The Italian Journal of Neurological Sciences

, Volume 11, Issue 5, pp 429–435 | Cite as

Usefulness and significance of the concept of leukoaraiosis in the study of dementia

  • Sanguineti I. 
  • Beghi E. 
  • Bogliun G. 


The term leukoaraiosis (LA), recently coined to designate the subcortical whitematter hypodensity most commonly seen on computerized tomography of the brain of demented and/or hypertensive subjects, is discussed with reference to the principal neurological disorders of the elderly. The contribution of published reports on LA are reviewed and some general comments are made in the light of the pathophysiology and classification of dementia.


Leukoaraiosis dementia cerebrovascular disease 


Gli Autori prendono in considerazione l'utilità ed il significato del concetto di leucoaraiosi recentemente introdotto per definire descrittivamente l'ipodensità della sostanza bianca sottocorticale alla tomografia computerizzata, rilievo ormai sempre più frequente nelle affezioni del senium legate alla demenza e all'ipertensione arteriosa. A questo scopo ricordano le diverse forme morbose che più significativamente presentano questo rilievo, illustrano i contributi della letteratura e traggono alcune conclusioni in merito ai problemi dottrinali posti dalle demenze e a quelli legati alla loro classificazione.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. [1]
    Adams R.D., Fisher C.M., Hakim S., Ojemann R.G., Sweet W.H.:Symptomatic Occult Hydrocephalus with “normal” cerebro-spinal fluid pressure. N. Engl. J. Med. 273:177–126, 1965.Google Scholar
  2. [2]
    Aharon-Peretz J., Cummings J.L., Hill M.A.:Vascular dementia and dementia of the Alzheimer type — Cognition, ventricular size, and leuko-araiosis. Arch. Neurol. 45:719–721, 1988.PubMedGoogle Scholar
  3. [3]
    Alzheimer A.:Die Seelesoerungen auf arteriosklerotisher: Glundlage Allgemeine Z. Psychiat. Psychish. Med. 59:695–711, 1902.Google Scholar
  4. [4]
    Awad I.A., Johnson P.C., Spetzler R.F., Hodak J.A.:Incidental subcortical lesions identified on Magnetic Resonance Imaging in the elderly. II Postmortem pathological correlations. Stroke 17:1090–1097, 1986.PubMedGoogle Scholar
  5. [5]
    Babikian V., Ropper A.:Binswanger's disease: a rieview. Stroke 18:2–12, 1987.PubMedGoogle Scholar
  6. [6]
    Ball M.J.:“Leukoaraiosis” explained (letter). Lancet 612–613, 1989.Google Scholar
  7. [7]
    Binswanger O.:Die abgrenzung der allgemeinen progressiven paralysie. Berliner Klinshe Wochenschrift 49:1103–1105, 50:1137–1139, 52:1180–1186, 1984.Google Scholar
  8. [8]
    Bogousslavsky J.:Leucoencéphalopathie, Leucoaraiose et infarctus cérébraux. Rev. Neurol. 144:11–17, 1988.PubMedGoogle Scholar
  9. [9]
    Brun A., Englund E.:A white matter disorder in dementia of the Alzehimer type: a pathoanatomical study. Ann. Neurol. 19:253–262, 1986.CrossRefPubMedGoogle Scholar
  10. [10]
    Brust J.C.M.:Vascular dementia is overdiagnosed. Arch. Neurol. 45:799–801, 1988.PubMedGoogle Scholar
  11. [11]
    Chimowitz M.I., Awad I.A., Furlana J.:Periventricular lesions on MRI — Facts and theories. Stroke 24:7–12, 1989.Google Scholar
