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<meta name="DC.Language" content="en" />
<meta name="DC.Title" content="Severity of Leukoaraiosis in Large Vessel Atherosclerotic Disease" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3015" />
<meta name="DC.Date" content="2012-09-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2012 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The severity of white matter hyperintensity, or leukoaraiosis, is a marker of cerebrovascular disease. In stroke, WMH burden is strongly linked to lacunar infarction; however, impaired cerebral perfusion due to extracranial or intracranial atherosclerosis may also contribute to WMH burden. We sought to determine whether WMH burden is associated with extracranial or intracranial stenosis in patients with AIS.

MATERIALS AND METHODS: Patients with AIS with admission head/neck CTA and brain MR imaging were included in this analysis. “Extracranial stenosis” was defined as &gt;50% stenosis in the extracranial ICA, and “intracranial,” as &gt;50% stenosis in either the middle, anterior, or posterior cerebral arteries on CTA, on either side. WMHV was determined by using a validated semiautomated protocol. Multiple regression was used to assess the relationship between WMHV and extracranial/intracranial atherosclerosis.

RESULTS: Of 201 subjects, 51 (25.4%) had extracranial and 63 (31.5%) had intracranial stenosis. Mean age was 62 ± 15 years; 36% were women. Mean WMHV was 12.87 cm3 in the extracranial and 8.59 cm3 in the intracranial stenosis groups. In univariate analysis, age ( P &lt; .0001), SBP and DBP ( P = .004), and HTN ( P = .0003) were associated with WMHV. Extracranial stenosis was associated with greater WMHV after adjustment for intracranial stenosis ( P = .04). In multivariate analysis including extracranial stenosis, only age ( P &lt; .0001) and HTN ( P = .03) demonstrated independent effects on WMHV.

CONCLUSIONS: In our cohort of patients with AIS, age and HTN were the strongest determinants of the WMHV severity. Future studies are warranted to unravel further association between WMHV and cerebral vessel atherosclerosis.

AF
:   atrial fibrillation
AIS
:   acute ischemic stroke
CAD
:   coronary artery disease
DBP
:   diastolic blood pressure
DM
:   iabetes mellitus
HTN
:   hypertension
IQR
:   interquartile range
lnWMHV
:   natural logarithm-transformed white matter hyperintensity volume
SBP
:   systolic blood pressure
TOAST
:   Trial of Org 10172 in Acute Stroke Treatment
WMH
:   white matter hyperintensity
WMHV
:   white matter hyperintensity volume" />
<meta name="DC.Contributor" content="A. Chutinet" />
<meta name="DC.Contributor" content="A. Biffi" />
<meta name="DC.Contributor" content="A. Kanakis" />
<meta name="DC.Contributor" content="K.M. Fitzpatrick" />
<meta name="DC.Contributor" content="K.L. Furie" />
<meta name="DC.Contributor" content="N.S. Rost" />
<meta name="article:published_time" content="2012-09-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="Severity of Leukoaraiosis in Large Vessel Atherosclerotic Disease" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The severity of white matter hyperintensity, or leukoaraiosis, is a marker of cerebrovascular disease. In stroke, WMH burden is strongly linked to lacunar infarction; however, impaired cerebral perfusion due to extracranial or intracranial atherosclerosis may also contribute to WMH burden. We sought to determine whether WMH burden is associated with extracranial or intracranial stenosis in patients with AIS.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Patients with AIS with admission head/neck CTA and brain MR imaging were included in this analysis. “Extracranial stenosis” was defined as &amp;gt;50% stenosis in the extracranial ICA, and “intracranial,” as &amp;gt;50% stenosis in either the middle, anterior, or posterior cerebral arteries on CTA, on either side. WMHV was determined by using a validated semiautomated protocol. Multiple regression was used to assess the relationship between WMHV and extracranial/intracranial atherosclerosis.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Of 201 subjects, 51 (25.4%) had extracranial and 63 (31.5%) had intracranial stenosis. Mean age was 62 ± 15 years; 36% were women. Mean WMHV was 12.87 cm&lt;sup&gt;3&lt;/sup&gt; in the extracranial and 8.59 cm&lt;sup&gt;3&lt;/sup&gt; in the intracranial stenosis groups. In univariate analysis, age (&lt;i&gt;P&lt;/i&gt; &amp;lt; .0001), SBP and DBP (&lt;i&gt;P&lt;/i&gt; = .004), and HTN (&lt;i&gt;P&lt;/i&gt; = .0003) were associated with WMHV. Extracranial stenosis was associated with greater WMHV after adjustment for intracranial stenosis (&lt;i&gt;P&lt;/i&gt; = .04). In multivariate analysis including extracranial stenosis, only age (&lt;i&gt;P&lt;/i&gt; &amp;lt; .0001) and HTN (&lt;i&gt;P&lt;/i&gt; = .03) demonstrated independent effects on WMHV.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In our cohort of patients with AIS, age and HTN were the strongest determinants of the WMHV severity. Future studies are warranted to unravel further association between WMHV and cerebral vessel atherosclerosis.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2012/09/01" />
<meta name="citation_mjid" content="ajnr;33/8/1591" />
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<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A3015" />
<meta name="citation_pmid" content="22422177" />
<meta name="citation_volume" content="33" />
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<meta name="citation_firstpage" content="1591" />
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<meta name="citation_author" content="A. Chutinet" />
<meta name="citation_author_institution" content="aFrom the J. Philip Kistler Stroke Research Center (A.C., A.B., A.K., K.M.F., K.L.F., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts" />
<meta name="citation_author_institution" content="bDivision of Neurology (A.C.), Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand." />
<meta name="citation_author" content="A. Biffi" />
<meta name="citation_author_institution" content="aFrom the J. Philip Kistler Stroke Research Center (A.C., A.B., A.K., K.M.F., K.L.F., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts" />
<meta name="citation_author" content="A. Kanakis" />
<meta name="citation_author_institution" content="aFrom the J. Philip Kistler Stroke Research Center (A.C., A.B., A.K., K.M.F., K.L.F., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts" />
<meta name="citation_author" content="K.M. Fitzpatrick" />
<meta name="citation_author_institution" content="aFrom the J. Philip Kistler Stroke Research Center (A.C., A.B., A.K., K.M.F., K.L.F., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts" />
<meta name="citation_author" content="K.L. Furie" />
<meta name="citation_author_institution" content="aFrom the J. Philip Kistler Stroke Research Center (A.C., A.B., A.K., K.M.F., K.L.F., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts" />
<meta name="citation_author" content="N.S. Rost" />
<meta name="citation_author_institution" content="aFrom the J. Philip Kistler Stroke Research Center (A.C., A.B., A.K., K.M.F., K.L.F., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_author=H. Ay;citation_author=EM. Arsava;citation_author=J. Rosand;citation_title=Severity of leukoaraiosis and susceptibility to infarct growth in acute stroke;citation_volume=39;citation_year=2008;citation_pmid=18340093;citation_doi=10.1161/STROKEAHA.107.501932" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_author=B. Kissela;citation_author=CJ. Lindsell;citation_author=D. Kleindorfer;citation_title=Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race;citation_volume=40;citation_year=2009;citation_pmid=19109548;citation_doi=10.1161/STROKEAHA.108.521906" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=EM. Arsava;citation_author=R. Rahman;citation_author=J. Rosand;citation_title=Severity of leukoaraiosis correlates with clinical outcome after ischemic stroke;citation_pages=1403-1410;citation_volume=72;citation_year=2009;citation_issue=16;citation_issn=0028-3878;citation_pmid=19380699;citation_doi=10.1212/WNL.0b013e3181a18823" />
<meta name="citation_reference" content="citation_journal_title=Annals of neurology;citation_journal_abbrev=Ann Neurol;citation_author=JC. van Swieten;citation_author=LJ. Kappelle;citation_author=A. Algra;citation_title=Hypodensity of the cerebral white matter in patients with transient ischemic attack or minor stroke: influence on the rate of subsequent stroke. Dutch TIA Trial Study Group.;citation_pages=177-183;citation_volume=32;citation_year=1992;citation_issue=2;citation_pmid=1510358;citation_doi=10.1002/ana.410320209" />
<meta name="citation_reference" content="citation_journal_title=European neurology;citation_journal_abbrev=Eur Neurol;citation_author=D. Leys;citation_author=E. Englund;citation_author=T. Del Ser;citation_title=White matter changes in stroke patients. Relationship with stroke subtype and outcome.;citation_pages=67-75;citation_volume=42;citation_year=1999;citation_issue=2;citation_pmid=10473977;citation_doi=10.1159/000069414" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_journal_abbrev=Stroke;citation_author=A. Hijdra;citation_author=B. Verbeeten;citation_author=JA. Verhulst;citation_title=Relation of leukoaraiosis to lesion type in stroke patients;citation_pages=890-894;citation_volume=21;citation_year=1990;citation_issue=6;citation_issn=0039-2499;citation_pmid=2349592" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=NS. Rost;citation_author=RM. Rahman;citation_author=A. Biffi;citation_title=White matter hyperintensity volume is increased in small vessel stroke subtypes;citation_pages=1670-1677;citation_volume=75;citation_year=2010;citation_issue=19;citation_issn=0028-3878;citation_pmid=21060091;citation_doi=10.1212/WNL.0b013e3181fc279a" />
<meta name="citation_reference" content="citation_journal_title=Lancet;citation_journal_abbrev=Lancet;citation_author=ML. Bots;citation_author=JC. van Swieten;citation_author=MM. Breteler;citation_title=Cerebral white matter lesions and atherosclerosis in the Rotterdam Study.;citation_pages=1232-1237;citation_volume=341;citation_year=1993;citation_issue=8855;citation_pmid=8098390;citation_doi=10.1016/0140-6736(93)91144-B" />
<meta name="citation_reference" content="citation_journal_title=Archives of Neurology;citation_journal_abbrev=Arch Neurol;citation_author=JY. Streifler;citation_author=M. Eliasziw;citation_author=OR. Benavente;citation_title=Lack of Relationship Between Leukoaraiosis and Carotid Artery Disease;citation_pages=21-24;citation_volume=52;citation_year=1995;citation_issue=1;citation_issn=0003-9942;citation_pmid=7826271;citation_doi=10.1001/archneur.1995.00540250025008" />
<meta name="citation_reference" content="citation_journal_title=J Neurol;citation_author=FE. de Leeuw;citation_author=JC. de Groot;citation_author=ML. Bots;citation_title=Carotid atherosclerosis and cerebral white matter lesions in a population based magnetic resonance imaging study;citation_pages=2919-26;citation_volume=247;citation_year=2000" />
<meta name="citation_reference" content="citation_journal_title=Cerebrovascular diseases (Basel, Switzerland);citation_journal_abbrev=Cerebrovasc Dis;citation_author=F. Pico;citation_author=C. Dufouil;citation_author=C. Levy;citation_title=Longitudinal study of carotid atherosclerosis and white matter hyperintensities: the EVA-MRI cohort.;citation_pages=109-115;citation_volume=14;citation_year=2002;citation_issue=2;citation_pmid=12187015;citation_doi=10.1159/000064741" />
<meta name="citation_reference" content="citation_journal_title=BMC neurology [electronic resource];citation_journal_abbrev=BMC Neurol;citation_author=SJ. Lee;citation_author=JS. Kim;citation_author=KS. Lee;citation_title=The leukoaraiosis is more prevalent in the large artery atherosclerosis stroke subtype among Korean patients with ischemic stroke.;citation_pages=31-31;citation_volume=8;citation_year=2008;citation_pmid=18687146;citation_doi=10.1186/1471-2377-8-31" />
<meta name="citation_reference" content="citation_journal_title=Archives of gerontology and geriatrics;citation_journal_abbrev=Arch Gerontol Geriatr;citation_author=SJ. Lee;citation_author=JS. Kim;citation_author=SW. Chung;citation_title=White matter hyperintensities (WMH) are associated with intracranial atherosclerosis rather than extracranial atherosclerosis.;citation_pages=e129-e132;citation_volume=53;citation_year=2011;citation_issue=2;citation_pmid=20800910;citation_doi=10.1016/j.archger.2010.07.008" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_author=J. Jimenez-Conde;citation_author=A. Biffi;citation_author=R. Rahman;citation_title=Hyperlipidemia and reduced white matter hyperintensity volume in patients with ischemic stroke;citation_volume=41;citation_year=2010;citation_pmid=20133919;citation_doi=10.1161/STROKEAHA.109.563502" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_journal_abbrev=Stroke;citation_author=HP. Adams;citation_author=BH. Bendixen;citation_author=LJ. Kappelle;citation_title=Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment;citation_pages=35-41;citation_volume=24;citation_year=1993;citation_issue=1;citation_issn=0039-2499;citation_pmid=7678184;citation_doi=10.1161/01.STR.24.1.35" />
<meta name="citation_reference" content="citation_journal_title=Vascular Medicine;citation_journal_abbrev=Vasc Med;citation_author=TG. Brott;citation_author=JL. Halperin;citation_author=S. Abbara;citation_title=2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/ SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease: Executive Summary;citation_pages=35-77;citation_volume=16;citation_year=2011;citation_issue=1;citation_issn=1358-863X;citation_pmid=21471149;citation_doi=10.1177/1358863X11399328" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=EE. Smith;citation_author=ME. Gurol;citation_author=JA. Eng;citation_title=White matter lesions, cognition, and recurrent hemorrhage in lobar intracerebral hemorrhage;citation_pages=1606-1612;citation_volume=63;citation_year=2004;citation_issue=9;citation_issn=0028-3878;citation_pmid=15534243" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=ME. Gurol;citation_author=MC. Irizarry;citation_author=EE. Smith;citation_title=Plasma {beta}-amyloid and white matter lesions in AD, MCI, and cerebral amyloid angiopathy;citation_pages=23-29;citation_volume=66;citation_year=2006;citation_issue=1;citation_issn=0028-3878;citation_pmid=16401840;citation_doi=10.1212/01.wnl.0000191403.95453.6a" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=YW. Chen;citation_author=ME. Gurol;citation_author=J. Rosand;citation_title=Progression of white matter lesions and hemorrhages in cerebral amyloid angiopathy.;citation_pages=83-87;citation_volume=67;citation_year=2006;citation_issue=1;citation_issn=0028-3878;citation_pmid=16832082;citation_doi=10.1212/01.wnl.0000223613.57229.24" />
<meta name="citation_reference" content="citation_journal_title=Journal of Neuroimaging;citation_journal_abbrev=J Neuroimaging;citation_author=RN. Nandigam;citation_author=YW. Chen;citation_author=ME. Gurol;citation_title=Validation of intracranial area as a surrogate measure of intracranial volume when using clinical MRI.;citation_pages=74-77;citation_volume=17;citation_year=2007;citation_issue=1;citation_issn=1051-2284;citation_pmid=17238873" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=MM. Breteler;citation_author=JC. van Swieten;citation_author=ML. Bots;citation_title=Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study: The Rotterdam Study;citation_pages=1246-1246;citation_volume=44;citation_year=1994;citation_issue=7;citation_issn=0028-3878;citation_pmid=8035924" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_journal_abbrev=Stroke;citation_author=TA. Manolio;citation_author=RA. Kronmal;citation_author=GL. Burke;citation_title=Magnetic resonance abnormalities and cardiovascular disease in older adults. The Cardiovascular Health Study;citation_pages=318-327;citation_volume=25;citation_year=1994;citation_issue=2;citation_issn=0039-2499;citation_pmid=8303738;citation_doi=10.1161/01.STR.25.2.318" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_journal_abbrev=Stroke;citation_author=WT. Longstreth;citation_author=TA. Manolio;citation_author=A. Arnold;citation_title=Clinical Correlates of White Matter Findings on Cranial Magnetic Resonance Imaging of 3301 Elderly People: The Cardiovascular Health Study;citation_pages=1274-1282;citation_volume=27;citation_year=1996;citation_issue=8;citation_issn=0039-2499;citation_pmid=8711786;citation_doi=10.1161/01.STR.27.8.1274" />
<meta name="citation_reference" content="citation_journal_title=JAMA;citation_journal_abbrev=JAMA;citation_author=TY. Wong;citation_author=R. Klein;citation_author=AR. Sharrett;citation_title=Cerebral White Matter Lesions, Retinopathy, and Incident Clinical Stroke;citation_pages=67-74;citation_volume=288;citation_year=2002;citation_issue=1;citation_issn=0002-9955;citation_pmid=12090864;citation_doi=10.1001/jama.288.1.67" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_author=T. Jeerakathil;citation_author=PA. Wolf;citation_author=A. Beiser;citation_title=Stroke risk profile predicts white matter hyperintensity volume: the Framingham Study;citation_volume=35;citation_year=2004;citation_pmid=15218158;citation_doi=10.1161/01.STR.0000135226.53499.85" />
<meta name="citation_reference" content="citation_journal_abbrev=J Stroke Cerebrovasc Dis;citation_author=NS. Rost;citation_author=R. Rahman;citation_author=S. Sonni;citation_title=Determinants of white matter hyperintensity volume in patients with acute ischemic stroke.;citation_pages=230-235;citation_volume=19;citation_year=2010;citation_issue=3;citation_pmid=20434052;citation_doi=10.1016/j.jstrokecerebrovasdis.2009.05.007" />
<meta name="citation_reference" content="citation_journal_title=Acta neurologica Scandinavica;citation_journal_abbrev=Acta Neurol Scand;citation_author=E. Auriel;citation_author=NM. Bornstein;citation_author=E. Berenyi;citation_title=Clinical, radiological and pathological correlates of leukoaraiosis.;citation_pages=41-47;citation_volume=123;citation_year=2011;citation_issue=1;citation_pmid=20219022;citation_doi=10.1111/j.1600-0404.2010.01341.x" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=D. Leifer;citation_author=FS. Buonanno;citation_author=EP. Richardson;citation_title=Clinicopathologic correlations of cranial magnetic resonance imaging of periventricular white matter;citation_pages=911-911;citation_volume=40;citation_year=1990;citation_issue=6;citation_issn=0028-3878;citation_pmid=2345614" />
<meta name="citation_reference" content="citation_journal_title=Brain;citation_journal_abbrev=Brain;citation_author=JC. van Swieten;citation_author=JH. van den Hout;citation_author=BA. van Ketel;citation_title=PERIVENTRICULAR LESIONS IN THE WHITE MATTER ON MAGNETIC RESONANCE IMAGING IN THE ELDERLY: A MORPHOMETRIC CORRELATION WITH ARTERIOLOSCLEROSIS AND DILATED PERIVASCULAR SPACES;citation_pages=761-774;citation_volume=114;citation_year=1991;citation_issue=2;citation_issn=0006-8950;citation_pmid=2043948;citation_doi=10.1093/brain/114.2.761" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=F. Fazekas;citation_author=R. Kleinert;citation_author=H. Offenbacher;citation_title=Pathologic correlates of incidental MRI white matter signal hyperintensities;citation_pages=1683-1683;citation_volume=43;citation_year=1993;citation_issue=9;citation_issn=0028-3878;citation_pmid=8414012;citation_doi=10.1212/WNL.43.9.1683" />
<meta name="citation_reference" content="citation_journal_title=Clinical neurosurgery;citation_journal_abbrev=Clin Neurosurg;citation_author=DM. Moody;citation_author=WP. Santamore;citation_author=MA. Bell;citation_title=Does tortuosity in cerebral arterioles impair down-autoregulation in hypertensives and elderly normotensives? A hypothesis and computer model.;citation_pages=372-387;citation_volume=37;citation_year=1991;citation_pmid=2009699" />
<meta name="citation_reference" content="citation_journal_title=Journal of neuropathology and experimental neurology;citation_journal_abbrev=J Neuropathol Exp Neurol;citation_author=KM. Spangler;citation_author=VR. Challa;citation_author=DM. Moody;citation_title=Arteriolar tortuosity of the white matter in aging and hypertension. A microradiographic study.;citation_pages=22-26;citation_volume=53;citation_year=1994;citation_issue=1;citation_pmid=8301316" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_journal_abbrev=Stroke;citation_author=L. Pantoni;citation_author=JH. Garcia;citation_title=Pathogenesis of Leukoaraiosis : A Review;citation_pages=652-659;citation_volume=28;citation_year=1997;citation_issue=3;citation_issn=0039-2499;citation_pmid=9056627;citation_doi=10.1161/01.STR.28.3.652" />
<meta name="citation_reference" content="citation_journal_title=European neurology;citation_journal_abbrev=Eur Neurol;citation_author=J. De Reuck;citation_title=The human periventricular arterial blood supply and the anatomy of cerebral infarctions.;citation_pages=321-334;citation_volume=5;citation_year=1971;citation_issue=6;citation_pmid=5141149" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_journal_abbrev=Stroke;citation_author=J. Bogousslavsky;citation_author=F. Regli;citation_author=A. Uske;citation_title=Leukoencephalopathy in patients with ischemic stroke;citation_pages=896-899;citation_volume=18;citation_year=1987;citation_issue=5;citation_issn=0039-2499;citation_pmid=3629648" />
<meta name="citation_reference" content="citation_journal_title=Neurological research;citation_journal_abbrev=Neurol Res;citation_author=Y. Pu;citation_author=L. Liu;citation_author=X. Zou;citation_title=Relationship between leukoaraiosis and cerebral large artery stenosis.;citation_pages=376-380;citation_volume=31;citation_year=2009;citation_issue=4;citation_pmid=19508822;citation_doi=10.1179/174313209X444071" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_journal_abbrev=Stroke;citation_author=D. Liao;citation_author=L. Cooper;citation_author=J. Cai;citation_title=Presence and Severity of Cerebral White Matter Lesions and Hypertension, Its Treatment, and Its Control: The ARIC Study;citation_pages=2262-2270;citation_volume=27;citation_year=1996;citation_issue=12;citation_issn=0039-2499;citation_pmid=8969791;citation_doi=10.1161/01.STR.27.12.2262" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=C. Dufouil;citation_author=A. de Kersaint-Gilly;citation_author=V. Besancon;citation_title=Longitudinal study of blood pressure and white matter hyperintensities: The EVA MRI Cohort;citation_pages=921-926;citation_volume=56;citation_year=2001;citation_issue=7;citation_issn=0028-3878;citation_pmid=11294930" />
<meta name="citation_reference" content="citation_journal_title=Advances in neurology;citation_journal_abbrev=Adv Neurol;citation_author=PT. Ostrow;citation_author=LL. Miller;citation_title=Pathology of small artery disease.;citation_pages=93-123;citation_volume=62;citation_year=1993;citation_pmid=8517214" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=E. Feldmann;citation_author=N. Daneault;citation_author=E. Kwan;citation_title=Chinese-white differences in the distribution of occlusive cerebrovascular disease;citation_pages=1541-1545;citation_volume=40;citation_year=1990;citation_issue=10;citation_issn=0028-3878;citation_pmid=2215945" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_journal_abbrev=Stroke;citation_author=RJ. Wityk;citation_author=D. Lehman;citation_author=M. Klag;citation_title=Race and Sex Differences in the Distribution of Cerebral Atherosclerosis;citation_pages=1974-1980;citation_volume=27;citation_year=1996;citation_issue=11;citation_issn=0039-2499;citation_pmid=8898801" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_journal_abbrev=Stroke;citation_author=M. Yasaka;citation_author=T. Yamaguchi;citation_author=M. Shichiri;citation_title=Distribution of atherosclerosis and risk factors in atherothrombotic occlusion;citation_pages=206-211;citation_volume=24;citation_year=1993;citation_issue=2;citation_issn=0039-2499;citation_pmid=8421820" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=KS. Wong;citation_author=YN. Huang;citation_author=S. Gao;citation_title=Intracranial stenosis in Chinese patients with acute stroke;citation_pages=812-813;citation_volume=50;citation_year=1998;citation_issue=3;citation_issn=0028-3878;citation_pmid=9521286" />
<meta name="citation_reference" content="citation_journal_title=Journal of clinical neuroscience :  official journal of the Neurosurgical Society of Australasia;citation_journal_abbrev=J Clin Neurosci;citation_author=H. Li;citation_author=KS. Wong;citation_title=Racial distribution of intracranial and extracranial atherosclerosis.;citation_pages=30-34;citation_volume=10;citation_year=2003;citation_issue=1;citation_pmid=12464517;citation_doi=10.1016/S0967-5868(02)00264-3" />
<meta name="citation_reference" content="citation_journal_title=European journal of vascular and endovascular surgery :  the official journal of the European Society for Vascular Surgery;citation_journal_abbrev=Eur J Vasc Endovasc Surg;citation_author=N. Altaf;citation_author=L. Daniels;citation_author=PS. Morgan;citation_title=Cerebral white matter hyperintense lesions are associated with unstable carotid plaques.;citation_pages=8-13;citation_volume=31;citation_year=2006;citation_issue=1;citation_pmid=16226900;citation_doi=10.1016/j.ejvs.2005.08.026" />
<meta name="citation_reference" content="citation_journal_title=Circulation;citation_journal_abbrev=Circulation;citation_author=HC. Stary;citation_author=AB. Chandler;citation_author=RE. Dinsmore;citation_title=A Definition of Advanced Types of Atherosclerotic Lesions and a Histological Classification of Atherosclerosis : A Report From the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association;citation_pages=1355-1374;citation_volume=92;citation_year=1995;citation_issue=5;citation_issn=0009-7322;citation_pmid=7648691;citation_doi=10.1161/01.CIR.92.5.1355" />
<meta name="citation_reference" content="citation_journal_title=American Journal of Neuroradiology;citation_journal_abbrev=Am. J. Neuroradiol.;citation_author=S. Bash;citation_author=JP. Villablanca;citation_author=R. Jahan;citation_title=Intracranial Vascular Stenosis and Occlusive Disease: Evaluation with CT Angiography, MR Angiography, and Digital Subtraction Angiography;citation_pages=1012-1021;citation_volume=26;citation_year=2005;citation_issue=5;citation_issn=0195-6108;citation_pmid=15891154" />
<meta name="citation_fulltext_world_readable" content="" />
<meta name="twitter:title" content="Severity of Leukoaraiosis in Large Vessel Atherosclerotic Disease" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/33/8.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The severity of white matter hyperintensity, or leukoaraiosis, is a marker of cerebrovascular disease. In stroke, WMH burden is strongly linked to lacunar infarction; however, impaired cerebral perfusion due to extracranial or intracranial atherosclerosis may also contribute to WMH burden. We sought to determine whether WMH burden is associated with extracranial or intracranial stenosis in patients with AIS.

MATERIALS AND METHODS: Patients with AIS with admission head/neck CTA and brain MR imaging were included in this analysis. “Extracranial stenosis” was defined as &gt;50% stenosis in the extracranial ICA, and “intracranial,” as &gt;50% stenosis in either the middle, anterior, or posterior cerebral arteries on CTA, on either side. WMHV was determined by using a validated semiautomated protocol. Multiple regression was used to assess the relationship between WMHV and extracranial/intracranial atherosclerosis.

RESULTS: Of 201 subjects, 51 (25.4%) had extracranial and 63 (31.5%) had intracranial stenosis. Mean age was 62 ± 15 years; 36% were women. Mean WMHV was 12.87 cm3 in the extracranial and 8.59 cm3 in the intracranial stenosis groups. In univariate analysis, age ( P &lt; .0001), SBP and DBP ( P = .004), and HTN ( P = .0003) were associated with WMHV. Extracranial stenosis was associated with greater WMHV after adjustment for intracranial stenosis ( P = .04). In multivariate analysis including extracranial stenosis, only age ( P &lt; .0001) and HTN ( P = .03) demonstrated independent effects on WMHV.

CONCLUSIONS: In our cohort of patients with AIS, age and HTN were the strongest determinants of the WMHV severity. Future studies are warranted to unravel further association between WMHV and cerebral vessel atherosclerosis.

AF
:   atrial fibrillation
AIS
:   acute ischemic stroke
CAD
:   coronary artery disease
DBP
:   diastolic blood pressure
DM
:   iabetes mellitus
HTN
:   hypertension
IQR
:   interquartile range
lnWMHV
:   natural logarithm-transformed white matter hyperintensity volume
SBP
:   systolic blood pressure
TOAST
:   Trial of Org 10172 in Acute Stroke Treatment
WMH
:   white matter hyperintensity
WMHV
:   white matter hyperintensity volume" />
<meta name="og-title" property="og:title" content="Severity of Leukoaraiosis in Large Vessel Atherosclerotic Disease" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/33/8/1591" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The severity of white matter hyperintensity, or leukoaraiosis, is a marker of cerebrovascular disease. In stroke, WMH burden is strongly linked to lacunar infarction; however, impaired cerebral perfusion due to extracranial or intracranial atherosclerosis may also contribute to WMH burden. We sought to determine whether WMH burden is associated with extracranial or intracranial stenosis in patients with AIS.

MATERIALS AND METHODS: Patients with AIS with admission head/neck CTA and brain MR imaging were included in this analysis. “Extracranial stenosis” was defined as &gt;50% stenosis in the extracranial ICA, and “intracranial,” as &gt;50% stenosis in either the middle, anterior, or posterior cerebral arteries on CTA, on either side. WMHV was determined by using a validated semiautomated protocol. Multiple regression was used to assess the relationship between WMHV and extracranial/intracranial atherosclerosis.

RESULTS: Of 201 subjects, 51 (25.4%) had extracranial and 63 (31.5%) had intracranial stenosis. Mean age was 62 ± 15 years; 36% were women. Mean WMHV was 12.87 cm3 in the extracranial and 8.59 cm3 in the intracranial stenosis groups. In univariate analysis, age ( P &lt; .0001), SBP and DBP ( P = .004), and HTN ( P = .0003) were associated with WMHV. Extracranial stenosis was associated with greater WMHV after adjustment for intracranial stenosis ( P = .04). In multivariate analysis including extracranial stenosis, only age ( P &lt; .0001) and HTN ( P = .03) demonstrated independent effects on WMHV.

CONCLUSIONS: In our cohort of patients with AIS, age and HTN were the strongest determinants of the WMHV severity. Future studies are warranted to unravel further association between WMHV and cerebral vessel atherosclerosis.

AF
:   atrial fibrillation
AIS
:   acute ischemic stroke
CAD
:   coronary artery disease
DBP
:   diastolic blood pressure
DM
:   iabetes mellitus
HTN
:   hypertension
IQR
:   interquartile range
lnWMHV
:   natural logarithm-transformed white matter hyperintensity volume
SBP
:   systolic blood pressure
TOAST
:   Trial of Org 10172 in Acute Stroke Treatment
WMH
:   white matter hyperintensity
WMHV
:   white matter hyperintensity volume" />
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      <h1 class="highwire-cite-title" id="page-title">Severity of Leukoaraiosis in Large Vessel Atherosclerotic Disease</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A. Chutinet</span>, <span class="highwire-citation-author" data-delta="1">A. Biffi</span>, <span class="highwire-citation-author" data-delta="2">A. Kanakis</span>, <span class="highwire-citation-author" data-delta="3">K.M. Fitzpatrick</span>, <span class="highwire-citation-author" data-delta="4">K.L. Furie</span> and <span class="highwire-citation-author" data-delta="5">N.S. Rost</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2012,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1591-1595; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3015 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-12065--61135976150" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A. Chutinet </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the J. Philip Kistler Stroke Research Center (A.C., A.B., A.K., K.M.F., K.L.F., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts</div><div class='author-affiliation'>bDivision of Neurology (A.C.), Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BChutinet%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Chutinet%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BChutinet%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">A. Biffi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the J. Philip Kistler Stroke Research Center (A.C., A.B., A.K., K.M.F., K.L.F., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BBiffi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Biffi%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BBiffi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">A. Kanakis </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the J. Philip Kistler Stroke Research Center (A.C., A.B., A.K., K.M.F., K.L.F., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BKanakis%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kanakis%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BKanakis%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">K.M. Fitzpatrick </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the J. Philip Kistler Stroke Research Center (A.C., A.B., A.K., K.M.F., K.L.F., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.M.%2BFitzpatrick%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Fitzpatrick%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AK.M.%2BFitzpatrick%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">K.L. Furie </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the J. Philip Kistler Stroke Research Center (A.C., A.B., A.K., K.M.F., K.L.F., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.L.%2BFurie%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Furie%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AK.L.%2BFurie%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">N.S. Rost </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the J. Philip Kistler Stroke Research Center (A.C., A.B., A.K., K.M.F., K.L.F., N.S.R.), Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.S.%2BRost%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rost%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AN.S.%2BRost%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> The severity of white matter hyperintensity, or leukoaraiosis, is a marker of cerebrovascular disease. In stroke, WMH burden is strongly linked to lacunar infarction; however, impaired cerebral perfusion due to extracranial or intracranial atherosclerosis may also contribute to WMH burden. We sought to determine whether WMH burden is associated with extracranial or intracranial stenosis in patients with AIS.</p></div>
<div id="sec-2" class="subsection"> 
<p id="p-3"><strong>MATERIALS AND METHODS:</strong> Patients with AIS with admission head/neck CTA and brain MR imaging were included in this analysis. “Extracranial stenosis” was defined as &gt;50% stenosis in the extracranial ICA, and “intracranial,” as &gt;50% stenosis in either the middle, anterior, or posterior cerebral arteries on CTA, on either side. WMHV was determined by using a validated semiautomated protocol. Multiple regression was used to assess the relationship between WMHV and extracranial/intracranial atherosclerosis.</p></div>
<div id="sec-3" class="subsection"> 
<p id="p-4"><strong>RESULTS:</strong> Of 201 subjects, 51 (25.4%) had extracranial and 63 (31.5%) had intracranial stenosis. Mean age was 62 ± 15 years; 36% were women. Mean WMHV was 12.87 cm<sup>3</sup> in the extracranial and 8.59 cm<sup>3</sup> in the intracranial stenosis groups. In univariate analysis, age (<em>P</em> &lt; .0001), SBP and DBP (<em>P</em> = .004), and HTN (<em>P</em> = .0003) were associated with WMHV. Extracranial stenosis was associated with greater WMHV after adjustment for intracranial stenosis (<em>P</em> = .04). In multivariate analysis including extracranial stenosis, only age (<em>P</em> &lt; .0001) and HTN (<em>P</em> = .03) demonstrated independent effects on WMHV.</p></div> 
<div id="sec-4" class="subsection"> 
<p id="p-5"><strong>CONCLUSIONS:</strong> In our cohort of patients with AIS, age and HTN were the strongest determinants of the WMHV severity. Future studies are warranted to unravel further association between WMHV and cerebral vessel atherosclerosis.</p></div></div><div class="section glossary" id="glossary-1"><h2>ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">AF<span class="def-item-dt-sep"></span></dt><dd>atrial fibrillation<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">AIS<span class="def-item-dt-sep"></span></dt><dd>acute ischemic stroke<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">CAD<span class="def-item-dt-sep"></span></dt><dd>coronary artery disease<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">DBP<span class="def-item-dt-sep"></span></dt><dd>diastolic blood pressure<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">DM<span class="def-item-dt-sep"></span></dt><dd>iabetes mellitus<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">HTN<span class="def-item-dt-sep"></span></dt><dd>hypertension<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">IQR<span class="def-item-dt-sep"></span></dt><dd>interquartile range<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">lnWMHV<span class="def-item-dt-sep"></span></dt><dd>natural logarithm-transformed white matter hyperintensity volume<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">SBP<span class="def-item-dt-sep"></span></dt><dd>systolic blood pressure<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">TOAST<span class="def-item-dt-sep"></span></dt><dd>Trial of Org 10172 in Acute Stroke Treatment<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">WMH<span class="def-item-dt-sep"></span></dt><dd>white matter hyperintensity<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">WMHV<span class="def-item-dt-sep"></span></dt><dd>white matter hyperintensity volume</dd></dl></div><p id="p-6">Leukoaraiosis, also known as WMH, is commonly found in patients with stroke or TIA.<sup><a id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1</a></sup> In patients with AIS, the severity of leukoaraiosis is associated with infarct growth, poor functional outcomes, and increased risk of recurrent stroke.<sup><a id="xref-ref-1-2" class="xref-bibr" href="#ref-1">1</a><a id="xref-ref-2-1" class="xref-down-link" href="#ref-2"><span>⇓</span></a><a id="xref-ref-3-1" class="xref-down-link" href="#ref-3"><span>⇓</span></a>–<a id="xref-ref-4-1" class="xref-bibr" href="#ref-4">4</a></sup> Furthermore, leukoaraiosis has been strongly linked to small-vessel disease or lacunar infarction.<sup><a id="xref-ref-5-1" class="xref-bibr" href="#ref-5">5</a><a id="xref-ref-6-1" class="xref-down-link" href="#ref-6"><span>⇓</span></a>–<a id="xref-ref-7-1" class="xref-bibr" href="#ref-7">7</a></sup></p><p id="p-7">However, impaired cerebral perfusion due to large-vessel atherosclerosis may affect the severity of leukoaraiosis. To date, association of leukoaraiosis and carotid stenosis in population-based studies remains controversial.<sup><a id="xref-ref-8-1" class="xref-bibr" href="#ref-8">8</a><a id="xref-ref-9-1" class="xref-down-link" href="#ref-9"><span>⇓</span></a><a id="xref-ref-10-1" class="xref-down-link" href="#ref-10"><span>⇓</span></a>–<a id="xref-ref-11-1" class="xref-bibr" href="#ref-11">11</a></sup> Among patients with ischemic stroke, an association between WMH severity and large-artery stroke subtype was reported in a single study of Korean patients,<sup><a id="xref-ref-12-1" class="xref-bibr" href="#ref-12">12</a></sup> whereas other studies demonstrated greater prevalence of leukoaraiosis in intracranial rather than extracranial atherosclerotic disease of the cerebral vasculature.<sup><a id="xref-ref-12-2" class="xref-bibr" href="#ref-12">12</a>,<a id="xref-ref-13-1" class="xref-bibr" href="#ref-13">13</a></sup></p><p id="p-8">We sought to determine whether the burden of WMH measured as MR imaging–detectable WMHV is associated with the radiographic evidence of extracranial or intracranial stenosis in patients with AIS.</p><div class="section materials-methods" id="sec-5"><h2>Materials and Methods</h2>
<div id="sec-6" class="subsection"><h3>Study Population</h3>
<p id="p-9">We selected subjects from consecutive patients with AIS older than 18 years of age with CTA of head and neck and a brain MR imaging completed on admission to our hospital between January 1, 2008, and January 1, 2009. A total of 201 subjects met the inclusion criteria. “Ischemic stroke” was defined as an acute vascular syndrome with evidence of cerebral infarction on DWI completed within 48 hours from symptom onset. </p>
<p id="p-10">All patients were assessed prospectively on admission and at 3- month follow-up. On admission, the NIHSS score was assessed as part of the AIS evaluation in the emergency department. Vascular risk factors, including HTN, DM, hyperlipidemia, CAD, and AF, were collected by patient or proxy interview or medical record review. Variables were defined as in prior publications.<sup><a id="xref-ref-14-1" class="xref-bibr" href="#ref-14">14</a></sup> The first available SBP, DBP, and creatinine levels measured on admission were recorded. Stroke subtypes were classified by using the TOAST criteria, which included large-artery atherosclerosis (embolus/thrombosis), cardioembolism (high-risk/medium-risk), small-vessel occlusion (LACUNE), stroke of other determined etiology, and stroke of undetermined etiology (<a id="xref-table-wrap-1-1" class="xref-table" href="#T1">Table 1</a>).<sup><a id="xref-ref-15-1" class="xref-bibr" href="#ref-15">15</a></sup> All patients or their health care proxy gave informed consent to take part in the ongoing prospective hospital-based cohort studies that were approved by the local institutional review board.</p> 
<div class="table pos-float" id="T1"><div class="table-inline table-callout-links"><div class="callout"><span>View this table:</span><ul class="callout-links"><li class="view-inline first"><a href="" class="table-expand-inline" data-table-url="/highwire/markup/38613/expansion?postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed&amp;table-expand-inline=1" data-icon-position="" data-hide-link-title="0">View inline</a></li><li class="view-popup last"><a href="/highwire/markup/38613/expansion?width=1000&amp;height=500&amp;iframe=true&amp;postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed" class="colorbox colorbox-load table-expand-popup" rel="gallery-fragment-tables" data-icon-position="" data-hide-link-title="0">View popup</a></li></ul></div></div><div class="table-caption"><span class="table-label">Table 1:</span> <p id="p-11" class="first-child">Baseline characteristics of 201 patients with AIS</p><div class="sb-div caption-clear"></div></div></div>
</div>
<div id="sec-7" class="subsection"><h3>Neuroimaging Analysis</h3>
<p id="p-12">CTA of the head and neck was performed by using a helical scanner (HiSpeed Advantage; GE Healthcare, Milwaukee, Wisconsin) as part of the emergency AIS evaluation. “Extracranial stenosis” was defined as evidence of &gt;50% stenosis in the extracranial ICA based on NASCET criteria,<sup><a id="xref-ref-16-1" class="xref-bibr" href="#ref-16">16</a></sup> and “intracranial,” as &gt;50% stenosis in either the middle (M1), anterior (A1), or posterior cerebral arteries (P1) on CTA, on either side (<a id="xref-fig-1-1" class="xref-fig" href="#F1">Fig 1</a>). CTA measurements were performed by a reader (A.C.) blinded to clinical data and WMHV measurements.</p>
<div id="F1" class="fig pos-float odd"><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/33/8/1591/F1.large.jpg?width=800&amp;height=600&amp;carousel=1" title="CTA definition of extracranial and intracranial large-vessel stenosis. Compared with the nonobstructive ICA disease (A), extracranial carotid artery stenosis was defined as evidence of &gt;50% stenosis based on the NASCET criteria (B). Similarly, compared with the large intracranial vessel disease (50% stenosis in either the middle (M1) (D), anterior (A1), or posterior cerebral arteries (P1) on CTA, on either side." class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-211763980" data-figure-caption="&lt;div class=&quot;highwire-markup&quot;&gt;&lt;div xmlns=&quot;http://www.w3.org/1999/xhtml&quot;&gt;CTA definition of extracranial and intracranial large-vessel stenosis. Compared with the nonobstructive ICA disease (&lt;em&gt;A&lt;/em&gt;), extracranial carotid artery stenosis was defined as evidence of &gt;50% stenosis based on the NASCET criteria (&lt;em&gt;B&lt;/em&gt;). Similarly, compared with the large intracranial vessel disease (&lt;50%, M1, &lt;em&gt;C&lt;/em&gt;), intracranial stenosis was defined as &gt;50% stenosis in either the middle (M1) (&lt;em&gt;D&lt;/em&gt;), anterior (A1), or posterior cerebral arteries (P1) on CTA, on either side.&lt;/div&gt;&lt;/div&gt;" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="Fig 1." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="http://ajnr-stage2.stage.highwire.org/content/ajnr/33/8/1591/F1.medium.gif" width="400" height="440"/><noscript><img class="highwire-fragment fragment-image" alt="Fig 1." src="http://ajnr-stage2.stage.highwire.org/content/ajnr/33/8/1591/F1.medium.gif" width="400" height="440"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/33/8/1591/F1.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download Fig 1." data-icon-position="" data-hide-link-title="0">Download figure</a></li><li class="new-tab"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/33/8/1591/F1.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li><li class="download-ppt last"><a href="/highwire/powerpoint/38617" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li></ul></div><div class="fig-caption" xmlns:xhtml="http://www.w3.org/1999/xhtml"><span class="fig-label">Fig 1.</span> <p id="p-13" class="first-child">CTA definition of extracranial and intracranial large-vessel stenosis. Compared with the nonobstructive ICA disease (<em>A</em>), extracranial carotid artery stenosis was defined as evidence of &gt;50% stenosis based on the NASCET criteria (<em>B</em>). Similarly, compared with the large intracranial vessel disease (&lt;50%, M1, <em>C</em>), intracranial stenosis was defined as &gt;50% stenosis in either the middle (M1) (<em>D</em>), anterior (A1), or posterior cerebral arteries (P1) on CTA, on either side.</p><div class="sb-div caption-clear"></div></div></div>
<p id="p-14">MR imaging was performed by using 1.5T scanners (Signa, GE Healthcare). We used MRIcro software (University of Nottingham School of Psychology, Nottingham, UK; www.mricro.com) to convert scans from DICOM into Analyze format and for computer-assisted determination of WMHV.<sup><a id="xref-ref-17-1" class="xref-bibr" href="#ref-17">17</a><a id="xref-ref-18-1" class="xref-down-link" href="#ref-18"><span>⇓</span></a>–<a id="xref-ref-19-1" class="xref-bibr" href="#ref-19">19</a></sup> Volumetric analysis of WMHV was performed on the T2 FLAIR axial sequences using a previously described semiautomated method (<a id="xref-fig-2-1" class="xref-fig" href="#F2">Fig 2</a>).<sup><a id="xref-ref-18-2" class="xref-bibr" href="#ref-18">18</a><a id="xref-ref-19-2" class="xref-down-link" href="#ref-19"><span>⇓</span></a>–<a id="xref-ref-20-1" class="xref-bibr" href="#ref-20">20</a></sup> To avoid confounding by the presence of focal white matter changes due to index stroke and to aid discrimination of infarcts from WMH, we simultaneously viewed DWI, ADC, and T2 FLAIR sequences. Total WMHV was measured from the hemisphere unaffected by AIS based on the previously validated protocol.<sup><a id="xref-ref-18-3" class="xref-bibr" href="#ref-18">18</a></sup> All WMHV measurements were performed by readers blinded to clinical data and the results of large-vessel stenosis assessment.</p>
<div id="F2" class="fig pos-float odd"><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/33/8/1591/F2.large.jpg?width=800&amp;height=600&amp;carousel=1" title="Volumetric analysis of WMH in patients with AIS. Left: for each subject, the T1 sagittal sequence of admission brain MR imaging (A) is used to outline the 2 adjacent median sections (B). The combined volume of these sections is used to calculate the intracranial area (C), a validated marker of intracranial volume. Right: T2 FLAIR axial sequences are examined for the presence of WMH (D). Regions of interest representing leukoaraiosis are outlined in the hemisphere contralateral to the acute infarct (E), and a semiautomated intensity filter is applied to all consecutive supratentorial axial FLAIR sections (F). The intersection between the initial region of interest and the intensity filter is examined by an operator trained to edit the final region of interest (G) and to finalize the WMH volume calculations adjusted for head size by using the intracranial area." class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-211763980" data-figure-caption="&lt;div class=&quot;highwire-markup&quot;&gt;&lt;div xmlns=&quot;http://www.w3.org/1999/xhtml&quot;&gt;Volumetric analysis of WMH in patients with AIS. Left: for each subject, the T1 sagittal sequence of admission brain MR imaging (&lt;em&gt;A&lt;/em&gt;) is used to outline the 2 adjacent median sections (&lt;em&gt;B&lt;/em&gt;). The combined volume of these sections is used to calculate the intracranial area (&lt;em&gt;C&lt;/em&gt;), a validated marker of intracranial volume. Right: T2 FLAIR axial sequences are examined for the presence of WMH (&lt;em&gt;D&lt;/em&gt;). Regions of interest representing leukoaraiosis are outlined in the hemisphere contralateral to the acute infarct (&lt;em&gt;E&lt;/em&gt;), and a semiautomated intensity filter is applied to all consecutive supratentorial axial FLAIR sections (&lt;em&gt;F&lt;/em&gt;). The intersection between the initial region of interest and the intensity filter is examined by an operator trained to edit the final region of interest (&lt;em&gt;G&lt;/em&gt;) and to finalize the WMH volume calculations adjusted for head size by using the intracranial area.&lt;/div&gt;&lt;/div&gt;" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="Fig 2." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="http://ajnr-stage2.stage.highwire.org/content/ajnr/33/8/1591/F2.medium.gif" width="440" height="333"/><noscript><img class="highwire-fragment fragment-image" alt="Fig 2." src="http://ajnr-stage2.stage.highwire.org/content/ajnr/33/8/1591/F2.medium.gif" width="440" height="333"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/33/8/1591/F2.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download Fig 2." data-icon-position="" data-hide-link-title="0">Download figure</a></li><li class="new-tab"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/33/8/1591/F2.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li><li class="download-ppt last"><a href="/highwire/powerpoint/38724" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li></ul></div><div class="fig-caption"><span class="fig-label">Fig 2.</span> <p id="p-15" class="first-child">Volumetric analysis of WMH in patients with AIS. Left: for each subject, the T1 sagittal sequence of admission brain MR imaging (<em>A</em>) is used to outline the 2 adjacent median sections (<em>B</em>). The combined volume of these sections is used to calculate the intracranial area (<em>C</em>), a validated marker of intracranial volume. Right: T2 FLAIR axial sequences are examined for the presence of WMH (<em>D</em>). Regions of interest representing leukoaraiosis are outlined in the hemisphere contralateral to the acute infarct (<em>E</em>), and a semiautomated intensity filter is applied to all consecutive supratentorial axial FLAIR sections (<em>F</em>). The intersection between the initial region of interest and the intensity filter is examined by an operator trained to edit the final region of interest (<em>G</em>) and to finalize the WMH volume calculations adjusted for head size by using the intracranial area.</p><div class="sb-div caption-clear"></div></div></div>
