Images from MRI performed at 15 month (A-C) and at 46 month of age (D-F).The white arrows point to the key findings in each case. Latest News Your top articles for Wednesday, Continuing Medical Education (CME/CE) Courses. Grueter B & Schulz U. Age-Related Cerebral White Matter Disease (Leukoaraiosis): A Review. Do Brain T2/FLAIR White Matter Hyperintensities Correspond to Myelin Loss in Normal Aging? Many symptoms of white matter disease dont appear until the disease has become more advanced. After asking you some specific questions about your symptoms, your doctor will likely order an MRI. But you can take steps to stop it from spreading. more frequent falls. Similar terms focused on the white matter include white matter disease, white matter damage, and leukoencephalopathy (the latter usually used in the context of CADASIL)16. Many variant terms for this entity presume an age-related etiology, such as age-related white matter hyperintensities/changes/disease/damage 16, although noting that not all age-related white matter changes are attributed to small vessel disease 14. Purpose To review the MRI findings associated with acute neurologic manifestations in patients with COVID-19. White matter is made up of tracts, or bundles, each of which contains millions of nerve fibers that connect gray matter regions throughout the central nervous system. Diagnostic equivalency of fast T2 and FLAIR sequences for pediatric brain MRI: a pilot study. WMH's are also referred to as Leukoaraiosis and are often found in CT or MRI's of older patients. Doctors try to treat the underlying cause of the myelin condition in order to slow down or stop disease progression. Progressive means that it gets worse over time. In this article, learn about the symptoms. Illustration of microstructural changes occurring in the grey-white matter junction when scar-border forming astrogliosis is present. Journal of Neuropsychology, Feb. 24, 2014. The signals that help you do these things cant get through. Epub 2015 Oct 24 doi: 10.1002/hbm.23022. eCollection 2016 Aug 8. At present, there is no universal staging system for the various forms of white matter disease. 10. MRI result (from Holland): white matter lesions. A physical therapist can provide exercises and other techniques to improve balance and gait. Repeated radiological evaluations were performed in 11 (47.8%) of the patients. White matter is the deepest part of the brain that contains millions of nerve fibres connecting other parts of the brain and spinal cord. MRI, or magnetic resonance imaging, reveals these spots with greater intensity because they have increased water content compared to normal, higher fat content, myelinated tissue in the brain. (2014). A total of 941 patients were included in the study. Th. White matter changes in the brain, . Changes of primary headache related white matter lesions in pediatric patients. Age Ageing. Sixty-one percent of the patients received cranial neuroimaging. Treatment Guideline Subcommittee of the Taiwan Headache Society. Nat Rev Neurol. They cause disease by altering the process of normal myelination . Neuromyelitis optica spectrum disorders (NMOSD) also share several characteristics with MS and need to be ruled out. In MS, for example, the newer disease-modifying therapies may lessen the number of demyelinating lesions, known as plaques, or keep them from getting larger. Your overall physical and mental health can be improved when youre able to walk and get around better with little or no assistance. MRI differential diagnosis of suspected multiple sclerosis. 1. These nerves are also called white matter. Stroke. This can make it especially difficult to exclude other potential diagnoses before MS can be diagnosed. The content on Healthgrades does not provide medical advice. depression. Schmahmann, J.D. Many etiopathogenic types of small vessel disease are described (see below). It can lead to early childhood death. 2013 Aug;33(11):906-13. doi: 10.1177/0333102413480955. In the below slideshow, Drs Lange, Melisaratos, and Schiess shared a collection of MRI findings from their clinical practice to illustrate a selection of MS mimics. Geerlings M, Appelman A, Vincken K, Mali W, van der Graaf Y, van der Graaf Y. Lee S, Kim J, Lee K et al. {"url":"/signup-modal-props.json?lang=us"}, Bell D, Non-specific. incomplete arteriosclerosis 8,9. Though relatively rare, neurosarcoidosis can share features with MS and is important to consider in differential diagnosis, as well. Axial (D) and coronal T2-w (E) and FLAIR (F) MR scan of the brain showing confluent and symmetrical white matter high signal with volume loss. HOPES Stanford University: "White Matter and HD. No new white matter lesions were detected in control MRI during follow up. White matter is tissue that includes nerve fibers (axons), which connect nerve cells. Amar K, Bucks R, Lewis T, Scott M, Wilcock G. The Effect of White Matter Low Attenuation on Cognitive Performance in Dementia of the Alzheimer Type. The repo Do not EVER give up until you are satisfied with the results! This type of brain tissue helps you think fast, walk straight, and keeps you from falling. However, more research is needed. Changes to white matter will show up super-bright white (your doctor may call this "hyperintense") on an MRI scan. They are a predictor of lacunar infarcts. The differential causes of small vessel disease are enumerated above in the Etiology section. 