  12. [12]
    De Reuck J.L.:The human periventricular arterial supply and the anatomy of cerebral infarction. Eur. Neurol. 5:321–334, 1971.PubMedGoogle Scholar
  13. [13]
    Durand-Fardel M.:Mémoire sur une altération particuliére de la substance cérébrale. Gazette Médicale de Paris 10:23–26 et 33–38, 1842.Google Scholar
  14. [14]
    Erkinijutti T.:CT in differential diagnosis between AD and vascular dementia. Acta Neurol. Scand. 75:262–270, 1987.Google Scholar
  15. [15]
    Erkinijutti T.:Differential diagnosis between AD and vascular dementia: evaluation of common clinical methods. Acta Neurol. Scand. 76:433–442, 1987.Google Scholar
  16. [16]
    Erkinijutti T:Types of multi-infarct dementia. Acta Neurol. Scand 75:391–399, 1987.Google Scholar
  17. [17]
    Fisher C.M.:Lacunes: small, deep cerebral infarcts. Neurology 15:774–784, 1965.PubMedGoogle Scholar
  18. [18]
    Fisher C.M.:Lacunar strokes and infarcts: a review. Neurology 38:871–876, 1982.Google Scholar
  19. [19]
    Fox A.J.:Leukoaraiosis (letter) Lancet 1261, 1989.Google Scholar
  20. [20]
    Gilbert J.J., Winters H.V.:Cerebral Amyloid Angiopaty: incidence and complications in the aging brain. I. Cerebral Hemorrhage. Stroke 14:915–923, 1983.PubMedGoogle Scholar
  21. [21]
    Gray F., Dubas F., Rouller E., Escourolle R.:Leukoencephalopathy in diffuse hemorrhagic cerebral amyloid angiopathy. Ann. Neurol. 18:54–59, 1985.CrossRefPubMedGoogle Scholar
  22. [22]
    Hachinski V.C., Potter P., Merskey H.:Leuko-Araiosis. Arch. Neurol. 44:21–23, 1987.PubMedGoogle Scholar
  23. [23]
    Hachinski V.C., Lassen N.A., Marshall J.:Multi-infarct dementia a cause of mental deterioration in elderly. The Lancet 27:207–210, 1974.Google Scholar
  24. [24]
    Inzitari D., Diaz F., Fox A. et al.:Vascular risk factors and Leuko-Araiosis. Arch. Neurol. 44:42–47, 1987.PubMedGoogle Scholar
  25. [25]
    Janota J., Misren T.R., Hachinski V.C., Lee D.H., Merskey H.:Neuropathologic Correlates of Leuko-Araiosis. Arch. Neurol. 46:1124–1128, 1989.PubMedGoogle Scholar
  26. [26]
    Joynt R.J.:Vascular dementia: too much or too little?. Arch. Neurol. 45:801, 1988.PubMedGoogle Scholar
  27. [27]
    Kinkel W.R., Jacobs L., Polachini I., Bates V., Heffner R.:Subcortical Arteriosclerotic Encephalopathy (Binswanger's Disease) — Computed Tomographic magnetic resonance and clinical correlations. Arch. Neurol. 42:951–959, 1985.PubMedGoogle Scholar
  28. [28]
    Lotz P.R., Ballinger W.E., Quisling S.G.:Subcortical arteriosclerotic encephalopathy: CT spectrum and pathologic correlation. AJNR 7:817–822, 1986.Google Scholar
  29. [29]
    Marie P.:Les lacunaires in Marie P. Travaux et Mémoires. Tome II — Masson Paris 1928.Google Scholar
  30. [30]
    Nichols F.T. III, Mohr J.P. (1986).Binswanger's subacute arteriosclerotic encephalopathy. In Barnett H.J.M., Stine B.M., Mohr J.P. Yatzu F.M. (eds); Stroke: pathophysiology diagnosis and management vol. 2, 1986, 875–885, Churchill Livingstone, New York.Google Scholar
  31. [31]
    O'Brien M.D.:Vascular dementia is underdiagnosed. Arch. Neurol. 45:797–798, 1988.PubMedGoogle Scholar
