title: White matter hyperintensity patterns in cerebral amyloid angiopathy and hypertensive arteriopathy.
abstract: OBJECTIVE
  To identify different white matter hyperintensity (WMH) patterns between 2 hemorrhage-prone cerebral small vessel diseases (SVD): cerebral amyloid angiopathy (CAA) and hypertensive arteriopathy (HA).
  
  
  METHODS
  Consecutive patients with SVD-related intracerebral hemorrhage (ICH) from a single-center prospective cohort were analyzed. Four predefined subcortical WMH patterns were compared between the CAA and HA groups. These WMH patterns were (1) multiple subcortical spots; (2) peri-basal ganglia (BG); (3) large posterior subcortical patches; and (4) anterior subcortical patches. Their associations with other imaging (cerebral microbleeds [CMBs], enlarged perivascular spaces [EPVS]) and clinical markers of SVD were investigated using multivariable logistic regression.
  
  
  RESULTS
  The cohort included 319 patients with CAA and 137 patients with HA. Multiple subcortical spots prevalence was higher in the CAA compared to the HA group (29.8% vs 16.8%; p = 0.004). Peri-BG WMH pattern was more common in the HA- vs the CAA-ICH group (19% vs 7.8%; p = 0.001). In multivariable logistic regression, presence of multiple subcortical spots was associated with lobar CMBs (odds ratio [OR] 1.23; 95% confidence interval [CI] 1.01-1.50, p = 0.039) and high degree of centrum semiovale EPVS (OR 2.43; 95% CI 1.56-3.80, p < 0.0001). By contrast, age (OR 1.05; 95% CI 1.02-1.09, p = 0.002), deep CMBs (OR 2.46; 95% CI 1.44-4.20, p = 0.001), total WMH volume (OR 1.02; 95% CI 1.01-1.04, p = 0.002), and high BG EPVS degree (OR 8.81; 95% CI 3.37-23.02, p < 0.0001) were predictors of peri-BG WMH pattern.
  
  
  CONCLUSIONS
  Different patterns of subcortical leukoaraiosis visually identified on MRI might provide insights into the dominant underlying microangiopathy type as well as mechanisms of tissue injury in patients with ICH.
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Andreas
authors.initials: A
authors.lastname: Charidimou
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Gregoire
authors.initials: G
authors.lastname: Boulouis
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Kellen
authors.initials: K
authors.lastname: Haley
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Eitan
authors.initials: E
authors.lastname: Auriel
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Ellis S
authors.initials: ES
authors.lastname: van Etten
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Fotiadis
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Yael
authors.initials: Y
authors.lastname: Reijmer
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Alison
authors.initials: A
authors.lastname: Ayres
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Vashkevich
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Zora Y
authors.initials: ZY
authors.lastname: Dipucchio
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Schwab
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Sergi
authors.initials: S
authors.lastname: Martinez-Ramirez
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rosand
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Anand
authors.initials: A
authors.lastname: Viswanathan
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Greenberg
authors.affiliation: From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center (A.C., G.B., K.H., E.A., E.S.v.E., P.F., Y.R., A.A., A. Vashkevich, Z.Y.D., K.M.S., S.M.-R., J.R., A. Viswanathan, S.M.G., M.E.G.), and Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital (J.R.), Harvard Medical School, Boston, MA. edip@mail.harvard.edu.
authors.forename: M Edip
authors.initials: ME
authors.lastname: Gurol
mesh_terms: D000368:Aged; D016657:Cerebral Amyloid Angiopathy / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D002539:Cerebral Arterial Diseases / Q000209:etiology / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D066127:White Matter / Q000473:pathology* / Q000503:physiopathology