[Age-related white matter lesions (leukoaraiosis): an update]
Yukio Miki1, Shinichi Sakamoto
1Department of Radiology, Osaka City University Graduate School of Medicine, Japan.
Abstract:
Leukoaraiosis (age-related white matter hyperintensities) is the most frequently seen lesion on brain magnetic resonance (MR) images. This lesion is a subject of much current interest, because a number of multicenter studies have revealed that it is associated with various disturbances and poor prognoses. Leukoaraiosis corresponds to various pathologies, including demyelination, apoptosis, edema, dilated perivascular spaces, axonal damage, gliosis, and infarcts. Also noted in leukoaraiosis are changes in small vessels, such as fibrohyalinosis and venous collagenosis. The main cause of leukoaraiosis is thought to be chronic ischemia; other causes include edema and breakdown of the blood-brain barrier. Major risk factors for leukoaraiosis are age and hypertension. Disturbances that are related to leukoaraiosis include stroke, dementia, cognitive impairment, gait disturbance, fall, and depression. Leukoaraiosis is also a risk factor for death. Technologies, such as automatic volumetry, tissue segmentation, diffusion tensor imaging, magnetization tensor imaging, diffusion kurtosis imaging, and ultra-high field MR imaging may provide further insights into leukoaraiosis.
Insights
Leukoaraiosis, or age-related white matter hyperintensities, is a common finding on brain MRIs. It is linked to various health issues and poor outcomes, with age and hypertension as key risk factors.
Area of Science:
- Neurology
- Radiology
- Pathology
Context:
- Leukoaraiosis, characterized by age-related white matter hyperintensities, is frequently observed in brain MRI scans.
- It is associated with significant neurological disturbances and negative prognoses, prompting extensive research.
- Pathologies include demyelination, apoptosis, edema, axonal damage, gliosis, infarcts, and small vessel changes.
Purpose:
- To explore the underlying pathologies and causes of leukoaraiosis.
- To identify major risk factors and associated clinical disturbances.
- To highlight the role of advanced MR imaging techniques in understanding leukoaraiosis.
Summary:
- Leukoaraiosis involves diverse pathologies like demyelination, edema, and small vessel changes, primarily attributed to chronic ischemia.
- Key risk factors include advanced age and hypertension.
- Associated conditions encompass stroke, dementia, cognitive impairment, gait disturbances, falls, depression, and increased mortality risk.
Impact:
- Understanding leukoaraiosis is crucial for predicting and managing neurological disorders.
- Identifying risk factors like hypertension allows for targeted preventive strategies.
- Advanced MR imaging technologies offer promising avenues for deeper insights and improved diagnostics.
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