title: Severity of leukoaraiosis in large vessel atherosclerotic disease.
abstract: OBJECTIVE
  The severity of white matter hyperintensity, or leukoaraiosis, is a marker of cerebrovascular disease. In stroke, WMH burden is strongly linked to lacunar infarction; however, impaired cerebral perfusion due to extracranial or intracranial atherosclerosis may also contribute to WMH burden. We sought to determine whether WMH burden is associated with extracranial or intracranial stenosis in patients with AIS.
  
  
  METHODS
  Patients with AIS with admission head/neck CTA and brain MR imaging were included in this analysis. "Extracranial stenosis" was defined as >50% stenosis in the extracranial ICA, and "intracranial," as >50% stenosis in either the middle, anterior, or posterior cerebral arteries on CTA, on either side. WMHV was determined by using a validated semiautomated protocol. Multiple regression was used to assess the relationship between WMHV and extracranial/intracranial atherosclerosis.
  
  
  RESULTS
  Of 201 subjects, 51 (25.4%) had extracranial and 63 (31.5%) had intracranial stenosis. Mean age was 62 ± 15 years; 36% were women. Mean WMHV was 12.87 cm(3) in the extracranial and 8.59 cm(3) in the intracranial stenosis groups. In univariate analysis, age (P < .0001), SBP and DBP (P = .004), and HTN (P = .0003) were associated with WMHV. Extracranial stenosis was associated with greater WMHV after adjustment for intracranial stenosis (P = .04). In multivariate analysis including extracranial stenosis, only age (P < .0001) and HTN (P = .03) demonstrated independent effects on WMHV.
  
  
  CONCLUSIONS
  In our cohort of patients with AIS, age and HTN were the strongest determinants of the WMHV severity. Future studies are warranted to unravel further association between WMHV and cerebral vessel atherosclerosis.
authors.affiliation: J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: A
authors.initials: A
authors.lastname: Chutinet
authors.forename: A
authors.initials: A
authors.lastname: Biffi
authors.forename: A
authors.initials: A
authors.lastname: Kanakis
authors.forename: K M
authors.initials: KM
authors.lastname: Fitzpatrick
authors.forename: K L
authors.initials: KL
authors.lastname: Furie
authors.forename: N S
authors.initials: NS
authors.lastname: Rost
mesh_terms: D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications* / Q000175:diagnosis; D049292:Leukoaraiosis / Q000150:complications / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed