With the advent of new neuroimaging techniques, it is now possible to validly show white-matter lesions in cerebrovascular disease. However, their pathogenesis and clinical significance remain elusive. Therefore we investigated periventricular hyperintensity (PVH) in white matter lesions in patients with cerebrovascular disease and obtained the following results :
1. Aging, hypertension and ischemia were risk factors for PVH production.
2. In multiple infarct cases without dementia, cases with PVH had low cerebral blood flow in the frontal cortex, especially in the frontal cingulate gryus in addition to the cortical white-matter.
3. In cases of severe ischemic white-matter lesions, the activity of cortical areas related to auditory cognition was shown to be decreased in a PET activation study.
4. An apoptoic mechanism was indicated in frontal deep white-matter legions in cases with multiple infarction dementia.
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