Leuko-araiosis and stroke: A case-control study

Objective - Association of leuko-araiosis (LA) with certain risk factors has been reported in Western patients. This is a case-control study to determine the risk factors and the type of stroke associated with LA in Saudi patients. Design and setting - 398 consecutive Saudi patients with the diagnosis of stroke admitted over a 6-year period were evaluated for presence or absence of LA on cranial computed tomography. LA and non-LA groups were compared with regards to the presence of certain risk factors such as type of stroke, age, brain atrophy, systemic hypertension and history of cardiac disease or diabetes mellitus. The odds ratio and its 95% confidence interval (CI) were used to estimate the strength of association between the different parameters. Results - The mean age in the LA group was 67.8+/-8.5 years as compared to 61.2+/-13.2 years in the non-LA group. No patient younger than 40 years had LA on CT. Incidence of LA increased with age. Forty-seven percent of the LA group were over 70 years of age compared to 31% of the non-LA group (OR=2, CI 1.26-3.15). Generalized atrophy was detected in 40% of patients with LA compared to 20% of non-LA group (OR 2.7, CI 1.65-4.39). Sixty-nine percent of patients in the LA group had lacunar infarct compare to 39% in the non-LA group (OR 3.4, CI 2.15-5.59). The difference was not significant between the two groups in relation to the frequency of cerebral hemorrhage or larger infarcts. Systemic hypertension was also significantly associated with the presence of LA (OR 2.15, CI 1.34-3.43). Conclusion - LA is associated mainly with lacunar infarcts, cerebral atrophy, systemic hypertension and advanced age in Saudi patients.