MRI white Matter Lesions in a Stroke Clinic Population: Correlation with Increased Carotid Intima-media Thickness on Ultrasonography

Cerebral white matter lesions (WML) on MRI have been related not only to age but also to cerebrovascular disorders. This study aimed to determine the prevalence of WML in a population of patients attending a stroke clinic and relate it to the presence of carotid atherosclerosis as determined by increased carotid intima-media thickness (IMT) on ultrasonography. Subjects were recruited from patients attending a stroke clinic at the National Hospital for Neurology and Neurosurgery, Queen square, London. The patients had cranial MRI and carotid ultrasonography (amongst other investigations). WML on MRI were graded according to the rating scale of the Task force on age-related white matter changes and a WML score was obtained based on the WML grades and geographical distribution. Patients with carotid intima-media thickness > 1cm on ultrasonography were considered to have increased intima-media thickness. WML was present in 63.46% of subjects. Patients with WML had a significantly higher mean age than those without (67.5 vs 53.5 years). Increased carotid IMT was found in 33.3% of those with WML and in 15.8% of those without. The difference was not statistically significant. There was no significant association between the presence of any grade of WML and increased carotid IMT. Similarly, the mean WML scores for patients with and without increased carotid IMT were not significantly different. A high proportion of patients in the stroke clinic had WML on MRI. Presence of WML was not associated with the presence of carotid atherosclerosis as shown by increased carotid intima-media thickness. Nigerian Medical Practitioner Vol. 52 (2) 2007: pp. 38-4