White matter changes in stroke patients. Relationship with stroke subtype and outcome

Didier Leys*, Elisabet Englund, Theodoro Del Ser, Domenico Inzitari, Franz Fazekas, Natan Bornstein, Timo Erkinjuntti, John V. Bowler, Leonardo Pantoni, Lucilla Parnetti, Jacques De Reuck, José Ferro, Julien Bogousslavsky

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


White matter changes (WMC), detected by imaging techniques, are frequent in stroke patients. The aim of the study was to determine how WMC relate to stroke subtypes and to stroke outcome. We made a systematic Medline search for articles appearing with two of the following key words: either 'WMC or white matter lesions or leukoencephalopathy or leukoaraiosis' and 'stroke or cerebral infarct or cerebral hemorrhage or cerebrovascular disease or transient ischemic attack (TIA)'. WMC, as defined radiologically, are present in up to 44% of patients with stroke or TIA and in 50% of patients with vascular dementia. WMC are more frequent in patients with lacunar infarcts, deep intracerebral hemorrhages, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy and cerebral amyloid angiopathy. After an acute ischemic stroke, WMC are associated with a higher risk of death or dependency, recurrent stroke of any type, cerebral bleeding under anticoagulation, myocardial infarction, and poststroke dementia. WMC in stroke patients are often associated with small-vessel disease and lead to a higher risk of death, and poor cardiac and neurological outcome. However, several questions remain open and need further investigations.

Original languageEnglish
Pages (from-to)67-75
Number of pages9
JournalEuropean Neurology
Issue number2
StatePublished - Aug 1999


  • Cerebral hemorrhage
  • Cerebral infarct
  • Leukoaraiosis
  • Leukoencephalopathy
  • Stroke
  • Stroke outcome
  • Stroke subtype
  • Transient ischemic attack
  • Vascular dementia
  • White matter


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