Abstract
OBJECTIVE: To study the clinical features of leuko-araiosis. METHODS: Age matched groups of patients with a CT finding of pure leukoaraiosis (n = 26) and a control group with a normal CT finding (n = 26) were formed (mean ages 78.6 (SD 3.3) v 76.5 (SD 4.6) years; NS). RESULTS: Dementia, vascular dementia, central brain atrophy on CT, disability in activities of daily living and instrumental activities of daily living, urinary incontinence, gait disorder (assistance needed), personality change, and night time confusion were found to be more commonly present in leuko-araiosis positive patients than in controls, whereas focal neurological symptoms and signs were not associated with leuko-araiosis. The occurrences of heart failure and systolic hypotension-but not hypertension-were higher in the leuko-araiosis positive group than in the controls. Leuko-araiosis was also found to be related to a less sudden onset of symptoms and a lower Hachinski score than true brain infarction(s). CONCLUSIONS: Leuko-araiosis on CT in these elderly patients seems to be a vascular disorder aetiologically different from brain infarction, with clinical manifestations of subtle onset and general disabling nature and no prominent focal neurological signs or symptoms.
Full text
PDF





Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bennett D. A., Gilley D. W., Wilson R. S., Huckman M. S., Fox J. H. Clinical correlates of high signal lesions on magnetic resonance imaging in Alzheimer's disease. J Neurol. 1992 Apr;239(4):186–190. doi: 10.1007/BF00839137. [DOI] [PubMed] [Google Scholar]
- Blennow K., Wallin A. Clinical heterogeneity of probable Alzheimer's disease. J Geriatr Psychiatry Neurol. 1992 Apr-Jun;5(2):106–113. doi: 10.1177/002383099200500208. [DOI] [PubMed] [Google Scholar]
- Bogucki A., Papierz W., Szymanska R., Staniaszczyk R. Cerebral amyloid angiopathy with attenuation of the white matter on CT scans: subcortical arteriosclerotic encephalopathy (Binswanger) in a normotensive patient. J Neurol. 1988 Sep;235(7):435–437. doi: 10.1007/BF00314490. [DOI] [PubMed] [Google Scholar]
- Brun A., Englund E. A white matter disorder in dementia of the Alzheimer type: a pathoanatomical study. Ann Neurol. 1986 Mar;19(3):253–262. doi: 10.1002/ana.410190306. [DOI] [PubMed] [Google Scholar]
- Dupont R. M., Jernigan T. L., Butters N., Delis D., Hesselink J. R., Heindel W., Gillin J. C. Subcortical abnormalities detected in bipolar affective disorder using magnetic resonance imaging. Clinical and neuropsychological significance. Arch Gen Psychiatry. 1990 Jan;47(1):55–59. doi: 10.1001/archpsyc.1990.01810130057008. [DOI] [PubMed] [Google Scholar]
- Englund E., Brun A. White matter changes in dementia of Alzheimer's type: the difference in vulnerability between cell compartments. Histopathology. 1990 May;16(5):433–439. doi: 10.1111/j.1365-2559.1990.tb01542.x. [DOI] [PubMed] [Google Scholar]
- Erkinjuntti T., Gao F., Lee D. H., Eliasziw M., Merskey H., Hachinski V. C. Lack of difference in brain hyperintensities between patients with early Alzheimer's disease and control subjects. Arch Neurol. 1994 Mar;51(3):260–268. doi: 10.1001/archneur.1994.00540150054016. [DOI] [PubMed] [Google Scholar]
- Ferrer I., Bella R., Serrano M. T., Martí E., Guionnet N. Arteriolosclerotic leucoencephalopathy in the elderly and its relation to white matter lesions in Binswanger's disease, multi-infarct encephalopathy and Alzheimer's disease. J Neurol Sci. 1990 Aug;98(1):37–50. doi: 10.1016/0022-510x(90)90180-u. [DOI] [PubMed] [Google Scholar]
- Fisher C. M. Binswanger's encephalopathy: a review. J Neurol. 1989 Feb;236(2):65–79. doi: 10.1007/BF00314400. [DOI] [PubMed] [Google Scholar]
- Hachinski V. C., Iliff L. D., Zilhka E., Du Boulay G. H., McAllister V. L., Marshall J., Russell R. W., Symon L. Cerebral blood flow in dementia. Arch Neurol. 1975 Sep;32(9):632–637. doi: 10.1001/archneur.1975.00490510088009. [DOI] [PubMed] [Google Scholar]
