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Updated: Jun 18, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Cerebral white matter hyperintensities predict functional stroke outcome
Li-Min Liou1, Chien-Fu Chen, Yuh-Cherng Guo
1Department of Neurology, Kaohsiung Municipal Hsiaokang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
Background:
Growing evidence suggests that white matter hyperintensities (WMHs) are implicated in stroke recurrence and mortality, and their location can be a critical factor. This study evaluated the impact of periventricular WMHs (PVWMHs) and subcortical WMHs (SWMHs) on poststroke functional outcomes.
Methods:
Brain MRI was performed on 187 acute ischemic stroke patients (57.8% male; mean age = 64.3 years) recruited from the Kaohsiung Municipal Hsiao-Kang Hospital from February 2007 to January 2008. A Fazekas score >or=2 in the periventrcular or subcortical white matter was taken as presence of WMHs. Demographic data and risk factors for stroke were assessed. Functional stroke outcomes were evaluated 30 days after stroke using the Barthel Index (BI) and the modifiedRankin Scale (mRS).
Results:
WMHs were inversely linked to favorable functional outcome measured by mRS (p = 0.001) and BI (p = 0.003). Evaluating different locations, PVWMHs were associated with unfavorable functional outcomes (p = 0.002, mRS; p = 0.001, BI). SWMHs were related to mRS (p = 0.026) but not BI (p = 0.069). After controlling other stroke risk factors, infarct volumes and initial stroke severity, PVWMHs were a significant indicator for both mRS (OR = 2.76; 95% CI = 1.03-7.40) and BI (OR = 3.07; 95% CI = 1.13-8.40), but SWMHs were not.
Conclusions:
Unfavorable functional stroke outcome is associated with MRI WMHs. In terms of location, PVWMHs but not SWMHs are related to functional stroke outcome.
Insights
White matter hyperintensities (WMHs) impact stroke outcomes. Periventricular WMHs significantly predict poor functional recovery, while subcortical WMHs show a weaker association.
Area of Science:
- Neurology
- Radiology
- Stroke Medicine
Background:
- White matter hyperintensities (WMHs) are increasingly linked to stroke recurrence and mortality.
- The specific location of WMHs, whether periventricular (PVWMHs) or subcortical (SWMHs), may critically influence patient outcomes.
Purpose of the Study:
- To investigate the differential impact of PVWMHs and SWMHs on functional outcomes in patients following acute ischemic stroke.
Main Methods:
- 187 acute ischemic stroke patients underwent brain MRI.
- WMHs were identified using a Fazekas score ≥2.
- Functional outcomes were assessed at 30 days using the Barthel Index (BI) and modified Rankin Scale (mRS).
Main Results:
- WMHs showed an inverse correlation with favorable functional outcomes (mRS and BI).
- PVWMHs were significantly associated with unfavorable outcomes (p=0.002 for mRS, p=0.001 for BI).
- SWMHs correlated with mRS (p=0.026) but not BI (p=0.069). After adjustments, PVWMHs remained a significant predictor of poor outcomes.
Conclusions:
- MRI-detected WMHs are associated with unfavorable functional outcomes post-stroke.
- Periventricular WMHs, specifically, are a significant predictor of poorer functional outcomes, unlike subcortical WMHs.
