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

Posted on May 26, 2017
Time to read: 4 minutes

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.

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  • Smart US

    well my partner has been just having some health issues and they did MRI and they came up with some white matter spots. She is losing balance as well as her eye sight not the best – double vision.
    is there are a way how to manage it- change of diet – what kind of diet etc. I know she dosnt have best diet although skinny. or medication?

    • PsychScene Hub

      Thanks for the message. It would be inappropriate to provide any advice and we would advise you to discuss this with your partner’s doctor. Neurological signs such as the ones you mention necessitate speaking to the doctor.

  • Kim Lawrie

    Hi, 6 of these lesions showed up in an MRI of my brain (I was having serious memory issues and still am due to an asthma attack that left me breathless for over an hour). They manually breathed for me after about 10 mins. Anyway, they didn’t mention the lesions. They are small, about the size of a half filled circle on a multiple choice exam. But I was 44 yrs old at the time. I would like to know what the doctors definition of “elderly” is. Thank you.

    • Psychscenehub

      Thank you for your message. ‘Elderly’ in psychiatry is considered >65. Since we cannot provide medical advice we would recommend discussing this with your doctor.

  • Brandy

    I am a 32 year old female. I had 1 WMH on an MRI in September. (frontal/parietal lobe) My dr ordered the test to look for MS, because of my symptoms. For a few years, I have had pain and weakness in my legs, tingling and pain in my hands, blurred/double vision, these are a few. They come and go, they are not constant. My dr just tells me what the radiologist said, “It is non-specific”. Should I get second opinion?

    • Psychscenehub

      Hi Brandy,
      We are unable to provide medical advice via this forum. In general non-specific should be differentiated from non-significant. Radiologists often state non-specific which may not mean non-significance. In order to establish clinical significance the findings should be correlated with a clinical history and examination.

  • THULI MSIMANGA

    Hello, what are areas of subcortical demyelination? Do they have anything to do with a pituitary microadenoma I have?

    • Psychscenehub

      Hi, The images should always be correlated clinically. Hence it would be appropriate to speak to your doctor or neurologist about this.

  • Jeannette Austin

    Hi Can someone explain my MRI FINDINGS:

    No acute infarct, hemorrhage, mass, abnormal enhancement,
    extra-axial fluid or midline shift. Major vascular flow voids
    preserved. Small number of punctate white matter hyperintensities
    bifrontal levels towards the vertex, nonspecific, can be seen with
    migraine headaches. Retention cyst left maxillary sinus.

    Major intracranial arterial vessels are patent, no cutoff or severe
    stenosis, no aneurysm identified.

    • Psychscenehub

      Hi Jeannette, we cannot provide medical advice on this forum. Please contact your doctor to discuss your MRI results as in general results should always be clinically correlated.