The term leukoaraiosis was first used by Hachinski and his colleagues in 1987 when they detected a white matter in the brain during a CT scan. The matter was seen as patchy and covered diffused areas with the boundaries not so well defined.
Leukoaraiosis is now being shown to have links with the history of stroke and it also can show the probability of occurrence of either ischemic or hemorrhagic stroke. Leukoaraiosis is the abnormal appearance of white matter, which is a deviation from the normal appearance. This abnormal appearance is believed to be caused by leakage disturbances of fluids through the structures located deep in the brain.
This white matter has quite an abnormal appearance and has been the subject of various studies due to the clinical relevance it has accumulated over the years. Techniques such as neuroimaging have shown that the occurrence of white matter is strongly related to ischemic stroke, worse long-term outcomes, and cognitive disturbances.
Even after immense studies, the pathogenesis of leukoaraiosis is not yet understood as to why the white matter assumes such abnormal appearance. Increasing age has been considered to be directly proportional to the prevalence of leukoaraiosis. The individual over 60 years of age are more prone to leukoaraiosis.
History of stroke, tobacco use, alcohol abuse, and chronic kidney diseases can make the specific individual susceptible to developing pathology of white matter. Among all these, age is the single factor that increases the chances of developing leukoaraiosis more than anything else. As mentioned earlier, leukoaraiosis is highly linked with stroke particularly lacunar stroke, vascular dementia, and Alzheimer’s disease are worth mentioning here.
Depression and mood disorders are significantly common in even young individuals. And some studies have shown an association of leukoaraiosis with depression and mood disorders which calls for attention more than anything else.
2) Association with Stroke?
Those patients who have had gone through a stroke are more prone to leukoaraiosis Studies have indicated that if the white matter is abnormal, it can be considered to cause the first stroke as well as the later ones which could happen to the patient as the illness gets worse with time passing by. There is a strong association between LA and lacunar infractions (LI). Leukoaraiosis is also associated with cerebral atrophy. There is a cerebral grey matter mass in the brain. If this mass starts to decline, this gives rise to an increase in the prevalence of the abnormality in the white matter. Differentiation can occur which leads to the destruction of different connections of nerve cells thus causing the breakdown of tissues in the grey matter. When this grey matter starts to decline, interruption of corticocortical connections starts to happen ultimately leading to pathology of the white matter.
3) Symptoms of Leukoaraiosis:
As with many other complex diseases, leukoaraiosis is no different in the aspect that its symptoms only start to show when the disease has spread to a significant level. These symptoms can range from being mild and average at the start of getting severe as time passes by. The following are some of the symptoms of leukoaraiosis.
- Difficulty in maintaining balance
- Unable to produce pace in a walk
- Falling more often
- Inability to do multi-tasking
- Frequent mood changes
4) Causes: Leukoaraiosis is Silent Strokes?
The actual cause of leukoaraiosis is still not clear. Some studies show that white matter is caused by some special types of strokes. These strokes are special in the sense that they are so small to the extent that the person having them is unable to identify is he having a stroke. These small strokes are called silent strokes. These strokes are silent and unnoticeable but could cause serious complications within the brain. The white matter gets damaged due to these silent strokes and hence leukoaraiosis is the result.
Some other risk factors are:
- Smoking cigarettes as addiction
- The old age of the individual
- Heart disease
- High blood pressure
- High cholesterol level
5) Diagnosing the Leukoaraiosis Disease:
The symptoms are mild in the beginning and get severe with time. The symptoms are used by the doctor in diagnosing this disease. Imaging tests can make it clear whether suffering from leukoaraiosis is or not.
Mostly MRI scan is done to diagnose the abnormality in white matter. MRI stands for magnetic resonance imaging. There is a special type of MRI scan called T2 Flair which is used to see and detect abnormalities in the white matter. The scan shows these abnormalities as bright spots that help in distinguishing the abnormal matter from the surrounding areas easily. The doctor then also asks questions about cardiovascular health, the symptoms of the patient to make the final verdict.
6) Prevention of Leukoaraiosis:
Since the real causes of leukoaraiosis are still unknown, the real and accurate treatment can’t be found anywhere yet. The risk factors can help prevent the abnormalities in white matter to a certain extent. As for many other diseases, some lifestyle changes and dietary modifications can help prevent leukoaraiosis. Dietary changes that lead to lowering blood pressure and blood sugar can place the person in a good position in preventing abnormalities in white matter.
Older people are at a higher risk of developing leukoaraiosis. But still, some steps can be chosen to stop it from spreading. The damage that has already been done can be repaired only if the disease is detected at an earlier stage which is sometimes difficult because the symptoms are not that much prominent at earlier stages.
7) Treatment of Leukoaraiosis:
Since there is no specific treatment for leukoaraiosis, the cause of damage is targeted to stop the disease from getting worse. Once the diagnosis is done, the underlying cause is put into perspective to slow and stop the progression altogether.
A person who has issues in keeping balance due to leukoaraiosis would sometimes need physical therapy to get the condition cured. Lifestyle changes are necessary if the abnormalities in white matter are to be cured to not produce any more complications in the brain making this disease significantly important to be addressed as soon as possible. Read more about White Matter Disease Anticipation!