: Uwe
authors.initials: U
authors.lastname: Malzahn
authors.forename: Heinrich J
authors.initials: HJ
authors.lastname: Audebert
authors.forename: Bruno-Marcel
authors.initials: BM
authors.lastname: Mackert