</div>
<div id="sec-8" class="subsection"><h3>Statistical Analysis</h3>
<p id="p-16">All continuous numeric variables are expressed as mean ± SD, with the exception of WMHV, creatinine level, and NIHSS scores, which are expressed as medians (IQR). WMHV was normalized for linear regression analysis by using lnWMHV. Univariate linear regression analysis was used to analyze the relationship between dichotomous and continuous variables and lnWMHV. Three multivariate linear regression models were built to test for independent predictors of lnWMHV. Model 1 included all univariate predictors with <em>P</em> &lt; .2. Model 2 included the additionally forced in intracranial arterial stenosis, whereas model 3 was an exploratory model of the effect of a subtype of large-artery stenosis on WMH burden. <em>P</em> value &lt;.05 was considered significant for all analyses. All statistical analyses were performed by using SAS software (SAS 9.2; SAS Institute, Cary, North Carolina). </p></div></div><div class="section results" id="sec-9"><h2>Results</h2>
<p id="p-17">A total of 201 consecutive patients with AIS with admission head and neck CTA and brain MR imaging suitable for WMH volumetric analysis were included in the study. Baseline characteristics are shown in <a id="xref-table-wrap-1-2" class="xref-table" href="#T1">Table 1</a>. Mean age was 62 ±15 years; 36% were women. Smoking (60.1%) and HTN (59%) were the leading vascular risk factors in this cohort, followed by hyperlipidemia (42%). Among these patients, 80 (40%) had cardioembolic, 50 (25%) had large-artery, 36 (18%) had undetermined, 27 (13.5%) had small-vessel, and 8 (4%) had other TOAST stroke subtypes.</p>
<p id="p-18">Median WMHV was 5 cm<sup>3</sup> (IQR, 2.5–10.7). Based on predefined CTA criteria, 51/201 patients (25%) had extracranial, whereas 63/201 (32%) had intracranial stenosis. Mean WMHV was greater in patients with extracranial (12.87 cm<sup>3</sup>) compared with intracranial stenosis (8.59 cm<sup>3</sup>).</p>
<p id="p-19">In univariate analysis, age, SBP, DBP, and history of HTN were significantly associated with lnWMHV (<em>P</em> &lt; .0001, .0003, .0041, and .0003, respectively), whereas extracranial stenosis demonstrated a trend for association with lnWMHV (<em>P</em> = .05) (<a id="xref-table-wrap-2-1" class="xref-table" href="#T2">Table 2</a>).</p>
<div class="table pos-float" id="T2"><div class="table-inline table-callout-links"><div class="callout"><span>View this table:</span><ul class="callout-links"><li class="view-inline first"><a href="" class="table-expand-inline" data-table-url="/highwire/markup/38608/expansion?postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed&amp;table-expand-inline=1" data-icon-position="" data-hide-link-title="0">View inline</a></li><li class="view-popup last"><a href="/highwire/markup/38608/expansion?width=1000&amp;height=500&amp;iframe=true&amp;postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed" class="colorbox colorbox-load table-expand-popup" rel="gallery-fragment-tables" data-icon-position="" data-hide-link-title="0">View popup</a></li></ul></div></div><div class="table-caption"><span class="table-label">Table 2:</span> <p id="p-20" class="first-child">Univariate predictors of lnWMHV in 201 patients with AIS</p><div class="sb-div caption-clear"></div></div></div>
<p id="p-22">In multivariate analysis (<a id="xref-table-wrap-3-1" class="xref-table" href="#T3">Table 3</a>), age and SBP (both <em>P</em> &lt; .0001) were independently associated with lnWMHV in model 1. Including intracranial stenosis into multivariable regression did not alter the results (model 2). Adjusting for the independent effect of extracranial and intracranial stenosis on WMH burden in model 3 demonstrated that extracranial but not intracranial stenosis was independently associated with lnWMHV (<em>P</em> = .04).</p>
<div class="table pos-float" id="T3"><div class="table-inline table-callout-links"><div class="callout"><span>View this table:</span><ul class="callout-links"><li class="view-inline first"><a href="" class="table-expand-inline" data-table-url="/highwire/markup/38757/expansion?postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed&amp;table-expand-inline=1" data-icon-position="" data-hide-link-title="0">View inline</a></li><li class="view-popup last"><a href="/highwire/markup/38757/expansion?width=1000&amp;height=500&amp;iframe=true&amp;postprocessors=highwire_tables%2Chighwire_reclass%2Chighwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed" class="colorbox colorbox-load table-expand-popup" rel="gallery-fragment-tables" data-icon-position="" data-hide-link-title="0">View popup</a></li></ul></div></div><div class="table-caption"><span class="table-label">Table 3:</span> <p id="p-23" class="first-child">Multivariate predictors of lnWMHV in 201 patients with AIS</p><div class="sb-div caption-clear"></div></div></div>
</div><div class="section discussion" id="sec-10"><h2>Discussion</h2>
<p id="p-28">In our study population, age and HTN were the independent predictors of WMH severity in patients with AIS. Increasing age is the strongest predictor of leukoaraiosis burden in general populations<sup><a id="xref-ref-11-2" class="xref-bibr" href="#ref-11">11</a>,<a id="xref-ref-21-1" class="xref-bibr" href="#ref-21">21</a><a id="xref-ref-22-1" class="xref-down-link" href="#ref-22"><span>⇓</span></a><a id="xref-ref-23-1" class="xref-down-link" href="#ref-23"><span>⇓</span></a><a id="xref-ref-24-1" class="xref-down-link" href="#ref-24"><span>⇓</span></a>–<a id="xref-ref-25-1" class="xref-bibr" href="#ref-25">25</a></sup> and in patients with ischemic stroke.<sup><a id="xref-ref-12-3" class="xref-bibr" href="#ref-12">12</a>,<a id="xref-ref-13-2" class="xref-bibr" href="#ref-13">13</a>,<a id="xref-ref-26-1" class="xref-bibr" href="#ref-26">26</a></sup> Furthermore, there is pathologic evidence linking age and WMH lesions.<sup><a id="xref-ref-27-1" class="xref-bibr" href="#ref-27">27</a></sup> Proposed mechanisms of association between leukoaraiosis and advancing age include the following: 1) alteration of blood supply to the white matter due to arteriosclerosis, tortuosity, and elongation of the vessels that result from the aging process<sup><a id="xref-ref-23-2" class="xref-bibr" href="#ref-23">23</a>,<a id="xref-ref-28-1" class="xref-bibr" href="#ref-28">28</a><a id="xref-ref-29-1" class="xref-down-link" href="#ref-29"><span>⇓</span></a><a id="xref-ref-30-1" class="xref-down-link" href="#ref-30"><span>⇓</span></a><a id="xref-ref-31-1" class="xref-down-link" href="#ref-31"><span>⇓</span></a><a id="xref-ref-32-1" class="xref-down-link" href="#ref-32"><span>⇓</span></a>–<a id="xref-ref-33-1" class="xref-bibr" href="#ref-33">33</a></sup>; and 2) age-related changes to the periventricular white matter regions that are in the arterial borderzone and easily susceptible to systemic or focal decreases in cerebral blood flow.<sup><a id="xref-ref-34-1" class="xref-bibr" href="#ref-34">34</a></sup></p>
<p id="p-29">Besides age, HTN is the most common risk factor for WMH. The association of elevated blood pressure and severity of WMH was demonstrated in previous population-based studies<sup><a id="xref-ref-21-2" class="xref-bibr" href="#ref-21">21</a><a id="xref-ref-22-2" class="xref-down-link" href="#ref-22"><span>⇓</span></a><a id="xref-ref-23-3" class="xref-down-link" href="#ref-23"><span>⇓</span></a><a id="xref-ref-24-2" class="xref-down-link" href="#ref-24"><span>⇓</span></a>–<a id="xref-ref-25-2" class="xref-bibr" href="#ref-25">25</a></sup> and in patients with ischemic stroke, including our results.<sup><a id="xref-ref-12-4" class="xref-bibr" href="#ref-12">12</a>–<a id="xref-ref-13-3" class="xref-bibr" href="#ref-13">13</a>,<a id="xref-ref-35-1" class="xref-bibr" href="#ref-35">35</a>,<a id="xref-ref-36-1" class="xref-bibr" href="#ref-36">36</a></sup> Despite differences in populations evaluated, our results are consistent with the Atherosclerosis Risk in Communities study, which demonstrated that the level of SBP is related to WMH severity.<sup><a id="xref-ref-35-2" class="xref-bibr" href="#ref-35">35</a>,<a id="xref-ref-37-1" class="xref-bibr" href="#ref-37">37</a></sup> Moreover, longitudinal investigations found that well-controlled blood pressure in patients with HTN can reduce the risk of severe WMH lesions.<sup><a id="xref-ref-38-1" class="xref-bibr" href="#ref-38">38</a>,<a id="xref-ref-39-1" class="xref-bibr" href="#ref-39">39</a></sup> Chronically elevated blood pressure changes small penetrating arteries and arterioles of the white matter by replacing the smooth muscle cells with fibrohyaline material, which, in turn, causes arteriosclerosis and, presumably, leukoaraiosis.<sup><a id="xref-ref-33-2" class="xref-bibr" href="#ref-33">33</a>,<a id="xref-ref-39-2" class="xref-bibr" href="#ref-39">39</a></sup></p>
<p id="p-30">Although previous studies showed that leukoaraiosis is strongly related to small-vessel disease,<sup><a id="xref-ref-5-2" class="xref-bibr" href="#ref-5">5</a><a id="xref-ref-6-2" class="xref-down-link" href="#ref-6"><span>⇓</span></a>–<a id="xref-ref-7-2" class="xref-bibr" href="#ref-7">7</a></sup> conflicting findings regarding the association between WMH and AIS subtypes have been reported. A study in Korean patients with ischemic stroke found that leukoaraiosis was predominately associated with large-artery stroke subtype.<sup><a id="xref-ref-12-5" class="xref-bibr" href="#ref-12">12</a></sup> In that study, WMH burden was assessed by using an ordinal visual scale, and prevalence of severe WMH was 55% in large-vessel, 30% in small-vessel, and 14% in cardioembolic stroke subtype groups. On the other hand, a study in Chinese patients with AIS did not show a relationship between large-artery stenosis and WMH lesion burden.<sup><a id="xref-ref-36-2" class="xref-bibr" href="#ref-36">36</a></sup> Most interesting, none of the previously published studies implicated diseased posterior cerebral vasculature in WMH severity or its burden accumulation.</p>
<p id="p-31">Our study aimed to determine whether pre-existing large-vessel stenosis predicted WMH severity independent of AIS subtype. We demonstrated that extracranial carotid stenosis was associated with higher WMHV compared with intracranial arterial stenosis. Our results differ from those in 2 prior studies in Korean patients with AIS, which reported WMH lesions to be more prevalent in intracranial arterial stenosis versus extracranial carotid stenosis.<sup><a id="xref-ref-12-6" class="xref-bibr" href="#ref-12">12</a>,<a id="xref-ref-13-4" class="xref-bibr" href="#ref-13">13</a></sup> This difference may partially be explained by the overall prevalence of extracranial carotid stenosis in white populations, whereas intracranial stenosis is known to be common in Asians.<sup><a id="xref-ref-40-1" class="xref-bibr" href="#ref-40">40</a><a id="xref-ref-41-1" class="xref-down-link" href="#ref-41"><span>⇓</span></a><a id="xref-ref-42-1" class="xref-down-link" href="#ref-42"><span>⇓</span></a><a id="xref-ref-43-1" class="xref-down-link" href="#ref-43"><span>⇓</span></a>–<a id="xref-ref-44-1" class="xref-bibr" href="#ref-44">44</a></sup> Some other explanations of the divergence in our results include using the different method of WMHV measurement (volumetric assessment in our study versus an ordinal visual rating scale) as well as the definition of the large-vessel stenosis (CTA evaluation in our study versus MR angiography).<sup><a id="xref-ref-12-7" class="xref-bibr" href="#ref-12">12</a>,<a id="xref-ref-13-5" class="xref-bibr" href="#ref-13">13</a></sup> Furthermore, the mechanism of extracranial carotid stenosis related to the severity of WMH might be through its link to microembolism of unstable plaques and other hemodynamic factors associated with extracranial carotid stenosis. A study in patients with symptomatic carotid stenosis showed an association between unstable (type IV: ulcerated surface, rupture, and hemorrhage) carotid plaques and WMH lesion numbers.<sup><a id="xref-ref-45-1" class="xref-bibr" href="#ref-45">45</a>,<a id="xref-ref-46-1" class="xref-bibr" href="#ref-46">46</a></sup></p>
<p id="p-32">The strength of our study is in using a validated highly accurate semiautomated protocol of WMHV assessment that allows detailed quantification of the WMH burden and stringent quality control. Furthermore, we used CTA to determine the degree of large-vessel stenosis, which is also known to have higher accuracy, compared with other noninvasive methods.<sup><a id="xref-ref-16-2" class="xref-bibr" href="#ref-16">16</a>,<a id="xref-ref-47-1" class="xref-bibr" href="#ref-47">47</a></sup> The limitations of our methods include relatively constrained technical ability to separate WMH resulting from chronic lacunar strokes versus that of “true” leukoaraiosis by using conventional MR imaging sequences. However, the overall accuracy of the WMH measurement by using our operator-mediated quantitative approach is reassuring with regard to its specificity. Other limitations include the inherent drawbacks associated with a retrospective study design and a relatively small study size, which likely limits our study power. However, despite its modest size, our study may provide important clues to the direction of future research in this important area.</p></div><div class="section conclusions" id="sec-11"><h2>Conclusions</h2>
<p id="p-33">Atherosclerosis of the cerebral vasculature may play an important role in the severity of WMH among patients with ischemic stroke and large-artery disease. In our cohort of patients with AIS, age and HTN were the strongest determinants of the WMHV severity; however, future studies are warranted to investigate whether this link has an independent and significant role in the biology of the WMH disease in this patient population and across various ethnicities. </p></div><div class="section fn-group" id="fn-group-1"><h2>Footnotes</h2><ul><li class="fn-supported-by" id="fn-6"><p id="p-46">This work was supported by the National Institutes of Health–National Institute of Neurological Disorders and Stroke (K23NS064052, N.S.R.; P50NS051343, K.L.F.), the American Heart Association/Bugher Foundation Centers for Stroke Prevention Research (0775010N), and the Deane Institute for Integrative Study of Atrial Fibrillation and Stroke.</p></li><li class="fn-financial-disclosure" id="fn-7"><p id="p-47">Disclosures: Alessandro Biffi—<em>UNRELATED</em>: <em>Grants/Grants Pending</em>: American Heart Association. Karen Furie—<em>UNRELATED</em>: <em>Consultancy</em>: Quintiles.</p></li></ul></div><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><div class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.1" data-doi="10.1161/STROKEAHA.107.501932"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Ay</span>  <span class="cit-name-given-names">H</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Arsava</span>  <span class="cit-name-given-names">EM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Rosand</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Severity of leukoaraiosis and susceptibility to infarct growth in acute stroke</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">2008</span>;
<span class="cit-vol">39</span>:
<span class="cit-fpage">1409</span>–
<span class="cit-lpage">13</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjk6IjM5LzUvMTQwOSI7czo0OiJhdG9tIjtzOjIwOiIvYWpuci8zMy84LzE1OTEuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">2.</span><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2. in text" id="ref-2">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.2" data-doi="10.1161/STROKEAHA.108.521906"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Kissela</span>  <span class="cit-name-given-names">B</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Lindsell</span>  <span class="cit-name-given-names">CJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kleindorfer</span>  <span class="cit-name-given-names">D</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">2009</span>;
<span class="cit-vol">40</span>:
<span class="cit-fpage">530</span>–
<span class="cit-lpage">36</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjg6IjQwLzIvNTMwIjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">3.</span><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3. in text" id="ref-3">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.3" data-doi="10.1212/WNL.0b013e3181a18823"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Arsava</span>  <span class="cit-name-given-names">EM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Rahman</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Rosand</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Severity of leukoaraiosis correlates with clinical outcome after ischemic stroke</span>.
<abbr class="cit-jnl-abbrev">Neurology</abbr>
<span class="cit-pub-date">2009</span>;
<span class="cit-vol">72</span>:
<span class="cit-fpage">1403</span>–
<span class="cit-lpage">10</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToibmV1cm9sb2d5IjtzOjU6InJlc2lkIjtzOjEwOiI3Mi8xNi8xNDAzIjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">4.</span><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4. in text" id="ref-4">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.4" data-doi="10.1002/ana.410320209"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">van Swieten</span>  <span class="cit-name-given-names">JC</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kappelle</span>  <span class="cit-name-given-names">LJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Algra</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Hypodensity of the cerebral white matter in patients with transient ischemic attack or minor stroke: influence on the rate of subsequent stroke—Dutch TIA Trial Study Group</span>.
<abbr class="cit-jnl-abbrev">Ann Neurol</abbr>
<span class="cit-pub-date">1992</span>;
<span class="cit-vol">32</span>:
<span class="cit-fpage">177</span>–
<span class="cit-lpage">83</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1002/ana.410320209&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=1510358&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">5.</span><a class="rev-xref-ref" href="#xref-ref-5-1" title="View reference 5. in text" id="ref-5">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.5" data-doi="10.1159/000069414"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Leys</span>  <span class="cit-name-given-names">D</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Englund</span>  <span class="cit-name-given-names">E</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Del Ser</span>  <span class="cit-name-given-names">T</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">White matter changes in stroke patients: relationship with stroke subtype and outcome</span>.
