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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/01/30 05:48:51」(JST)

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Axial T2 FLAIR sequence MR image of a middle-aged man with leukoaraiosis.

MRI image: Leukoaraiosis in a 90 year old patient with cerebral atrophy.

Leukoaraiosis^[1] or white matter hyperintensities (WMHs)^[2] describes the nonspecific changes in the cerebral white matter frequently seen on CT and MRI in aged individuals and even young adults sometimes.^[3] It is a condition routinely found in elderly people.

The term leukoaraiosis was coined in 1986^[4]^[5] as a descriptive term for rarefaction ("araiosis") of the white matter, showing up as decreased density on CT and increased signal intensity on T2/FLAIR sequences (white matter hyperintensities) performed as part of MRI brain scans.

These white matter changes are also commonly referred to as periventricular white matter disease, or white matter hyperintensities (WMH) due to their bright white appearance on T2 MRI scans. Many patients can have leukoaraiosis without any associated clinical abnormality. However, underlying vascular mechanisms are suspected to be the cause of the imaging findings. Hypertension, smoking, diabetes, hyperhomocysteinemia, and heart disease are all risk factors for leukoaraiosis.

The abnormalities are thought to be caused by multiple small vessel infarcts in the subcortical white matter, often the result of chronic hypertension leading to lipohyalinosis of the small vessels. Patients may develop subcortical dementia syndrome.^[6]

Leukoaraiosis has been reported to be an initial stage of Binswanger's disease but this evolution does not always happen.

Special cases

Ischaemic Leukoaraiosis has been defined as the leukoaraiosis present after a stroke.^[7]

Diabetes associated leukoaraiosis has been reported^[8]

References

^ O'Sullivan, M. (2008). "Leukoaraiosis". Practical Neurology 8 (1): 26–38. doi:10.1136/jnnp.2007.139428. PMID 18230707.
^ http://journal.frontiersin.org/Journal/10.3389/fnagi.2014.00144/full
^ J. Putaala, MD, M. Kurkinen, MD, V. Tarvos, MD, O. Salonen, MD, PhD, M. Kaste, MD, PhD and T. Tatlisumak, MD, PhD Silent brain infarcts and leukoaraiosis in young adults with first-ever ischemic stroke, Neurology May 26, 2009 vol. 72 no. 21 1823-1829, doi: 10.1212/WNL.0b013e3181a711df
^ Hachinski, VC; Potter, P; Merskey, H (1986). "Leuko-araiosis: An ancient term for a new problem". The Canadian journal of neurological sciences 13 (4 Suppl): 533–4. PMID 3791068.
^ Hachinski, V. C.; Potter, P.; Merskey, H. (1987). "Leuko-Araiosis". Archives of Neurology 44 (1): 21–3. doi:10.1001/archneur.1987.00520130013009. PMID 3800716.
^ Fauci, Anthony S.; Braunwald, Eugene; Weiner, Charles; Kasper, Dennis L.; Hauser, Stephen L.; Longo, Dan L.; Jameson, J. Larry; Loscalzo, Joseph (2008). Harrison's Principles of Internal Medicine (17th ed.). New York: McGraw-Hill. ISBN 978-0-07-149619-3. ^{[page needed]}
^ M O’Sullivan1, R G Morris2, B Huckstep2, D K Jones3, S C R Williams4, H S Markus1, Diffusion tensor MRI correlates with executive dysfunction in patients with ischaemic leukoaraiosis, J Neurol Neurosurg Psychiatry 2004;75:441-447 doi:10.1136/jnnp.2003.014910 [1]
^ Maldjian JA, Whitlow CT, Saha BN, Kota G, Vandergriff C, Davenport EM, Divers J, Freedman BI, Bowden DW. Automated White Matter Total Lesion Volume Segmentation in Diabetes. AJNR Am J Neuroradiol. 2013 Jul 18

UpToDate Contents

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1. 脳血管性認知症の病因、臨床症状、および診断 etiology clinical manifestations and diagnosis of vascular dementia
2. 皮質下梗塞および白質脳症を伴う常染色体優性脳動脈症（CADASIL） cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy cadasil
3. 成人における虚血性脳卒中の予後 ischemic stroke prognosis in adults
4. 抗凝固剤投与患者における脳出血のリスク risk of intracerebral bleeding in patients treated with anticoagulants
5. 急性脳出血または脳出血既往歴のある患者における抗血栓療法の利用 the use of antithrombotic therapy in patients with an acute or prior intracerebral hemorrhage

English Journal

Small vessel disease and memory loss: what the clinician needs to know to preserve patients' brain health.

Schenk C, Wuerz T, Lerner AJ.SourceDepartment of Neurology, University Hospitals Case Medical Center, 3619 Park East Drive, suite 211, Beachwood, OH, 44122, USA.
Current cardiology reports.Curr Cardiol Rep.2013 Dec;15(12):427. doi: 10.1007/s11886-013-0427-6.
Small vessel disease (SVD) in the brain manifests in the periventricular and deep white matter and radiographically is described as "leukoaraiosis". It is increasingly recognized as a cause of morbidity from middle age onward and this clinical relevance has paralleled advances in the field of neuror
PMID 24105643

Jugular Venous Reflux and White Matter Abnormalities in Alzheimer's Disease: A Pilot Study.

Chung CP, Beggs C, Wang PN, Bergsland N, Shepherd S, Cheng CY, Ramasamy DP, Dwyer MG, Hu HH, Zivadinov R.SourceDepartment of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurology, National Yang Ming University of Medicine, Taipei, Taiwan.
Journal of Alzheimer's disease : JAD.J Alzheimers Dis.2013 Nov 8. [Epub ahead of print]
To determine whether jugular venous reflux (JVR) is associated with cerebral white matter changes (WMCs) in individuals with Alzheimer's disease (AD), we studied 12 AD patients 24 mild cognitive impairment (MCI) patients, and 17 elderly age- and gender-matched controls. Duplex ultrasonography and 1.
PMID 24217278

Association between the volume of carotid artery plaque and its subcomponents and the volume of white matter lesions in patients selected for endarterectomy.

Saba L, Raz E, Grassi R, Di Paolo PL, Iacomino A, Montisci R, Piga M.Source1 Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Polo di Monserrato s.s. 554, Monserrato, Cagliari 09045, Italy.
AJR. American journal of roentgenology.AJR Am J Roentgenol.2013 Nov;201(5):W747-52. doi: 10.2214/AJR.12.10217.
OBJECTIVE. The amount of cerebral white matter lesions (WMLs) and the severity of carotid artery disease are correlated in this study. The association between the severity of WMLs and the volume of the different components of carotid artery plaque is also evaluated. MATERIALS AND METHODS. Fifty cons
PMID 24147504