Leukoaraiosis: what is it?

Leukoaraiosis is a depletion of white matter in the brain. These white matter abnormalities are usually detected in the elderly or in people with a history of vascular disorders, but they can also be discovered incidentally in a younger individual without symptoms or history.

Among the most frequent risk factors of leucoaraiosis we can mention: age, high blood pressure, coronary heart disease, diabetes, smoking, high cholesterol but also a history of cerebrovascular accident (ischemic stroke) . Leucoaraiosis is also called vascular dementia. In terms of symptoms, leukoaraiosis can cause various signs, including mood disorders, cognitive disorders but also headaches or walking disorders.

How to diagnose leukoaraiosis?

Leukoaraiosis is detected during a CT scan, or computed tomography (CT), or during magnetic resonance imaging (MRI). The examination will then show what are called hypersignals, which appear in the image as small white spots.

Depending on the patient’s age, history and possible symptoms, the discovery of leucoaraiosis should lead the doctor to carry out further investigations, in particular by carrying out an in-depth cognitive assessment. He can also investigate to detect possible hypertension, diabetes, heart failure, the presence of atheroma plaques in the arteries of the neck.

What diseases can it be a sign of?

Leukoaraiosis is not a disease as such but rather a sign of one or more pathologies. In most cases, leukoaraiosis will be detected in elderly patients with dementia, high blood pressure, or with a history of stroke. But leukoaraiosis can also be a risk factor in the occurrence of a stroke.

Leukoaraiosis: how to treat it?

In the current state of research, there is currently no treatment allowing the lesions of leucoaraiosis to disappear. The attack is irreversible and the management will consist in reducing the risk factors to prevent new vascular accidents from occurring. The doctor will therefore take care to control the patient’s hypertension with medication, to ensure that he does not develop diabetes and that his cholesterol level is within the norm. If the Doppler reveals the presence of atheroma plaques, the doctor may consider angioplasty to remove it.

Leucoaraiosis: Alzheimer’s disease and vascular dementia

Leukoaraiosis, also known as vascular dementia, is often associated with Alzheimer’s disease. We will then speak of “mixed” dementia. These two dementias are, however, of different types and if they can be combined, they should not be confused. Where leucoaraiosis is of vascular origin, Alzheimer’s disease results from a neurodegenerative process. Vascular dementia progresses in spurts if new vascular events occur in the brain. In the case of Alzheimer’s disease, the evolution occurs gradually as the neurons are destroyed. However, some symptoms are very similar between these two forms of dementia, it is not uncommon for the diagnosis to be difficult to establish.

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