<abbr class="cit-jnl-abbrev">Eur Neurol</abbr>
<span class="cit-pub-date">1999</span>;
<span class="cit-vol">42</span>:
<span class="cit-fpage">67</span>–
<span class="cit-lpage">75</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1159/000069414&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=10473977&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">6.</span><a class="rev-xref-ref" href="#xref-ref-6-1" title="View reference 6. in text" id="ref-6">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.6"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Hijdra</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Verbeeten</span>  <span class="cit-name-given-names">B</span>  <span class="cit-name-suffix">Jr</span>.</span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Verhulst</span>  <span class="cit-name-given-names">JA</span></span></li></ol><cite>.
<span class="cit-article-title">Relation of leukoaraiosis to lesion type in stroke patients</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">1990</span>;
<span class="cit-vol">21</span>:
<span class="cit-fpage">890</span>–
<span class="cit-lpage">94</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjg6IjIxLzYvODkwIjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">7.</span><a class="rev-xref-ref" href="#xref-ref-7-1" title="View reference 7. in text" id="ref-7">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.7" data-doi="10.1212/WNL.0b013e3181fc279a"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Rost</span>  <span class="cit-name-given-names">NS</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Rahman</span>  <span class="cit-name-given-names">RM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Biffi</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">White matter hyperintensity volume is increased in small vessel stroke subtypes</span>.
<abbr class="cit-jnl-abbrev">Neurology</abbr>
<span class="cit-pub-date">2010</span>;
<span class="cit-vol">75</span>:
<span class="cit-fpage">1670</span>–
<span class="cit-lpage">77</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToibmV1cm9sb2d5IjtzOjU6InJlc2lkIjtzOjEwOiI3NS8xOS8xNjcwIjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">8.</span><a class="rev-xref-ref" href="#xref-ref-8-1" title="View reference 8. in text" id="ref-8">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.8" data-doi="10.1016/0140-6736(93)91144-B"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Bots</span>  <span class="cit-name-given-names">ML</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">van Swieten</span>  <span class="cit-name-given-names">JC</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Breteler</span>  <span class="cit-name-given-names">MM</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Cerebral white matter lesions and atherosclerosis in the Rotterdam Study</span>.
<abbr class="cit-jnl-abbrev">Lancet</abbr>
<span class="cit-pub-date">1993</span>;
<span class="cit-vol">341</span>:
<span class="cit-fpage">1232</span>–
<span class="cit-lpage">37</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/0140-6736(93)91144-B&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=8098390&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">9.</span><a class="rev-xref-ref" href="#xref-ref-9-1" title="View reference 9. in text" id="ref-9">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.9" data-doi="10.1001/archneur.1995.00540250025008"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Streifler</span>  <span class="cit-name-given-names">JY</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Eliasziw</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Benavente</span>  <span class="cit-name-given-names">OR</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Lack of relationship between leukoaraiosis and carotid artery disease: the North American Symptomatic Carotid Endarterectomy Trial</span>.
<abbr class="cit-jnl-abbrev">Arch Neurol</abbr>
<span class="cit-pub-date">1995</span>;
<span class="cit-vol">52</span>:
<span class="cit-fpage">21</span>–
<span class="cit-lpage">24</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1001/archneur.1995.00540250025008&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=7826271&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">10.</span><a class="rev-xref-ref" href="#xref-ref-10-1" title="View reference 10. in text" id="ref-10">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.10"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">de Leeuw</span>  <span class="cit-name-given-names">FE</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">de Groot</span>  <span class="cit-name-given-names">JC</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Bots</span>  <span class="cit-name-given-names">ML</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Carotid atherosclerosis and cerebral white matter lesions in a population based magnetic resonance imaging study</span>.
<abbr class="cit-jnl-abbrev">J Neurol</abbr>
<span class="cit-pub-date">2000</span>;
<span class="cit-vol">247</span>:
<span class="cit-fpage">2919</span>–
<span class="cit-lpage">26</span>
</cite></div><div class="cit-extra"></div></div>
</li><li><span class="ref-label">11.</span><a class="rev-xref-ref" href="#xref-ref-11-1" title="View reference 11. in text" id="ref-11">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.11" data-doi="10.1159/000064741"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Pico</span>  <span class="cit-name-given-names">F</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Dufouil</span>  <span class="cit-name-given-names">C</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Levy</span>  <span class="cit-name-given-names">C</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Longitudinal study of carotid atherosclerosis and white matter hyperintensities: the EVA-MRI cohort</span>.
<abbr class="cit-jnl-abbrev">Cerebrovasc Dis</abbr>
<span class="cit-pub-date">2002</span>;
<span class="cit-vol">14</span>:
<span class="cit-fpage">109</span>–
<span class="cit-lpage">15</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1159/000064741&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=12187015&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">12.</span><a class="rev-xref-ref" href="#xref-ref-12-1" title="View reference 12. in text" id="ref-12">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.12" data-doi="10.1186/1471-2377-8-31"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Lee</span>  <span class="cit-name-given-names">SJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kim</span>  <span class="cit-name-given-names">JS</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Lee</span>  <span class="cit-name-given-names">KS</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">The leukoaraiosis is more prevalent in the large artery atherosclerosis stroke subtype among Korean patients with ischemic stroke</span>.
<abbr class="cit-jnl-abbrev">BMC Neurol</abbr>
<span class="cit-pub-date">2008</span>;
<span class="cit-vol">8</span>:
<span class="cit-fpage">31</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1186/1471-2377-8-31&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=18687146&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">13.</span><a class="rev-xref-ref" href="#xref-ref-13-1" title="View reference 13. in text" id="ref-13">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.13" data-doi="10.1016/j.archger.2010.07.008"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Lee</span>  <span class="cit-name-given-names">SJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kim</span>  <span class="cit-name-given-names">JS</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Chung</span>  <span class="cit-name-given-names">SW</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">White matter hyperintensities (WMH) are associated with intracranial atherosclerosis rather than extracranial atherosclerosis</span>.
<abbr class="cit-jnl-abbrev">Arch Gerontol Geriatr</abbr>
<span class="cit-pub-date">2011</span>;
<span class="cit-vol">53</span>:
<span class="cit-fpage">e129</span>–
<span class="cit-lpage">32</span>.
<span class="cit-comment">Epub 2010 Aug 30</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.archger.2010.07.008&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=20800910&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">14.</span><a class="rev-xref-ref" href="#xref-ref-14-1" title="View reference 14. in text" id="ref-14">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.14" data-doi="10.1161/STROKEAHA.109.563502"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Jimenez-Conde</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Biffi</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Rahman</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Hyperlipidemia and reduced white matter hyperintensity volume in patients with ischemic stroke</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">2010</span>;
<span class="cit-vol">41</span>:
<span class="cit-fpage">437</span>–
<span class="cit-lpage">42</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjg6IjQxLzMvNDM3IjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">15.</span><a class="rev-xref-ref" href="#xref-ref-15-1" title="View reference 15. in text" id="ref-15">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.15" data-doi="10.1161/01.STR.24.1.35"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Adams</span>  <span class="cit-name-given-names">HP</span>  <span class="cit-name-suffix">Jr</span>.</span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Bendixen</span>  <span class="cit-name-given-names">BH</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kappelle</span>  <span class="cit-name-given-names">LJ</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trial—TOAST. Trial of Org 10172 in Acute Stroke Treatment</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">1993</span>;
<span class="cit-vol">24</span>:
<span class="cit-fpage">35</span>–
<span class="cit-lpage">41</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjc6IjI0LzEvMzUiO3M6NDoiYXRvbSI7czoyMDoiL2FqbnIvMzMvOC8xNTkxLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">16.</span><a class="rev-xref-ref" href="#xref-ref-16-1" title="View reference 16. in text" id="ref-16">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.16" data-doi="10.1177/1358863X11399328"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Brott</span>  <span class="cit-name-given-names">TG</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Halperin</span>  <span class="cit-name-given-names">JL</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Abbara</span>  <span class="cit-name-given-names">S</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/ SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary—a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery</span>.
<abbr class="cit-jnl-abbrev">Vasc Med</abbr>
<span class="cit-pub-date">2011</span>;
<span class="cit-vol">16</span>:
<span class="cit-fpage">35</span>–
<span class="cit-lpage">77</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6MzoiUERGIjtzOjExOiJqb3VybmFsQ29kZSI7czo1OiJzcHZtaiI7czo1OiJyZXNpZCI7czo3OiIxNi8xLzM1IjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">17.</span><a class="rev-xref-ref" href="#xref-ref-17-1" title="View reference 17. in text" id="ref-17">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.17"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Smith</span>  <span class="cit-name-given-names">EE</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Gurol</span>  <span class="cit-name-given-names">ME</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Eng</span>  <span class="cit-name-given-names">JA</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">White matter lesions, cognition, and recurrent hemorrhage in lobar intracerebral hemorrhage</span>.
<abbr class="cit-jnl-abbrev">Neurology</abbr>
<span class="cit-pub-date">2004</span>;
<span class="cit-vol">63</span>:
<span class="cit-fpage">1606</span>–
<span class="cit-lpage">12</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToibmV1cm9sb2d5IjtzOjU6InJlc2lkIjtzOjk6IjYzLzkvMTYwNiI7czo0OiJhdG9tIjtzOjIwOiIvYWpuci8zMy84LzE1OTEuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">18.</span><a class="rev-xref-ref" href="#xref-ref-18-1" title="View reference 18. in text" id="ref-18">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.18" data-doi="10.1212/01.wnl.0000191403.95453.6a"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Gurol</span>  <span class="cit-name-given-names">ME</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Irizarry</span>  <span class="cit-name-given-names">MC</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Smith</span>  <span class="cit-name-given-names">EE</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Plasma beta-amyloid and white matter lesions in AD, MCI, and cerebral amyloid angiopathy</span>.
<abbr class="cit-jnl-abbrev">Neurology</abbr>
<span class="cit-pub-date">2006</span>;
<span class="cit-vol">66</span>:
<span class="cit-fpage">23</span>–
<span class="cit-lpage">29</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToibmV1cm9sb2d5IjtzOjU6InJlc2lkIjtzOjc6IjY2LzEvMjMiO3M6NDoiYXRvbSI7czoyMDoiL2FqbnIvMzMvOC8xNTkxLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">19.</span><a class="rev-xref-ref" href="#xref-ref-19-1" title="View reference 19. in text" id="ref-19">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.19" data-doi="10.1212/01.wnl.0000223613.57229.24"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Chen</span>  <span class="cit-name-given-names">YW</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Gurol</span>  <span class="cit-name-given-names">ME</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Rosand</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Progression of white matter lesions and hemorrhages in cerebral amyloid angiopathy</span>.
<abbr class="cit-jnl-abbrev">Neurology</abbr>
<span class="cit-pub-date">2006</span>;
<span class="cit-vol">67</span>:
<span class="cit-fpage">83</span>–
<span class="cit-lpage">87</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToibmV1cm9sb2d5IjtzOjU6InJlc2lkIjtzOjc6IjY3LzEvODMiO3M6NDoiYXRvbSI7czoyMDoiL2FqbnIvMzMvOC8xNTkxLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">20.</span><a class="rev-xref-ref" href="#xref-ref-20-1" title="View reference 20. in text" id="ref-20">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.20"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Nandigam</span>  <span class="cit-name-given-names">RN</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Chen</span>  <span class="cit-name-given-names">YW</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Gurol</span>  <span class="cit-name-given-names">ME</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Validation of intracranial area as a surrogate measure of intracranial volume when using clinical MRI</span>.
<abbr class="cit-jnl-abbrev">J Neuroimaging</abbr>
<span class="cit-pub-date">2007</span>;
<span class="cit-vol">17</span>:
<span class="cit-fpage">74</span>–
<span class="cit-lpage">77</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=17238873&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">21.</span><a class="rev-xref-ref" href="#xref-ref-21-1" title="View reference 21. in text" id="ref-21">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.21"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Breteler</span>  <span class="cit-name-given-names">MM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">van Swieten</span>  <span class="cit-name-given-names">JC</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Bots</span>  <span class="cit-name-given-names">ML</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study: the Rotterdam Study</span>.
<abbr class="cit-jnl-abbrev">Neurology</abbr>
<span class="cit-pub-date">1994</span>;
<span class="cit-vol">44</span>:
<span class="cit-fpage">1246</span>–
<span class="cit-lpage">52</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToibmV1cm9sb2d5IjtzOjU6InJlc2lkIjtzOjk6IjQ0LzcvMTI0NiI7czo0OiJhdG9tIjtzOjIwOiIvYWpuci8zMy84LzE1OTEuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">22.</span><a class="rev-xref-ref" href="#xref-ref-22-1" title="View reference 22. in text" id="ref-22">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.22" data-doi="10.1161/01.STR.25.2.318"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Manolio</span>  <span class="cit-name-given-names">TA</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kronmal</span>  <span class="cit-name-given-names">RA</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Burke</span>  <span class="cit-name-given-names">GL</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Magnetic resonance abnormalities and cardiovascular disease in older adults: the Cardiovascular Health Study</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">1994</span>;
<span class="cit-vol">25</span>:
<span class="cit-fpage">318</span>–
<span class="cit-lpage">27</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjg6IjI1LzIvMzE4IjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">23.</span><a class="rev-xref-ref" href="#xref-ref-23-1" title="View reference 23. in text" id="ref-23">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.23" data-doi="10.1161/01.STR.27.8.1274"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Longstreth</span>  <span class="cit-name-given-names">WT</span>  <span class="cit-name-suffix">Jr</span>.</span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Manolio</span>  <span class="cit-name-given-names">TA</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Arnold</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people: the Cardiovascular Health Study</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">1996</span>;
<span class="cit-vol">27</span>:
<span class="cit-fpage">1274</span>–
<span class="cit-lpage">82</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjk6IjI3LzgvMTI3NCI7czo0OiJhdG9tIjtzOjIwOiIvYWpuci8zMy84LzE1OTEuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">24.</span><a class="rev-xref-ref" href="#xref-ref-24-1" title="View reference 24. in text" id="ref-24">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.24" data-doi="10.1001/jama.288.1.67"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Wong</span>  <span class="cit-name-given-names">TY</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Klein</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Sharrett</span>  <span class="cit-name-given-names">AR</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Cerebral white matter lesions, retinopathy, and incident clinical stroke</span>.
<abbr class="cit-jnl-abbrev">JAMA</abbr>
<span class="cit-pub-date">2002</span>;
<span class="cit-vol">288</span>:
<span class="cit-fpage">67</span>–
<span class="cit-lpage">74</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1001/jama.288.1.67&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=12090864&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">25.</span><a class="rev-xref-ref" href="#xref-ref-25-1" title="View reference 25. in text" id="ref-25">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.25" data-doi="10.1161/01.STR.0000135226.53499.85"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Jeerakathil</span>  <span class="cit-name-given-names">T</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Wolf</span>  <span class="cit-name-given-names">PA</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Beiser</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Stroke risk profile predicts white matter hyperintensity volume: the Framingham Study</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">2004</span>;
<span class="cit-vol">35</span>:
<span class="cit-fpage">1857</span>–
