Leukoaraiosis describes the nonspecific changes in the cerebral white matter frequently seen on CT and MRI in aged individuals. The term leukoaraiosis was first coined in 1986 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 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 sub cortical white matter, often the result of chronic hypertension leading to lipohyalinosis of the small vessels. Patients may develop subcortical dementia syndrome.

Binswanger disease is a form of small vessel vascular dementia caused by damage to the white brain matter.

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