- Hachinski V. C., Potter P., Merskey H. Leuko-araiosis. Arch Neurol. 1987 Jan;44(1):21–23. doi: 10.1001/archneur.1987.00520130013009. [DOI] [PubMed] [Google Scholar]
- Kobari M., Meyer J. S., Ichijo M. Leuko-araiosis, cerebral atrophy, and cerebral perfusion in normal aging. Arch Neurol. 1990 Feb;47(2):161–165. doi: 10.1001/archneur.1990.00530020061017. [DOI] [PubMed] [Google Scholar]
- Kobari M., Meyer J. S., Ichijo M., Oravez W. T. Leukoaraiosis: correlation of MR and CT findings with blood flow, atrophy, and cognition. AJNR Am J Neuroradiol. 1990 Mar-Apr;11(2):273–281. [PMC free article] [PubMed] [Google Scholar]
- Kontsevoy V. A., Medvedev A. V., Vavilov S. B., Shchirina M. G. Clinico-tomographical aspects in the pathogenesis of vascular dementia. Int Psychogeriatr. 1992 Fall;4(2):223–230. doi: 10.1017/s1041610292001054. [DOI] [PubMed] [Google Scholar]
- Lopez O. L., Becker J. T., Rezek D., Wess J., Boller F., Reynolds C. F., 3rd, Panisset M. Neuropsychiatric correlates of cerebral white-matter radiolucencies in probable Alzheimer's disease. Arch Neurol. 1992 Aug;49(8):828–834. doi: 10.1001/archneur.1992.00530320052012. [DOI] [PubMed] [Google Scholar]
- Marini C., D'Andrea F., Serio A., Petruzzi C. Risk factors and clinical features of leukoaraiosis. Ital J Neurol Sci. 1991 Feb;12(1):123–123. doi: 10.1007/BF02337627. [DOI] [PubMed] [Google Scholar]
- Masdeu J. C., Wolfson L., Lantos G., Tobin J. N., Grober E., Whipple R., Amerman P. Brain white-matter changes in the elderly prone to falling. Arch Neurol. 1989 Dec;46(12):1292–1296. doi: 10.1001/archneur.1989.00520480034016. [DOI] [PubMed] [Google Scholar]
- McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan E. M. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul;34(7):939–944. doi: 10.1212/wnl.34.7.939. [DOI] [PubMed] [Google Scholar]
- Mirsen T. R., Lee D. H., Wong C. J., Diaz J. F., Fox A. J., Hachinski V. C., Merskey H. Clinical correlates of white-matter changes on magnetic resonance imaging scans of the brain. Arch Neurol. 1991 Oct;48(10):1015–1021. doi: 10.1001/archneur.1991.00530220031015. [DOI] [PubMed] [Google Scholar]
- Miyao S., Takano A., Teramoto J., Takahashi A. Leukoaraiosis in relation to prognosis for patients with lacunar infarction. Stroke. 1992 Oct;23(10):1434–1438. doi: 10.1161/01.str.23.10.1434. [DOI] [PubMed] [Google Scholar]
- Román G. C., Tatemichi T. K., Erkinjuntti T., Cummings J. L., Masdeu J. C., Garcia J. H., Amaducci L., Orgogozo J. M., Brun A., Hofman A. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology. 1993 Feb;43(2):250–260. doi: 10.1212/wnl.43.2.250. [DOI] [PubMed] [Google Scholar]
- Räihä I., Tarvonen S., Kurki T., Rajala T., Sourander L. Relationship between vascular factors and white matter low attenuation of the brain. Acta Neurol Scand. 1993 Apr;87(4):286–289. doi: 10.1111/j.1600-0404.1993.tb05509.x. [DOI] [PubMed] [Google Scholar]
- Skoog I., Palmertz B., Andreasson L. A. The prevalence of white-matter lesions on computed tomography of the brain in demented and nondemented 85-year-olds. J Geriatr Psychiatry Neurol. 1994 Jul-Sep;7(3):169–175. doi: 10.1177/089198879400700308. [DOI] [PubMed] [Google Scholar]
- Steingart A., Hachinski V. C., Lau C., Fox A. J., Diaz F., Cape R., Lee D., Inzitari D., Merskey H. Cognitive and neurologic findings in subjects with diffuse white matter lucencies on computed tomographic scan (leuko-araiosis). Arch Neurol. 1987 Jan;44(1):32–35. doi: 10.1001/archneur.1987.00520130024012. [DOI] [PubMed] [Google Scholar]
- Steingart A., Hachinski V. C., Lau C., Fox A. J., Fox H., Lee D., Inzitari D., Merskey H. Cognitive and neurologic findings in demented patients with diffuse white matter lucencies on computed tomographic scan (leuko-araiosis). Arch Neurol. 1987 Jan;44(1):36–39. doi: 10.1001/archneur.1987.00520130028013. [DOI] [PubMed] [Google Scholar]
- Wallin A., Blennow K. Pathogenetic basis of vascular dementia. Alzheimer Dis Assoc Disord. 1991 Summer;5(2):91–102. doi: 10.1097/00002093-199100520-00006. [DOI] [PubMed] [Google Scholar]