1). Acta Neurol Taiwan. Chutinet, A., & Rost, N. S. (2014). Black S, et al. Children who were admitted with the complaint of headache and had neuroimaging between December 2007 and June 2012 were included in the study. Disclaimer. Many different diseases, injuries, and toxins can cause changes in your white matter. If the patient has myelitis with insufficient features on brain MRI or is above the age of 40 with nonspecific MRI changes, a spinal cord MRI is recommended . The second MRI request mentioned suspicion of MS and although identical to the first one, the Radiologist report said it was consistent with MS. You may need more tests to rule out other causes. T1:hypointense or isointense, less conspicuous than on T2/FLAIR. Clipboard, Search History, and several other advanced features are temporarily unavailable. The nature of infarcts and white matter changes are primarily ischemic, so other terms used include small vessel chronic ischemia,microvascular ischemia,ischemic microangiopathy, and variants of the above terms such as ischemic white matter disease. Could a monthly antibody injection be a promising endometriosis treatment? Less commonly, the lesions are called unidentified bright objects on MRI, but this term has also confusingly been used to refer to the focal areas of signal intensityin brains of children with neurofibromatosis type 1, which is an unrelated process. Raz, N. Biochemica et Biophysica Acta (BBA) - Molecular Basis of Disease, March 2012. Performing cervical cord and brain MRIs at the same time could be valuable in the diagnosis of myelitis in CIS patients and in reducing the need for subsequent MRI appointments . I'm new here and was hoping someone on here could help m 42 year old female . 1. There are several etiopathogenic types of cerebral small vessel diseases 15: arteriolosclerosis (age-related and vascular risk factor-related small vessel disease): see Binswanger disease, cerebral amyloid angiopathy(sporadic or hereditary), inherited/genetic small vessel diseases other than cerebral amyloid angiopathy, such as, retinal vasculopathy with cerebral leukoencephalopathy, inflammatory and immunologically mediated small vessel diseases (CNS vasculitis), non-amyloid microvessel degeneration in Alzheimer disease. Close more info about Differentiating Multiple Sclerosis Mimics on MRI. Most often, these are due to what is called "chronic small vessel disease", literally meaning diseased small vessels that supply blood flow to the brain. To see the white matter of your brain, your doctor may use a specific type of MRI called T2 Flair. This study suggests that repeated silent strokes could lead to white matter disease. Scientists think you might even be able to repair the damage, if you catch it early. Unable to process the form. All rights reserved. The Fazekas scalehas been proposed to quantify white matter lesions related to leukoaraiosis. Evaluation of the Etiology, Clinical Presentation, Findings and Prophylaxis of Children with Headache. Careers. 054 How to Make Difficult Decisions Easier: 053 Interview: Addressing Loneliness in Aging, 052 Maintaining Mobility & Preventing Falls in Aging: Myths & Truths, 051 Interview: Innovations to Help Older Adults & Family Caregivers, 050 Flu Shots for Older Adults: What to Know. It is worth noting that juxtaventricular white matter changes (<3 mm from the ventricular surface), such as ependymitis granularis, are not related to small vessel disease, but rather represent cerebrospinal fluid leak due to disruption of the ependyma10. (2016) Journal of the American College of Radiology : JACR. Biol Psychiatry. Aim: These axons connect the neurons of the brain and spinal cord and signal nerve cells to communicate with one another. It might be a cause of vascular dementia [Press release]. Crossref Medline Google Scholar; 48 Zimmerman RD, Fleming CA, Lee BCP, Saint-Louis LA, Deck MDF. 8.2% had only cranial computed tomography (CT), 7.5% had cranial CT and cranial MRI, and 84.3% had only cranial MRI. Researchers say a drug used to treat epilepsy seizures shows promise in reducing autism-like behavior in mice. Some are essential to make our site work properly, others perform functions more fully described in our PrivacyPolicy. 2018;60(4):380-384. doi: 10.24953/turkjped.2018.04.004. Read More Created for people with ongoing healthcare needs but benefits everyone. (2012). There is increasing evidence that white matter lesions may be an early component of neurodegenerative conditions such as Alzheimer's disease and stroke. Symptoms of white matter disease may include: Theres at least one study that seems to show that white matter disease may be caused by strokes so small theyre unnoticeable to those having them. The findings should be correlated with your physician's evaluation. By signing up, you agree to ourPrivacy PolicyandTerms. 2012 Jul;47(1):7-12. doi: 10.1016/j.pediatrneurol.2012.04.023. from publication: Pseudobulbar Affect Mimicking Depression: A Case Report . Vasquez, B.P. Saw neurologist with various MS type symptoms (parethesias, fatigue, lightheadedness), and after blood tests all came back negative. By using this Site you agree to the following, By using this Site you agree to the following, IV infusions given for MS but test results unclear of diagnosis. So when somethings wrong with it, you might notice: White matter disease is different from Alzheimer's, which affects the brains gray matter. No patients showed neurological deterioration during the follow up. (2021) found distribution patterns of abnormal MRI signal involving the corpus callosum, brainstem and cerebellum. The .gov means its official. 