Document Type : Original Article

Authors

• Seyyed Amir Hejazi ¹
• Payam Molavi ²
• Fereshte Shahrab ²
• Fatemeh Mollarahimi ³
• Sajjad Rezvan ⁴
• Zahra Mohammadi ⁵
• Rezvaneh Najafi ⁶
• Seyed Vahid Taheri ⁷
• Mahdieh Taheri ⁸

¹ Professor of Neurology, Department of Neurology, School of Medicine, Neuroscience Research Centez, Shahid Beheshti Hospital, Qom University of Medical Sciences

² Assistant Professor of Neurosurgery, School of Medicine, Shahid Beheshti Hospital, Qom University of Medical Sciences

³ Assistant Professor of Community Medicine Department of Family and Community Medicine, School of Medicine Spiritual Health Research Center Qom University of Medical Sciences

⁴ Assistant Professor of Radiology School of Medicine Qom University of Medical Sciences

⁵ QOM

⁶ Department of Neurology, School of Medicine , Neuroscience Research Center , Shahid Beheshti Hospital Qom University of Medical Sciences

⁷ Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

⁸ Clinical Research Development Unit, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Background and Objective: Leukoaraiosis (LA) and lacunar infarction (LI) share pathophysiological mechanisms related to cerebral small vessel disease (CSVD), but their clinical associations require further elucidation. This cross-sectional study aimed to determine the prevalence of LA and its association with clinical characteristics and infarct locations in patients with LI at Shahid Beheshti Hospital, Qom.

Methods: We enrolled 100 patients with confirmed LI (aged 30–80 years) who underwent brain MRI between 2024–2025. LA severity was assessed using the Fazekas scale, while infarct locations were categorized. Demographic data, vascular risk factors, and clinical findings were collected. Statistical analyses included chi-square tests, regression models, and significance threshold of p < 0.05.

Results: LA was present in 82% of patients (50% severe Fazekas grade 3). The mean age was significantly higher in patients with LA (68.28 ± 11.74 vs. 59.06 ± 13.20 years; p = 0.004). Infarcts were most frequent in the corona radiata (35%) and least in the left internal capsule (9%). Severe LA was significantly associated with corona radiata and brainstem infarcts (p = 0.040). Logistic regression confirmed age as an independent predictor of LA (OR = 1.095; p = 0.007), while basal ganglia infarcts showed lower odds compared to corona radiata (OR = 0.073; p = 0.038).

Conclusion: LA is highly prevalent in LI patients and strongly associated with advanced age and specific infarct locations. These findings support LA as a marker of impaired cerebral microvascular reserve, particularly affecting watershed zones like the corona radiata.

Keywords

• Leukoaraiosis
• Lacunar Infarction
• Brain MRI
• Small Vessel Disease
• Fazekas Scale
• Cerebral Microangiopathy

Main Subjects

• Radiology