Factors associated with severity of leukoaraiosis in first-ever lacunar stroke and atherosclerotic ischemic stroke patients.

Abstract

BACKGROUND:

Leukoaraiosis (LA) is an indicator of small vessel disease, but little is known about the relationship between the severity of LA and etiologic subtype of ischemic stroke. Our study aimed to investigate the factors associated with the severity of LA and the relationship between the severity of LA and etiologic subtype of ischemic stroke.

METHODS:

A total of 791 patients with first-ever ischemic stroke within 7 days were enrolled in our study. We evaluated cranial magnetic resonance imagings including severity of LA in periventricular and deep white matter, severity of silent lacunar infarcts (SLIs), etiologic subtype of ischemic stroke, and topographic patterns of acute cerebral infarcts. Severity of LA was graded as grade 0 when Fazekas scores = 0, grade 1 when Fazekas scores ranged from 1 to 2, and grade 2 when Fazekas scores were greater than or equal to 3. Multivariable ordinal logistic regression was used to analyze the factors associated with the severity of LA.

RESULTS:

A total of 748 patients (94.6%) had LA, the numbers and proportions of grade 0, grade 1, and grade 2 LA were 43 patients (5.4%), 413 patients (52.2%), and 335 patients (42.4%), respectively. In multivariable ordinal logistic regression analysis, increasing age, higher diastolic blood pressure, admission National Institutes of Health Stroke Scale scores less than or equal to 3, presence of SLIs, and small artery occlusion (SAO) subtype of ischemic stroke were found to be independently associated with higher grade of LA.

CONCLUSIONS:

LA is prevalent in first-ever ischemic stroke patients. Severe LA is more frequently associated with higher grades of SLIs and ischemic stroke due to SAO.

• Authors: Changqing Zhang, Yilong Wang, Xingquan Zhao, Chunxue Wang, Liping Liu, Yuehua Pu, Xinying Zou, Yuesong Pan, Wanliang Du, Zixiao Li, Jing Jing, Dongxue Wang, Yang Luo, Ka Sing Wong, Yongjun Wang, Chinese IntraCranial AtheroSclerosis (CICAS) Study Group
• Journal: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (J Stroke Cerebrovasc Dis) 2014 Nov-Dec Vol. 23 Issue 10 Pg. 2862-2868 ISSN: 1532-8511 [Electronic] United States
• PMID: 25280817 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Brain Ischemia (diagnosis, etiology, mortality)
• Cerebral Angiography (methods)
• China (epidemiology)
• Female
• Humans
• Intracranial Arteriosclerosis (complications, diagnosis, mortality)
• Leukoaraiosis (complications, diagnosis, mortality)
• Logistic Models
• Magnetic Resonance Angiography
• Male
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Prevalence
• Prognosis
• Prospective Studies
• Risk Factors
• Severity of Illness Index
• Stroke (diagnosis, etiology, mortality)
• Stroke, Lacunar (diagnosis, etiology, mortality)