<span class="cit-lpage">61</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjk6IjM1LzgvMTg1NyI7czo0OiJhdG9tIjtzOjIwOiIvYWpuci8zMy84LzE1OTEuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">26.</span><a class="rev-xref-ref" href="#xref-ref-26-1" title="View reference 26. in text" id="ref-26">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.26" data-doi="10.1016/j.jstrokecerebrovasdis.2009.05.007"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Rost</span>  <span class="cit-name-given-names">NS</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Rahman</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Sonni</span>  <span class="cit-name-given-names">S</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Determinants of white matter hyperintensity volume in patients with acute ischemic stroke</span>.
<abbr class="cit-jnl-abbrev">J Stroke Cerebrovasc Dis</abbr>
<span class="cit-pub-date">2010</span>;
<span class="cit-vol">19</span>:
<span class="cit-fpage">230</span>–
<span class="cit-lpage">35</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.jstrokecerebrovasdis.2009.05.007&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=20434052&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">27.</span><a class="rev-xref-ref" href="#xref-ref-27-1" title="View reference 27. in text" id="ref-27">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.27" data-doi="10.1111/j.1600-0404.2010.01341.x"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Auriel</span>  <span class="cit-name-given-names">E</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Bornstein</span>  <span class="cit-name-given-names">NM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Berenyi</span>  <span class="cit-name-given-names">E</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Clinical, radiological and pathological correlates of leukoaraiosis</span>.
<abbr class="cit-jnl-abbrev">Acta Neurol Scand</abbr>
<span class="cit-pub-date">2011</span>;
<span class="cit-vol">123</span>:
<span class="cit-fpage">41</span>–
<span class="cit-lpage">47</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1111/j.1600-0404.2010.01341.x&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=20219022&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">28.</span><a class="rev-xref-ref" href="#xref-ref-28-1" title="View reference 28. in text" id="ref-28">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.28"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Leifer</span>  <span class="cit-name-given-names">D</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Buonanno</span>  <span class="cit-name-given-names">FS</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Richardson</span>  <span class="cit-name-given-names">EP</span>  <span class="cit-name-suffix">Jr</span>.</span></li></ol><cite>.
<span class="cit-article-title">Clinicopathologic correlations of cranial magnetic resonance imaging of periventricular white matter.</span>
<abbr class="cit-jnl-abbrev">Neurology</abbr>
<span class="cit-pub-date">1990</span>;
<span class="cit-vol">40</span>:
<span class="cit-fpage">911</span>–
<span class="cit-lpage">18</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToibmV1cm9sb2d5IjtzOjU6InJlc2lkIjtzOjg6IjQwLzYvOTExIjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">29.</span><a class="rev-xref-ref" href="#xref-ref-29-1" title="View reference 29. in text" id="ref-29">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.29" data-doi="10.1093/brain/114.2.761"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">van Swieten</span>  <span class="cit-name-given-names">JC</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">van den Hout</span>  <span class="cit-name-given-names">JH</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">van Ketel</span>  <span class="cit-name-given-names">BA</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Periventricular lesions in the white matter on magnetic resonance imaging in the elderly: a morphometric correlation with arteriolosclerosis and dilated perivascular spaces</span>.
<abbr class="cit-jnl-abbrev">Brain</abbr>
<span class="cit-pub-date">1991</span>;
<span class="cit-vol">114</span>:
<span class="cit-fpage">761</span>–
<span class="cit-lpage">74</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToiYnJhaW4iO3M6NToicmVzaWQiO3M6OToiMTE0LzIvNzYxIjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">30.</span><a class="rev-xref-ref" href="#xref-ref-30-1" title="View reference 30. in text" id="ref-30">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.30" data-doi="10.1212/WNL.43.9.1683"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Fazekas</span>  <span class="cit-name-given-names">F</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kleinert</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Offenbacher</span>  <span class="cit-name-given-names">H</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Pathologic correlates of incidental MRI white matter signal hyperintensities</span>.
<abbr class="cit-jnl-abbrev">Neurology</abbr>
<span class="cit-pub-date">1993</span>;
<span class="cit-vol">43</span>:
<span class="cit-fpage">1683</span>–
<span class="cit-lpage">89</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToibmV1cm9sb2d5IjtzOjU6InJlc2lkIjtzOjk6IjQzLzkvMTY4MyI7czo0OiJhdG9tIjtzOjIwOiIvYWpuci8zMy84LzE1OTEuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">31.</span><a class="rev-xref-ref" href="#xref-ref-31-1" title="View reference 31. in text" id="ref-31">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.31"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Moody</span>  <span class="cit-name-given-names">DM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Santamore</span>  <span class="cit-name-given-names">WP</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Bell</span>  <span class="cit-name-given-names">MA</span></span></li></ol><cite>.
<span class="cit-article-title">Does tortuosity in cerebral arterioles impair down-autoregulation in hypertensives and elderly normotensives? A hypothesis and computer model.</span>
<abbr class="cit-jnl-abbrev">Clin Neurosurg</abbr>
<span class="cit-pub-date">1991</span>;
<span class="cit-vol">37</span>:
<span class="cit-fpage">372</span>–
<span class="cit-lpage">87</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=2009699&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">32.</span><a class="rev-xref-ref" href="#xref-ref-32-1" title="View reference 32. in text" id="ref-32">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.32"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Spangler</span>  <span class="cit-name-given-names">KM</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Challa</span>  <span class="cit-name-given-names">VR</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Moody</span>  <span class="cit-name-given-names">DM</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Arteriolar tortuosity of the white matter in aging and hypertension: a microradiographic study</span>.
<abbr class="cit-jnl-abbrev">J Neuropathol Exp Neurol</abbr>
<span class="cit-pub-date">1994</span>;
<span class="cit-vol">53</span>:
<span class="cit-fpage">22</span>–
<span class="cit-lpage">26</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=8301316&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">33.</span><a class="rev-xref-ref" href="#xref-ref-33-1" title="View reference 33. in text" id="ref-33">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.33" data-doi="10.1161/01.STR.28.3.652"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Pantoni</span>  <span class="cit-name-given-names">L</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Garcia</span>  <span class="cit-name-given-names">JH</span></span></li></ol><cite>.
<span class="cit-article-title">Pathogenesis of leukoaraiosis: a review</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">1997</span>;
<span class="cit-vol">28</span>:
<span class="cit-fpage">652</span>–
<span class="cit-lpage">59</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjg6IjI4LzMvNjUyIjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">34.</span><a class="rev-xref-ref" href="#xref-ref-34-1" title="View reference 34. in text" id="ref-34">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.34"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">De Reuck</span>  <span class="cit-name-given-names">J</span></span></li></ol><cite>.
<span class="cit-article-title">The human periventricular arterial blood supply and the anatomy of cerebral infarctions</span>.
<abbr class="cit-jnl-abbrev">Eur Neurol</abbr>
<span class="cit-pub-date">1971</span>;
<span class="cit-vol">5</span>:
<span class="cit-fpage">321</span>–
<span class="cit-lpage">34</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=5141149&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">35.</span><a class="rev-xref-ref" href="#xref-ref-35-1" title="View reference 35. in text" id="ref-35">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.35"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Bogousslavsky</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Regli</span>  <span class="cit-name-given-names">F</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Uske</span>  <span class="cit-name-given-names">A</span></span></li></ol><cite>.
<span class="cit-article-title">Leukoencephalopathy in patients with ischemic stroke</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">1987</span>;
<span class="cit-vol">18</span>:
<span class="cit-fpage">896</span>–
<span class="cit-lpage">99</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjg6IjE4LzUvODk2IjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">36.</span><a class="rev-xref-ref" href="#xref-ref-36-1" title="View reference 36. in text" id="ref-36">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.36" data-doi="10.1179/174313209X444071"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Pu</span>  <span class="cit-name-given-names">Y</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Liu</span>  <span class="cit-name-given-names">L</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Zou</span>  <span class="cit-name-given-names">X</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Relationship between leukoaraiosis and cerebral large artery stenosis</span>.
<abbr class="cit-jnl-abbrev">Neurol Res</abbr>
<span class="cit-pub-date">2009</span>;
<span class="cit-vol">31</span>:
<span class="cit-fpage">376</span>–
<span class="cit-lpage">80</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1179/174313209X444071&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=19508822&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">37.</span><a class="rev-xref-ref" href="#xref-ref-37-1" title="View reference 37. in text" id="ref-37">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.37" data-doi="10.1161/01.STR.27.12.2262"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Liao</span>  <span class="cit-name-given-names">D</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Cooper</span>  <span class="cit-name-given-names">L</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Cai</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Presence and severity of cerebral white matter lesions and hypertension, its treatment, and its control: the ARIC Study—Atherosclerosis Risk in Communities Study</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">1996</span>;
<span class="cit-vol">27</span>:
<span class="cit-fpage">2262</span>–
<span class="cit-lpage">70</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjEwOiIyNy8xMi8yMjYyIjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">38.</span><a class="rev-xref-ref" href="#xref-ref-38-1" title="View reference 38. in text" id="ref-38">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.38"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Dufouil</span>  <span class="cit-name-given-names">C</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">de Kersaint-Gilly</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Besancon</span>  <span class="cit-name-given-names">V</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Longitudinal study of blood pressure and white matter hyperintensities: the EVA MRI Cohort</span>.
<abbr class="cit-jnl-abbrev">Neurology</abbr>
<span class="cit-pub-date">2001</span>;
<span class="cit-vol">56</span>:
<span class="cit-fpage">921</span>–
<span class="cit-lpage">26</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToibmV1cm9sb2d5IjtzOjU6InJlc2lkIjtzOjg6IjU2LzcvOTIxIjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">39.</span><a class="rev-xref-ref" href="#xref-ref-39-1" title="View reference 39. in text" id="ref-39">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.39"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Ostrow</span>  <span class="cit-name-given-names">PT</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Miller</span>  <span class="cit-name-given-names">LL</span></span></li></ol><cite>.
<span class="cit-article-title">Pathology of small artery disease</span>.
<abbr class="cit-jnl-abbrev">Adv Neurol</abbr>
<span class="cit-pub-date">1993</span>;
<span class="cit-vol">62</span>:
<span class="cit-fpage">93</span>–
<span class="cit-lpage">123</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=8517214&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">40.</span><a class="rev-xref-ref" href="#xref-ref-40-1" title="View reference 40. in text" id="ref-40">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.40"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Feldmann</span>  <span class="cit-name-given-names">E</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Daneault</span>  <span class="cit-name-given-names">N</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kwan</span>  <span class="cit-name-given-names">E</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Chinese-white differences in the distribution of occlusive cerebrovascular disease</span>.
<abbr class="cit-jnl-abbrev">Neurology</abbr>
<span class="cit-pub-date">1990</span>;
<span class="cit-vol">40</span>:
<span class="cit-fpage">1541</span>–
<span class="cit-lpage">45</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=2215945&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">41.</span><a class="rev-xref-ref" href="#xref-ref-41-1" title="View reference 41. in text" id="ref-41">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.41"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Wityk</span>  <span class="cit-name-given-names">RJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Lehman</span>  <span class="cit-name-given-names">D</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Klag</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Race and sex differences in the distribution of cerebral atherosclerosis</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">1996</span>;
<span class="cit-vol">27</span>:
<span class="cit-fpage">1974</span>–
<span class="cit-lpage">80</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjEwOiIyNy8xMS8xOTc0IjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">42.</span><a class="rev-xref-ref" href="#xref-ref-42-1" title="View reference 42. in text" id="ref-42">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.42"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Yasaka</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Yamaguchi</span>  <span class="cit-name-given-names">T</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Shichiri</span>  <span class="cit-name-given-names">M</span></span></li></ol><cite>.
<span class="cit-article-title">Distribution of atherosclerosis and risk factors in atherothrombotic occlusion</span>.
<abbr class="cit-jnl-abbrev">Stroke</abbr>
<span class="cit-pub-date">1993</span>;
<span class="cit-vol">24</span>:
<span class="cit-fpage">206</span>–
<span class="cit-lpage">11</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToic3Ryb2tlYWhhIjtzOjU6InJlc2lkIjtzOjg6IjI0LzIvMjA2IjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">43.</span><a class="rev-xref-ref" href="#xref-ref-43-1" title="View reference 43. in text" id="ref-43">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.43"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Wong</span>  <span class="cit-name-given-names">KS</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Huang</span>  <span class="cit-name-given-names">YN</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Gao</span>  <span class="cit-name-given-names">S</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Intracranial stenosis in Chinese patients with acute stroke</span>.
<abbr class="cit-jnl-abbrev">Neurology</abbr>
<span class="cit-pub-date">1998</span>;
<span class="cit-vol">50</span>:
<span class="cit-fpage">812</span>–
<span class="cit-lpage">13</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToibmV1cm9sb2d5IjtzOjU6InJlc2lkIjtzOjg6IjUwLzMvODEyIjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMzLzgvMTU5MS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">44.</span><a class="rev-xref-ref" href="#xref-ref-44-1" title="View reference 44. in text" id="ref-44">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.44" data-doi="10.1016/S0967-5868(02)00264-3"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Li</span>  <span class="cit-name-given-names">H</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Wong</span>  <span class="cit-name-given-names">KS</span></span></li></ol><cite>.
<span class="cit-article-title">Racial distribution of intracranial and extracranial atherosclerosis</span>.
<abbr class="cit-jnl-abbrev">J Clin Neurosci</abbr>
<span class="cit-pub-date">2003</span>;
<span class="cit-vol">10</span>:
<span class="cit-fpage">30</span>–
<span class="cit-lpage">34</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/S0967-5868(02)00264-3&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=12464517&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">45.</span><a class="rev-xref-ref" href="#xref-ref-45-1" title="View reference 45. in text" id="ref-45">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.45" data-doi="10.1016/j.ejvs.2005.08.026"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Altaf</span>  <span class="cit-name-given-names">N</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Daniels</span>  <span class="cit-name-given-names">L</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Morgan</span>  <span class="cit-name-given-names">PS</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Cerebral white matter hyperintense lesions are associated with unstable carotid plaques</span>.
<abbr class="cit-jnl-abbrev">Eur J Vasc Endovasc Surg</abbr>
<span class="cit-pub-date">2006</span>;
<span class="cit-vol">31</span>:
<span class="cit-fpage">8</span>–
<span class="cit-lpage">13</span>
</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.ejvs.2005.08.026&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=16226900&amp;link_type=MED&amp;atom=%2Fajnr%2F33%2F8%2F1591.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div>
</li><li><span class="ref-label">46.</span><a class="rev-xref-ref" href="#xref-ref-46-1" title="View reference 46. in text" id="ref-46">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.46" data-doi="10.1161/01.CIR.92.5.1355"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Stary</span>  <span class="cit-name-given-names">HC</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Chandler</span>  <span class="cit-name-given-names">AB</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Dinsmore</span>  <span class="cit-name-given-names">RE</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis: a report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association</span>.
<abbr class="cit-jnl-abbrev">Circulation</abbr>
<span class="cit-pub-date">1995</span>;
<span class="cit-vol">92</span>:
<span class="cit-fpage">1355</span>–
<span class="cit-lpage">74</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6MTQ6ImNpcmN1bGF0aW9uYWhhIjtzOjU6InJlc2lkIjtzOjk6IjkyLzUvMTM1NSI7czo0OiJhdG9tIjtzOjIwOiIvYWpuci8zMy84LzE1OTEuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li><li><span class="ref-label">47.</span><a class="rev-xref-ref" href="#xref-ref-47-1" title="View reference 47. in text" id="ref-47">↵</a>

