White Matter Hyperintensities on MRI – Coincidental Finding or Something Sinister?

Posted on May 26, 2017

White matter hyperintensities (WMHs) are lesions in the brain that show up as areas of increased brightness when visualised by T2-weighted magnetic resonance imaging (MRI).

WMH’s are also referred to as Leukoaraiosis and are often found in CT or MRI’s of older patients. The prevailing view is that these intensities are a marker of small-vessel vascular disease and in clinical practice, are indicative of cognitive and emotional dysfunction, particularly in the ageing population.

The initial discovery of WMH’s was made in the late 1980’s by Hachinski and colleagues. They described WMH’s as patchy low attenuation in the periventricular and deep white matter.

References

Pathology of WMH's
Wardlaw, J. M., Hernández, M. C. V., & Muñoz‐Maniega, S. (2015). What are white matter hyperintensities made of? Relevance to vascular cognitive impairment. Journal of the American Heart Association, 4(6), e001140.
The clinical importance of white matter hyperintensities

Debette et al., The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis, BMJ 2010; 341: c3666.