Stroke, Vol 17, 1084-1089, Copyright © 1986 by American Heart Association
IA Awad, RF Spetzler, JA Hodak, CA Awad and R Carey
Patchy subcortical foci of increased signal intensity are frequently
identified on magnetic resonance imaging (MRI) in the elderly. The
incidence and clinical correlates of these lesions remain unknown. In this
report, 240 consecutive MRI scans performed over a 6-month period were
reviewed (excluding patients with recent brain trauma or known
demyelinating disease). Subcortical incidental lesions (ILs) were
identified, which could not be accounted for by the patient's current
clinical diagnosis, neurological status, or CT scan. The ILs were graded
according to size, multiplicity, and location. The incidence and severity
of ILs increased with advancing age (p less than 0.0005). Among patients
over 50 years of age, the incidence and severity of ILs were correlated
with a previous history of history of ischemic cerebrovascular disease (p
less than 0.05) and with hypertension (p less than 0.05). Multivariable
regression analysis identified age, prior brain ischemia, and hypertension
as the major predictors of ILs in the elderly. Diabetes, coronary artery
diseases, and sex did not play a significant role. With the exception of
cerebrovascular disease, there was no association between ILs and any
particular clinical entity, including dementia. It is concluded that
subcortical parenchymal lesions are frequent incidental findings on MRI in
the elderly, and may represent an index of chronic cerebrovascular diseases
in such patients.
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Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. I. Correlation with age and cerebrovascular risk factors
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