Leukoaraiosis and acute ischemic stroke

Abstract

Ischaemic stroke is characterized by high morbidity, high disability rate, high mortality and high recurrence rate, which can have a grave impact on the quality of life of the patients and consequently becomes an economic burden on their families and society. With the developments in imaging technology in recent years, patients with acute cerebral infarction are predominantly more likely to be diagnosed with leukoaraiosis (LA). LA is a common degenerative disease of the nervous system, which is related to cognitive decline, depression, abnormal gait, ischaemic stroke and atherosclerosis. The aetiology of LA is not clear and there is no gold standard for imaging assessment. Related studies have shown that LA has an adverse effect on the prognosis of cerebral infarction, but some experts have contrary beliefs. Hence, we undertook the present review of the literature on the mechanism and the effect of LA on the prognosis of patients with acute ischaemic stroke.

Right hemispheric white matter hyperintensities improve the prediction of spatial neglect severity in acute stroke

“…White matter hyperintensities (WMH), also called white matter lesions or leukoaraiosis, are frequently seen as hyperintense areas on T2-weighted brain MRI of predominantly elderly people ( Manolio et al, 1994 ; for a review, see Tang et al, 2021 ). While not fully understood, both vascular and non-vascular causes are involved ( Schmidt et al, 2011 ).…”

Changes of fatty acid metabolism in FA 26:0, FA 22:2 and FA 24:1 are associated with leukoaraiosis in the elderly

“…Early research primarily centered on the intimate link between LA and vascular health, especially its connection to cerebral small vessel disease (CSVD) [26][27][28]. Multiple clinical studies have robustly established a signi cant correlation between LA and lacunar infarctions [29], hemorrhagic strokes [30,31], and ischemic strokes [5,32]. Some investigations have suggested that individuals with severe LA face twice the risk of stroke compared to the general population [5,33].…”

Diagnostic Accuracy of Posterior/Anterior Periventricular WMH Ratio to Differentiate CAA From Hypertensive Arteriopathy

“…Small vessel disease-related WMHs are associated with pathologies of the vascular structures including small arteries, arterioles, capillaries, small veins, venules, and the glymphatic system. [13][14][15][16] Possible mechanisms of these vascular pathologies include arterial stiffness, vascular oxidative stress, chronic hypoxia, vascular endothelial cell damage, blood-brain barrier dysfunction, inflammation, demyelination, axonal cleavage, gliosis, and brain connectivity destruction. [13][14][15][16][17] Earlier data suggested different vasculogenic mechanisms in deep versus PVWMH.…”

“…[13][14][15][16] Possible mechanisms of these vascular pathologies include arterial stiffness, vascular oxidative stress, chronic hypoxia, vascular endothelial cell damage, blood-brain barrier dysfunction, inflammation, demyelination, axonal cleavage, gliosis, and brain connectivity destruction. [13][14][15][16][17] Earlier data suggested different vasculogenic mechanisms in deep versus PVWMH. 18 Destruction of endothelium and interstitial edema (by accumulation of interstitial fluid around the ventricle by preventing its reabsorption due to venous occlusion) seems to play a crucial role in PVWMH.…”