Axial T2 FLAIR sequence MR image of a middle-aged man with leukoaraiosis.
MRI image: Leukoaraiosis in a 90 year old patient with cerebral atrophy.
Leukoaraiosis or white matter hyperintensities (WMHs) describes the nonspecific changes in the cerebral white matter frequently seen on CT and MRI in aged individuals and even young adults sometimes. It is a condition routinely found in elderly people.
The term leukoaraiosis was coined in 1986 as a descriptive term for rarefaction ("araiosis") of the white matter, showing up as decreased density on CT and increased signal intensity on T2/FLAIR sequences (white matter hyperintensities) performed as part of MRI brain scans.
These white matter changes are also commonly referred to as periventricular white matter disease, or white matter hyperintensities (WMH) due to their bright white appearance on T2 MRI scans. Many patients can have leukoaraiosis without any associated clinical abnormality. However, underlying vascular mechanisms are suspected to be the cause of the imaging findings. Hypertension, smoking, diabetes, hyperhomocysteinemia, and heart disease are all risk factors for leukoaraiosis.
The abnormalities are thought to be caused by multiple small vessel infarcts in the subcortical white matter, often the result of chronic hypertension leading to lipohyalinosis of the small vessels. Patients may develop subcortical dementia syndrome.
Leukoaraiosis has been reported to be an initial stage of Binswanger's disease but this evolution does not always happen.
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