MAGNITUDE, DEGREE AND RISK FACTORS OF LEUKOARAIOSIS AMONG AGE ABOVE 40 YEARS OLD BRAIN MRI IMAGED PATIENTS AT SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA, 2019

Abstract

ABSTRACT Background: Leukoaraiosis (LA), also known as white matter lesions (WMLs), is age-related white matter changes (WMC) which is considered as manifestation of arteriosclerotic small vessel disease and are related to age and vascular risk factors. Leukoaraiosis seems asymptomatic but it is not benign. Some reports also showed that Leukoaraiosis could coexist with other geriatric disorders. In Ethiopia, there is scarcity of evidence on magnitude and degree of Leukoaraiosis or investigation of risk factors for Leukoaraiosis had found being the problem frequently seen in our clinical practice. Objective: The aim of this study was to determine Magnitude, degree and associated factors of white matter changes (WMC) among age above 40 years old brain MRI imaged patients at Saint Paul’s Hospital Millennium Medical College (SPHMMC) radiology department from September, 01, 2018 to December /31/2018. Methods: A Hospital based retrospective cross –sectional study was conducted on 102 Brain MRI imaged age above 40 years old patients. Data was collected by using data abstraction tool in the radiology department from medical record (card and PACS). The data was analyzed using SPSS version 20. Time and budget plan: The study was conducted from April to August 2019 with estimated grand total budget of 25,500 birr. Results: From a total of 102 subjects 94(92.4%) have some degree of MRI FLAIR cortical hyper intensities, from this 57(60.6%) have asymmetric distribution whereas 37(39.4%) have symmetrical distribution. The majority 85(92%) involved both deep subcortical and periventricular white matters and 52.9% had mild LA (52.4% were men, 47.9% were women) and 21.4% had moderate and 26.6 severe LA (50.1% were men, 49.9% were women). Majority of subjects 78.4% of age from 40 to 49 have no Global cortical atrophy whereas 80% (30% mild, 50% moderate or severe) subjects age above 70 years have some degree of global cortical atrophy. Similarly, subjects 82.4% of age from 40 to 49 have no Parietal cortical atrophy whereas 80% subjects age above 70 years have some degree of Parietal cortical atrophy and 90% of age above 70 subjects have some degree of medial temporal lobe atrophy. Conclusions: This study highlighted the high incidence of LA in hospitalized patients in Ethiopia and confirmed age and hypertension as the most important risk factors for LA. In the present study, we revealed that LA was a complex illness that may be driven by multiple vascular factors, including diabetes. The identification and further confirmation of those factors for overall LA risk, LA occurrence, and LA progression could provide effective information for clinicians and scientists to explore effective strategies for the prevention and treatment of LA.