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Domenico Inzitari, MD; Antonio Di Carlo, MD; Mario Mascalchi, MD; Giovanni Pracucci, MD; Luigi Amaducci, MD

Arch Neurol. 1995;52(7):687-691.

Abstract
Background and Methods
The long-term outcome of patients with motor impairment and extensive leukoaraiosis on computed tomographic scan is unknown. We studied the incidence of stroke, myocardial infarction, and death in 31 such patients (cases) and in 68 neurologic patients without leukoaraiosis (controls). The patients in both groups had a routine neurologic and cardiovascular assessment and were followed up for 51.9±20.1 (mean±SD) months (cases) and 49.5±18.6 months (controls).

Results
The 6-year risk of cumulative stroke, as determined by life table analysis, was 49% among cases and 16% among controls (hazard ratio, 3.0; 95% confidence interval, 1.2 to 7.5). The risk of stroke or myocardial infarction was 69% vs 36% (hazard ratio, 2.9; 95% confidence interval, 1.4 to 6.2). The stroke risk remained significantly increased among cases after adjustment for age, sex, and any conventional vascular risk factor, while it was reduced (hazard ratio, 2.5; 95% confidence interval, 0.8 to 7.4) after adjustment for history of lacunar stroke was corrected for and was almost halved (hazard ratio, 1.6; 95% confidence interval, 0.5 to 4.6) after adjustment for the presence of lacunar infarction images on computed tomographic scan.

Conclusions
Patients with motor impairment and extensive leukoaraiosis have a very poor cardiovascular outcome. Lacunar infarction might be the major determinant of the outcome in these patients.

Author Affiliations
From the Department of Neurological and Psychiatric Sciences, University of Florence (Italy) (Drs Inzitari, Di Carlo, Pracucci, and Amaducci), and the Institute of Radiology, University of Pisa (Italy) (Dr Mascalchi).

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