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Leukoaraiosis (also termed small vessel ischemic dis-ease [SVID] or vascular white matter disease) may be seen on brain CT and more commonly on MRI of the brain. Such lesions may be multifocal and progress to confluence over time. They show increasing prevalence with age, multiple vascular risk factors including emerging risk factors such as elevated homocysteine,1,2 and are associated with stroke and recurrent stroke.3 Leukoaraiosis is probably a different pathologic process from plain atrophy, lacunar infarct without white matter disease, and embolic infarction.4 A specific genetic profile may predispose to leukoaraiosis.5,6
There is a good correlation between brain imaging appearance and neuropathologic evidence of subcortical vascular disease.7 Repeated episodes of sublethal hypoperfusion lead to apoptosis of oligodendroglia with resultant ischemic demyelination.8,9 Venous collagenosis is seen.10 On imaging, these lesions are different from lacunes: they …
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