title: [Carotid atherosclerosis and white matter hypodensities: a controversial relationship].
abstract: BACKGROUND
  White matter hypodensities of presumed vascular origin, are recognized as an important cause of morbidity with established clinical and cognitive consequences. Nonetheless, many doubts remain on its physiopathology. Our goal is to clarify the potential role of carotid atherosclerosis and other vascular risk factors in the development of white matter hypodensities of presumed vascular origin.
  
  
  METHODS
  We included patients that underwent CT brain scan and neurosonologic evaluation within a one-month period. Full assessment of vascular risks factors was performed. We seek to find independent associations between white matter hypodensities of presumed vascular origin, carotid intima-media thickness and vascular risk factors.
  
  
  RESULTS
  472 patients were included, mean age was 67.32 (SD: 14.75), 274 (58.1%) were male. The independent predictors of white matter hypodensities of presumed vascular origin were age (OR: 1.067, 95% IC: 1.049 - 1.086, p < 0.001) and hypertension (OR: 1.726, 95% IC: 1.097 - 2.715, p = 0.018). No association was found between IMT (OR: 2.613, 95% IC: 0.886 - 7.708, p = 0.082) or carotid artery stenosis (OR: 1.021, 95% IC: 0.785 - 1.328, p = 0.877) and white matter hypodensities of presumed vascular origin.
  
  
  CONCLUSIONS
  Only age and hypertension proved to have an independent association with white matter hypodensities of presumed vascular origin. Carotid atherosclerosis, evaluated by IMT and the degree of carotid artery stenosis, showed no association with white matter hypodensities of presumed vascular origin. Since atherosclerosis is a systemic pathology, these results suggest that alternative mechanisms are responsible for the development of white matter hypodensities of presumed vascular origin.
  
  
  CONCLUSIONS
  Age and hypertension seem to be the main factors in the development of white matter hypodensities of presumed vascular origin. No association was found between carotid atherosclerosis and white matter hypodensities of presumed vascular origin.
authors.affiliation: Departamento de Imagem Médica. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Félix-Morais
authors.affiliation: Departamento de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Sargento-Freitas
authors.affiliation: Departamento de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Fernando
authors.initials: F
authors.lastname: Silva
authors.affiliation: Departamento de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Cordeiro
authors.affiliation: Departamento de Imagem Médica. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: César
authors.initials: C
authors.lastname: Nunes
authors.affiliation: Faculdade de Medicina da Universidade de Coimbra. Coimbra. Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Ribeiro
authors.affiliation: Departamento de Imagem Médica. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Cordeiro
authors.affiliation: Departamento de Imagem Médica. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Moura
authors.affiliation: Departamento de Neurologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Luis
authors.initials: L
authors.lastname: Cunha
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors