Multifocal hypointense cerebral lesions on gradient-echo MR are associated with chronic hypertension

S Chan, K Kartha, S S Yoon, D W Desmond, S K Hilal
AJNR. American Journal of Neuroradiology 1996, 17 (10): 1821-7

PURPOSE: To investigate the basis for multifocal hypointense lesions within the brain as identified on T2*-weighted gradient-echo MR imaging in patients with no known or presumed cause of these lesions.

METHODS: In the first of a two-part study design, we retrospectively reviewed a case series of 38 patients whose gradient-echo MR images showed multiple hypointense lesions within the brain parenchyma. Thirty-one cases in which the cause was known or presumed (eg, head trauma or cavernous angioma) were excluded from further review. The MR studies and clinical findings of the remaining seven cases were reexamined. In the second part, using a cohort study design with respect to hypertension, we prospectively reviewed the gradient-echo images from MR studies of 65 patients and control subjects enrolled in two ongoing clinical studies, one on "possible vascular dementia" (n = 33) and the other on "possible motor neuron disorder" (n = 32).

RESULTS: In the first part of the study, we found seven cases with a pattern of multiple hypointense lesions involving the deep gray matter nuclei, especially the basal ganglia (n = 6) and thalamus (n = 5). In addition, involvement of the corona radiata (n = 5), brain stem (n = 4), and cerebellum (n = 3) was seen. Clinical review revealed a history of chronic hypertension in all seven patients. In the cohort study, we found three of 65 persons who had two or more focal hypointense lesions that involved the basal ganglia or thalami. Review of the clinical data showed that all three patients were being treated for hypertension; also, all three were patients from the "possible vascular dementia" group.

CONCLUSIONS: The MR imaging pattern of multifocal hypointense lesions within the basal ganglia, thalamus, and other deep cerebral structures is more commonly found among patients with a history of chronic hypertension than in patients without chronic hypertension.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.