<div class="cit ref-cit ref-journal" id="cit-33.8.1591.47"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Bash</span>  <span class="cit-name-given-names">S</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Villablanca</span>  <span class="cit-name-given-names">JP</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Jahan</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>.
<span class="cit-article-title">Intracranial vascular stenosis and occlusive disease: evaluation with CT angiography, MR angiography, and digital subtraction angiography</span>.
<abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr>
<span class="cit-pub-date">2005</span>;
<span class="cit-vol">26</span>:
<span class="cit-fpage">1012</span>–
<span class="cit-lpage">21</span>
</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo5OiIyNi81LzEwMTIiO3M6NDoiYXRvbSI7czoyMDoiL2FqbnIvMzMvOC8xNTkxLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div>
</li></ol></div><ul class="history-list"><li xmlns:hwp="http://schema.highwire.org/Journal" class="received" hwp:start="2011-09-22"><span class="received-label">Received </span>September 22, 2011.</li><li xmlns:hwp="http://schema.highwire.org/Journal" class="accepted" hwp:start="2011-11-10"><span class="accepted-label">Accepted after revision </span>November 10, 2011.</li></ul><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2012 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/33/8/1591.abstract" class="hw-link hw-link-article-abstract" data-icon-position="" data-hide-link-title="0">View Abstract</a></div>  </div>

  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Chutinet</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Biffi</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Kanakis</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">K.M.</span> <span class="nlm-surname">Fitzpatrick</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">K.L.</span> <span class="nlm-surname">Furie</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">N.S.</span> <span class="nlm-surname">Rost</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2012, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1591-1595; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3015 </span></div>
  
  
  
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