Brain hyperintensities in magnetic resonance imaging of patients with mild acute focal neurology

Ourania Varsou (Corresponding Author), Mary J. Macleod, Christian Schwarzbauer, Alison D. Murray, Catarina Dinis Fernandes, Michael S. Stringer, Katie Turnbull

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Hyperintensities are common in neuroimaging scans of patients with mild acute focal neurology. However, their pathogenic role and clinical significance is not well understood. We assessed whether there was an association between hyperintensity score with diagnostic category and clinical assessments/measures.

One hundred patients (51 ± 12 years; 45:55 women:men), with symptomatology suggestive of short duration ischemia referred for magnetic resonance imaging, were prospectively recruited in NHS Grampian between 2012 and 2014. Hyperintensities were quantified, on T2 and FLAIR, using the Scheltens score.

The most frequent diagnosis was minor stroke (33%), migraine (25%) and transient ischemic attack (17%). The mean total Scheltens score was 28.49 ± 11.93 with all participants having various loads of hyperintensities. Statistically significant correlations between hyperintensity scores and clinical assessments/measures (age, systolic blood pressure, pulse pressure, MoCA) at the global level were also reflected regionally. These provide further supporting data in terms of the robustness of the Scheltens scale.

Hyperintensities could serve as a diagnostic and prognostic imaging biomarker for patients, presenting with mild acute focal neurology, warranting application of automated quantification methods. However, larger cohorts are required to provide a definitive answer especially as this is a heterogenous group of patients.
Original languageEnglish
Pages (from-to)1633-1635
Number of pages3
JournalNeurological Sciences
Issue number6
Early online date23 Jan 2020
Publication statusPublished - Jun 2020

Bibliographical note

We would like to thank the NHS Grampian Stroke Managed Clinical Network for contracting the scanner and the Aberdeen Biomedical Imaging Centre staff for their support.


  • white matter hyperintensities
  • leukoaraiosis
  • stroke
  • TIA
  • Migraine
  • White matter hyperintensities
  • Stroke
  • Leukoaraiosis


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