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Deep white matter hyperintensities occur deep within white matter, periventricular white matter hyperintensities occur adjacent to the lateral ventricles and subcortical hyperintensities occur in the basal ganglia. [citation needed] Hyperintensities are often seen in auto immune diseases that have effects on the brain. [6]
Head CT showing periventricular white matter lesions. Leukoaraiosis is a particular abnormal change in appearance of white matter near the lateral ventricles. It is often seen in aged individuals, but sometimes in young adults. [1] [2] On MRI, leukoaraiosis changes appear as white matter hyperintensities (WMHs) in T2 FLAIR images.
lower white matter hyperintensity volume, indicating less damage to the white matter in the brain increased fractional anisotropy, indicating well-organized and healthy white matter connections.
[4] [5] If lumbar puncture is performed this may show increased protein levels but no white blood cells. [1] [3] [4] Computed tomography scanning may be performed in the first instance; this may show low density white matter areas in the posterior lobes. [4] The diagnosis is typically made with magnetic resonance imaging of the brain.
Others classify them as hippocampal, cortical, and WM lesions, [23] and finally, others give seven areas: intracortical, mixed white matter-gray matter, juxtacortical, deep gray matter, periventricular white matter, deep white matter, and infratentorial lesions. [24] The distribution of the lesions could be linked to the clinical evolution [25]
The gray matter remains normal in all characteristics while the white matter changes texture, becoming soft and gelatinous. Rarefaction of the white matter is seen through light microscopy and the small number of axons and U-fibers that were affected can also be seen. Numerous small cavities in the white matter are also apparent.
FLAIR hyperintensity confined to sulcus and/or cortex/subcortical white matter in one location < 5 cm FLAIR hyperintensity 5 to 10 cm, or more than 1 site of involvement, each measuring < 10 cm FLAIR hyperintensity measuring > 10 cm, often with significant subcortical white matter and/or sulcal involvement.
The criteria for MRI-defined vascular depression focus on the presence and severity of either deep white matter lesions, often referred to as white matter hyperintensities, or subcortical grey matter lesions. The most severe lesion in an individual is scored based on predefined criteria and considered in combination with two measures of ...