  32. [32]
    Pantano P., Baron J.C., Lebrun-Grandié P., Duquesnoy N., Bousser M.G., Commar D.:Regional cerebral blood flow and oxygen consumption in human aging. Stroke 15:635–641, 1984.PubMedGoogle Scholar
  33. [33]
    Poirier J., Derouesné C.:Le concept de lacune cérébrale de 1938 è nos jours. Rev. Neurol. 141:3–17, 1985.PubMedGoogle Scholar
  34. [34]
    Rao S.M., Mittenberg W., Bernardin L., Haughton V., Leo G.J.:Neuropsychological test findings in subjects with leukoaraiosis. Arch. Neurol. 46:40–44, 1989.PubMedGoogle Scholar
  35. [35]
    Roman G.C.:Senile Dementia of the Binswanger Type — A vascular form of dementia in the ederly. JA-MA 258:1782–1788, 1987.Google Scholar
  36. [36]
    Scheinberg P.:Dementia due to vascular diseasea multifactorial disorder. Stroke 19:1291–1299, 1988.PubMedGoogle Scholar
  37. [37]
    Selekler K., Erzen C.:Leuko-Araiosis and intracerebral hematoma. Stroke 20:1016–1020, 1989.PubMedGoogle Scholar
  38. [38]
    Steingart A., Hachinski V.C., Lau C., Fox A.J., Fox H., Lee D., Inzitari D., Merskey H.:Cognitive and neurologic findings in demented patients with diffuse white matter luciencies on computed tomographic scan (Leuko-Araioisis). Arch. Neurol. 44:36–39, 1987.PubMedGoogle Scholar
  39. [39]
    Steingart A., Hachinski V.C., Lau C., Fox A.J., Diaz F., Cape R., Lee D., Inzitari D., Merskey H.:Cognitive and neurologic findings in subjects with diffuse white matter lucencies on computed tomographic scan (Leuko-Araiosis). Arch. Neurol. 44:32–35, 1987.PubMedGoogle Scholar
  40. [40]
    Vassilouthis J.:The syndrome of normal pressure hydrocephalus. J. Neurosurg. 61:501–509.Google Scholar
  41. [41]
    Vinters H.V., Gilbert J.J.:Cerebral Amyloid Angiopathy: Incidence and complications in the aging brain. The distribution of amyloid vascular changes. Stroke 14:924–926, 1983.PubMedGoogle Scholar
  42. [42]
    Vinters H.V.:Cerebral Amyloid Angiopathy. A critical review. Stroke 18:311–324, 1987.PubMedGoogle Scholar
  43. [43]
    Wallin A., Blennow K., Uhlemann C., Längrström G., Gottfries C.G.:White matter low attenuation on computed tomography in Alzheimer's disease and vascular dementia — Diagnostic and pathogenetic aspects. Acta Neurol. Scand. 80:518–523, 1989.PubMedGoogle Scholar
  44. [44]
    Wong C.W., Quaranta V., Glennerg G.:Neuritic plaques and cerebrovascular amyloid in Alzheimer's disease are antigenically related. Proc. Natl. Acad. Sci. USA 82:8729–8732, 1985.PubMedGoogle Scholar
  45. [45]
    Yamada M.:Cerebral amyloid angiopathy in the aged. J. Neurol. 234:371–376, 1987.CrossRefPubMedGoogle Scholar
  46. [46]
    Zemer D., Pras M., Sohar E., Modan M., Cabili S., Gafni J.:Colchicine in the prevention and treatment of the amyloidosis of familial mediterranean fever. N. Engl. J. Med. 16:1001–1005, 1986.Google Scholar

Copyright information

© Masson Italia Periodici 1990

Authors and Affiliations

  • Sanguineti I. 
    • 1
  • Beghi E. 
    • 1
    • 2
  • Bogliun G. 
    • 1
  1. 1.Dipartimento di NeurologiaOspedale S. GerardoMonza
  2. 2.Istituto di Ricerche Farmacologiche “Mario Negri”Milano

Personalised recommendations