Department of Neurology, The Catholic University of Korea, Seoul St. Mary's Hospital, 505, Banpo-dong, Seocho-gu, Seoul 137-701, South Korea.
Arch Gerontol Geriatr. 2011 Sep-Oct;53(2):e129-32. doi: 10.1016/j.archger.2010.07.008. Epub 2010 Aug 30.
There is increasing evidence for an association between WMH and large-artery atherosclerosis. We evaluated 268 patients with acute ischemic stroke to assess the relationship between intracranial (IC) atherosclerosis and WMH. The patients were classified into three groups according to the location of the stenosis; IC, extracranial (EC), and non-stenosis (NS) group. WMH were rated using the semiquantitative method of Scheltens and coworkers. The IC group had significantly more WMH score in comparison with the other groups after controlling age. The linear regression analysis showed that age was the factor most strongly associated with the total score of WMH; and the location of stenosis was positively related to WMH, especially in deep white matter. Our data show that IC stenosis is associated with WMH, indicating that IC stenosis, rather than EC stenosis, is likely to cause white matter lesions. These findings raise the possibility that occlusion of penetrating arteries, embolism to border-zone areas and a hemodynamic mechanism associated with IC stenosis leads to the formation of white matter lesions.
越来越多的证据表明，脑白质病变（WMH）与大动脉粥样硬化之间存在关联。我们评估了 268 例急性缺血性脑卒中患者，以评估颅内（IC）动脉粥样硬化与 WMH 之间的关系。根据狭窄部位，患者被分为三组：IC 组、颅外（EC）组和非狭窄（NS）组。采用 Scheltens 及其同事的半定量方法对 WMH 进行评分。在控制年龄后，IC 组的 WMH 评分明显高于其他组。线性回归分析表明，年龄是与 WMH 总分相关性最强的因素；而狭窄的部位与 WMH 呈正相关，尤其是深部白质。我们的数据表明，IC 狭窄与 WMH 相关，这表明 IC 狭窄而不是 EC 狭窄可能导致白质病变。这些发现提示，穿透动脉闭塞、向边缘区栓塞以及与 IC 狭窄相关的血液动力学机制可能导致白质病变的形成。
