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Leukoencephalopathy in patients with ischemic stroke.

J Bogousslavsky, F Regli, A Uske

    Stroke
    |September 1, 1987
    PubMed
    Summary

    Leukoencephalopathy, a white matter change, is common in ischemic stroke patients, especially with deep infarcts. Hypertension is a key risk factor, suggesting it

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    Area of Science:

    • Neurology
    • Radiology
    • Vascular Medicine

    Background:

    • Leukoencephalopathy, characterized by diffuse white matter hypodensity on CT, is observed in ischemic stroke patients.
    • This condition is more prevalent in patients with deep cerebral infarcts compared to cortical infarcts.

    Purpose of the Study:

    • To investigate the prevalence and clinical associations of leukoencephalopathy in acute ischemic stroke patients.
    • To determine the relationship between leukoencephalopathy, infarct topography, cognitive impairment, and vascular risk factors.

    Main Methods:

    • Systematic investigation of 1,000 ischemic stroke patients using computed tomography (CT), Doppler, electrocardiography (ECG), and biological tests.
    • Comparison of patients with leukoencephalopathy to matched controls without leukoencephalopathy.
    • Assessment of cognitive function and vascular risk factors including hypertension, carotid artery stenosis, diabetes, and hypercholesterolemia.

    Main Results:

    • Leukoencephalopathy was identified in 3.1% of ischemic stroke patients, significantly more frequent in those with deep infarcts (8%) than cortical infarcts (0.8%).
    • Patients with leukoencephalopathy exhibited higher rates of progressive intellectual impairment and dementia compared to controls.
    • Hypertension was the most common risk factor and was more frequent in patients with leukoencephalopathy; conversely, carotid artery stenosis was less frequent.

    Conclusions:

    • Leukoencephalopathy in acute stroke patients is not a coincidental finding and is strongly associated with hypertension.
    • Hypertension appears to be more closely linked to leukoencephalopathy than to deep infarcts.
    • The presence of leukoencephalopathy warrants further investigation into underlying vascular risk factors, particularly hypertension.

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