Studies Of Relationship About Asymmetric Leukoaraiosis

Background and ObjectiveLeukoaraiosis(LA) is a common imaging findings in the elderly, and mainly looks bilateralsymmetry change, but some studies shows us it exists asymmetry phenomenon. Lots of studieshave suggested that vascular risk factors such as hypertension, stroke, diabetes et.al wereclosely related with LA, But asymmetric LA and the relationship with various vascular riskfactors need to be researched. At present many reseschers have a thought that LA is brain smallvascular disease, whether the big vascular deseases are participate in the occurrence of LA ornot is still in dispute. My study has collected materials of the elder than 40years old patientshospitalized in the nerology department of the general hospatial of Beijing Amy Area, toanalysis the risk factor of asymmetric Leukoaraiosis(LA), and observe changes ofhemodynamic of all the patients with different degreeds LA, then to explore the pathogenesis ofLA.Methods268 consecutive patients elder than 40 years were consecutively included prospectively,analyze their clinical data respectively, all of them had accepted a Magnetic ResonanceImaging(MRI) and a Ultrasonic examination. The white matter hyperintensities(WMH) volumeof Fluid attenuated inversion recovery(FLAIR) were quantified with a semi-automated method,Leukoaraiosis patients with a ratio of WMH volumes in heavy side and in light side >1.5 wereconsidered as asymmetric LA, and numbers of lacunes were counted. Local factors wererecords for the analysis. All the pathiets have taken a Transcranial Doppler (TCD) examination,recording the average flow velocity (Vm) and pulse index (PI) of the middle cerebral artery(MCA ), anterior cerebral artery (ACA), internal carotid artery (ICA), posterior cerebral artery(PCA), vertebral artery (VA) and basilar artery (BSA). The SPSS 15.0 software were used forstatistical calculations, andα=0.05 .Results(1) The prevalence of asymmetric LA in the patients eledly 40 years hospitalized in thenerology department of the general hospatial of Beijing Amy Area is 11.94%, Binary Logisticregression analysis showed that age, history of hypertension, lacunar cerebral infarction,Carotid artery plaques/ stenosis were the independent risk factors of asymmetric LA.(2) The heave side of asymmetric LA has more lacunar infaction, higher Crouse scale thanlight side. TCD results shows us heavy side MCA, ICA, ACA's Vm were slower than lighterside; The comparation of PCA, VA'Vm between the two sides is not significant difference in asymmetric LA. But the pulse index(PI) for the high side were higher than the light side in bothformer and posterior circulation.(3) Compared with symmetry LA pathents, the one with asymmetry LA whose averag age isyounger, their mumbers with hypertension, diabetes, carotid plaques or narrow, cerebralinfarction/TIA history was more, as the mean, their diastolic blood pressure and Crouse scoreswere higher.(4) LA patients with smoking history, hypertension, diabetes, carotid plaques or narrow,cerebral infarction/TIA history were obviously more than non-LA patients; Compared with thenon-LA, the Vm of bilateral MCA, ICA, ACA in LA patients were slower down, But PI wascommon higher. Followed the degree mild, moderate or severe heavyer, the Vm of MCA,ICA ,ACA in the same side were slower down and PI were higher. But the comparation betweenposterior circulation of both sides was no statistically significance.ConclusionConclusions(1) The prevalence of asymmetric LA in the patients eledly 40 years hospitalized in thenerology department of the general hospatial of Beijing Amy Area is 11.94%. age, history ofhypertension, lacunar cerebral infarction, Carotid artery plaques/ stenosis were the independentrisk factors of asymmetric LA. lacunar infarction and carotid artery disease is closely relatedwith asymmetric LA, they are possibly the local factors in the developing of LA.(2) The patients with LA suffers a chronic ischemia, and positively related with the degreeofLA, while they has the brain small vesell disease(SVD) wildely.(3) SVDs and carotid artery diseases are all participate in the developing of LA.