title: Immediate regression of leukoaraiosis after carotid artery revascularization.
abstract: BACKGROUND
  Leukoaraiosis (LA) affects cognition after stroke and reversal of LA may improve cognitive performance. We aimed to determine the impact of cerebral perfusion and circle of Willis (CoW) flow patterns on the extent of LA after carotid artery revascularization.
  
  
  METHODS
  LA was scored on fluid-attenuated inversion recovery magnetic resonance (MR) images at the levels of the centrum semiovale and frontal horns in both cerebral hemispheres of 62 contiguous patients (men/women = 38/24, mean age = 63.2 ± 8.4 years, range 44-82) before and after unilateral carotid artery revascularization. The pre- and poststenting differences in LA scores, CoW flow pattern on MR angiography, and MR perfusion parameters were analyzed.
  
  
  RESULTS
  The total LA score decreased from 9.87 ± 0.65 to 8.33 ± 0.72 after stenting (p = 0.03). The CoW was complete in 21 subjects and incomplete in 41 subjects. The incomplete CoW group had a higher preoperative LA load and higher cerebral interhemispheric asymmetry index, both of which decreased significantly postoperatively.
  
  
  CONCLUSIONS
  CoW anomalies may contribute to LA in patients with carotid artery stenosis, and restoration of cerebral perfusion by carotid artery revascularization can reduce LA severity.
authors: Department of Neurology, Far-Eastern Memorial Hospital, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
authors: Yu-Ming
authors: YM
authors: Chuang
authors: Kuo-Lun
authors: KL
authors: Huang
authors: Yeu-Jhy
authors: YJ
authors: Chang
authors: Chien-Hung
authors: CH
authors: Chang
authors: Ting-Yu
authors: TY
authors: Chang
authors: Tai-Cheng
authors: TC
authors: Wu
authors: Ho-Fai
authors: HF
authors: Wong
authors: Shan-Jin
authors: SJ
authors: Liu
authors: Tsong-Hai
authors: TH
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000503:physiopathology*; D016893:Carotid Stenosis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D002548:Cerebral Revascularization / Q000379:methods*; D002560:Cerebrovascular Circulation / Q000502:physiology; D002941:Circle of Willis / Q000002:abnormalities / Q000503:physiopathology; D003072:Cognition Disorders / Q000209:etiology; D005260:Female; D006801:Humans; D049292:Leukoaraiosis / Q000209:etiology* / Q000628:therapy*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome