White matter changes in stroke patients - Relationship with stroke subtypeand outcome

White matter changes (WMC), detected by imaging techniques, are frequent in stroke patients. The aim of the study was to determine how WMC relate to s troke subtypes and to stroke outcome. We made a systematic Medline search f or articles appearing with two of the following key words: either 'WMC or w hite matter lesions or leukoencephalopathy or leukoaraiosis' and 'stroke or cerebral infarct or cerebral hemorrhage or cerebrovascular disease or tran sient ischemic attack (TIA)'. WMC, as defined radiologically, are present i n up to 44% of patients with stroke or TIA and in 50% of patients with vasc ular dementia. WMC are more frequent in patients with lacunar infarcts, dee p intracerebral hemorrhages, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy and cerebral amyloid angiopath y. After an acute ischemic stroke, WMC are associated with a higher risk of death or dependency, recurrent stroke of any type, cerebral bleeding under anticoagulation, myocardial infarction, and poststroke dementia. WMC in st roke patients are often associated with small-vessel disease and lead to a higher risk of death, and poor cardiac and neurological outcome. However, s everal questions remain open and need further investigations.