PT  - JOURNAL ARTICLE
AU  - Arsava, E. M.
AU  - Rahman, R.
AU  - Rosand, J.
AU  - Lu, J.
AU  - Smith, E. E.
AU  - Rost, N. S.
AU  - Singhal, A. B.
AU  - Lev, M. H.
AU  - Furie, K. L.
AU  - Koroshetz, W. J.
AU  - Sorensen, A. G.
AU  - Ay, H.
TI  - Severity of leukoaraiosis correlates with clinical outcome after ischemic stroke
AID  - 10.1212/WNL.0b013e3181a18823
DP  - 2009 Apr 21
TA  - Neurology
PG  - 1403--1410
VI  - 72
IP  - 16
4099  - http://n.neurology.org/content/72/16/1403.short
4100  - http://n.neurology.org/content/72/16/1403.full
SO  - Neurology2009 Apr 21; 72
AB  - Background: Leukoaraiosis (LA) is closely associated with aging, a major determinant of clinical outcome after ischemic stroke. In this study we sought to identify whether LA, independent of advancing age, affects outcome after acute ischemic stroke. Methods: LA volume was quantified in 240 patients with ischemic stroke and MRI within 24 hours of symptom onset. We explored the relationship between LA volume at admission and clinical outcome at 6 months, as assessed by the modified Rankin Scale (mRS). An ordinal logistic regression model was developed to analyze the independent effect of LA volume on clinical outcome. Results: Bivariate analyses showed a significant correlation between LA volume and mRS at 6 months (r = 0.19, p = 0.003). Mean mRS was 1.7 ± 1.8 among those in the lowest (≤1.2 mL) and 2.5 ± 1.9 in the highest (>9.9 mL) quartiles of LA volume (p = 0.01). The unfavorable prognostic effect of LA volume on clinical outcome was retained in the multivariable model (p = 0.002), which included age, gender, stroke risk factors (hypertension, diabetes mellitus, atrial fibrillation), previous history of brain infarction, admission plasma glucose level, admission NIH Stroke Scale score, IV rtPA treatment, and acute infarct volume on MRI as covariates. Conclusions: The volume of leukoaraiosis is a predictor of clinical outcome after ischemic stroke and this relationship persists after adjustment for important prognostic factors including age, initial stroke severity, and infarct volume. CCS=Causative Classification of Stroke; CE=cardioaortic embolism; CI=confidence interval; DWI=diffusion-weighted imaging; FLAIR=fluid-attenuated inversion recovery; IQR=interquartile range; LA=leukoaraiosis; LAA=large artery atherosclerosis; mRS=modified Rankin Scale; NIHSS=National Institute of Health Stroke Scale; OR=odds ratio; rtPA=recombinant tissue plasminogen activator; SAO=small artery occlusion; STOPStroke=Screening Technology and Outcome Project in Stroke Study; UND/UNC=undetermined/unclassified.