title: Characteristics of Cerebral Hemodynamics in Patients with Ischemic Leukoaraiosis and New Ultrasound Indices of Ischemic Leukoaraiosis.
abstract: OBJECTIVE
  The diagnosis of ischemic leukoaraiosis (ILA) is based on head magnetic resonance imaging (MRI) and exclusion of other causes of white matter hyperintensities (WMHs). Recent studies have shown increased arterial stiffness and diminished carotid flow in ILA patients. So far, there are very little data on intracerebral hemodynamic parameters in ILA. Due to the specific structure of the intracranial arteries, our aim was to investigate intracerebral hemodynamic parameters in ILA patients and, possibly, to find a reliable ultrasound index of combined intra- and extracranial cerebral arteries.
  
  
  METHODS
  We compared different hemodynamic parameters in the middle cerebral artery (MCA) and local carotid stiffness parameters in 53 ILA patients to 40 gender and risk factor-matched controls with normal head MRI. The ILA diagnosis was based on head MRI and exclusion of other causes of WMH. In addition, we introduced new ischemic leukoariosis indices (ILAi) that are ratios of carotid stiffness parameters and MCA mean blood flow velocity. The diagnostic significance of ILAi for the prediction of ILA was analyzed.
  
  
  RESULTS
  We found significantly lower diastolic, systolic, and mean MCA blood flow velocities and increased carotid stiffness in the ILA group (P ≤ .05). All ILAi significantly differed between the groups (P < .05), were significantly associated with ILA (P < .01), and were sensitive and specific for predicting ILA (P < .05).
  
  
  CONCLUSIONS
  MCA blood flow velocities in ILA patients are lower compared to risk factor-matched controls. A combination of lower velocities and increased carotid stiffness represented as ILAi could have a potential diagnostic value for ILA.
authors.affiliation: Department of Vascular Neurology and Intensive Neurological Therapy, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
authors.forename: Monika
authors.initials: M
authors.lastname: Turk
authors.affiliation: Department of Vascular Neurology and Intensive Neurological Therapy, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
authors.forename: Marjan
authors.initials: M
authors.lastname: Zaletel
authors.affiliation: Department of Vascular Neurology and Intensive Neurological Therapy, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia. Electronic address: janja.pretnar@kclj.si.
authors.forename: Janja
authors.initials: J
authors.lastname: Pretnar Oblak
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000150:complications; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D049292:Leukoaraiosis / Q000000981:diagnostic imaging* / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000503:physiopathology*; D012044:Regression Analysis; D014463:Ultrasonography
keywords: Carotid Doppler ultrasound; carotid stiffness; cerebral blood flow; leukoaraiosis; transcranial Doppler sonography; white matter hyperintensities