Comparison of congitive function,image characteristics and risk factors in patients with leukoaraiosis,Bingswanger disease and cerebral infarction combining leukoaraiosis

doi:10.3321/j.issn:1673-8225.2004.28.010

Abstract：BACKGROUND:Leukoaraiosis(LA) is a clinical syndrome manifested by a group of images,which is caused by various factors. However,it has not been attached much importance to its mechanism,clinical manifestations as well as early assessment. OBJECTIVE:To explore the risk factors,cognition,gait,CT and MRI characteristics of simply leukoaraiosis(LA) as well as its relationship with Binswanger's disease(BD) and cerebral infarction (CI). DESIGN:Retrospective case control study on the basis of diagnosis. SETTING and PARTICIPANTS:The patients were diagnosed with cerebrovascular diseases in Qilu Hospital of Shandong University during August 1995 to March 2000.There were 114 patients with LA,41 patients with BD and 113 patients with CI combining LA. INTERVENTIONS:The participants were asked detailed medical histories,taken neural examinations,head CT or MRI and MMES scale to measure neuropsychological states. MAIN OUTCOME MEASURES:①Previous history of hypertension,coronary heart disease,diabetes,hyperlipemia,smoking and cerebral infarction;②Clinical features of patients in each group,head CT or MRI images. RESULTS: There were diversified risk factors of simply LA which were characterized by mild hypomnesia,instable gait.Both CT and MRI showed that type 1 anomaly of white matter was commonly seen(70.2% ,71.6% )respectively.There was no dilated ventricle found in simply LA group. Hypertension was the primary risk factor of BD group(95.1% ). Patients in this group all had local neurological signs,obvious cognitive dysfunction and symptoms like cerebral apoplexy.CT showed that the type 3 anomaly of white matter accounts for 73.2% .MRI showed that type 3,type 4 anomaly were common seen which was 54.3% and 45.7% respectively. There were bilateral ventricle dilations in this group.In CI combining LA group,coronary heart disease(50% ),hypertension(43.4% ) and hyperlipemia(31.0% ) were major risk factors.Patients in this group had obvious cognitive dysfunction than patient in simply LA group besides suffering different level of neural focal sign such as hemiplegia and so on.Type 2 anomaly of white matter was commonly seen from both CT(66.4% ) and MRI(68.1% ) with dilated ventricle(39.8% ). CONCLUSION:Simply LA has various risk factors. It has no obvious neural focal sign and the diagnosis of it is mainly based on the imaging showing of type 1 white matter anomaly.The diagnostic standard of BD includes hypertension,obvious cognitive dysfunction and episode of CI.The imaging diagnosis is based on the type 3 anomaly of white matter in CT and type 3 or 4 in MRI.The risk factors of CI combining LA are coronary heart dishease,ypertension and hyperlipemia.It has more obvious cognitive dysfunction that simply LA.