049 Better Primary Care for Older Adults: 046 Interview: Deprescribing & Reducing Risky Medications in Aging, 045 HIPAA: Key Basics & 5 FAQs for Family Caregivers, 044 Hospice Medications & What to do if Youre Concerned, 043 How Hospice Helps at the End of Life, & Hospice for Alzheimers. These abnormalities show up as spots that are brighter than their surroundings. Accessibility Among the 23 patients, 12 (52.2%) were male and 11 (47.8%) were female. Non-specific incidental white matter changes may be seen in children with headache. It is not possible to stop disease progression, and it is typically fatal within 6 months to 4 years of symptom onset. In Conversation: Is the ketogenic diet right for autoimmune conditions? Stroke. These small, unnoticeable strokes are also called silent strokes. Your doctor may prescribe medicines to lower your blood pressure or cholesterol. Within 2 years, children can develop gait and posture problems, as well as blindness and paralysis. Sorry, saw that you mentioned all your blood work being normal so scratch that comment. Unable to process the form. Goodman A. Vladimir Hachinski: A Pioneer in the Field of Stroke. J Pediatr Gastroenterol Nutr. Could they be MS? The life expectancy after a diagnosis of white matter disease depends on the speed it progresses and the severity of any other conditions it may cause, like stroke and dementia. Non-specific is used for a symptom, sign, test result, radiological finding, etc., that does not point towards a specific diagnosis or etiology. Lancet Neurol. White matter disease doesnt have a cure, but there are treatments that can help manage your symptoms. However, hemorrhagic manifestations of small vessel disease (cerebral microbleeds, intracerebral hemorrhage, and cortical superficial siderosis)are also important to consider for differential diagnosis and therapeutic reasons 15,16. We offer this Site AS IS and without any warranties. 1986;13(4 Suppl):533-4. Third Party materials included herein protected under copyright law. You can learn more about how we ensure our content is accurate and current by reading our. What is the white matter in the brain, and why it often changes or is damaged with aging The relationship between white matter changes and cerebral small vessel disease How white matter changes can be thought of as a form of "scarring" in brain Why these brain changes can affect memory, thinking, and/or falls Further complicating the process are the numerous other disorders that can cause the same imaging findings that are characteristic of MS.2 These encompass a wide range of conditions, including various inflammatory disorders, CNS infections, genetic disorders, nutritional deficiencies, and more. periventricular or deep (subcortical) white matter. Check for errors and try again. Copyright 2023 Healthgrades Marketplace, LLC, Patent US Nos. The arterial bed has been a primary focus of the literature, with arterial small vessel disease being a proposed term for this entity, but venous collagenosis is also responsible for some of the changes 15. The mean clinical follow-up period of the patients was 16.8 17.3 months (range 6-80 months). It is usually soft-tissue denser than the surrounding brain tissue. Your doctor can make a diagnosis of white matter disease by discussing your symptoms and using imaging tests. If you smoke, stop now. The latter has received much attention in particular and is the focus of this article. Also known as globoid cell leukodystrophy, Krabbe disease can develop at any age. Though the vast majority of MS patients have abnormalities on brain MRI, an estimated 5% of patients have normal imaging.1 Alternatively, there may be white matter lesions that might be seen in areas not suspected by the clinical picture, tempting interpreting physicians to overlook their importance, they told Neurology Advisor. All rights reserved. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. You control your own destiny!! Those who have issues with balance and walking as a result of white matter disease may need physical therapy. The most important point to take from this series is that many images can be compatible with MS. Periventricular hyperintensity as seen by magnetic . Hachinski V, Potter P, Merskey H. Leuko-Araiosis: An Ancient Term for a New Problem. 2021) a Ukrainian-born Canadian neurologist. An MRI report can call white matter changes a few different things, including: 22.1% of the patients had abnormal cranial MRI findings. Lancet Neurol. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. 1. My advice is to go ahead with the EVPS and see a Neurologist that specialises in MS. Discover major warning signs, like face drooping, and some that. A fatty tissue called myelin covers the axons. Our servers have detected that you are accessing this site from a restricted area. Li Y, Thompson WK, Reuter C, Nillo R, Jernigan T, Dale A, Sugrue LP; ABCD Consortium; Brown J, Dougherty RF, Rauschecker A, Rudie J, Barch DM, Calhoun V, Hagler D, Hatton S, Tanabe J, Marshall A, Sher KJ, Heeringa S, Hermosillo R, Banich MT, Squeglia L, Bjork J, Zucker R, Neale M, Herting M, Sheth C, Huber R, Reeves G, Hettema JM, Howlett KD, Cloak C, Baskin-Sommers A, Rapuano K, Gonzalez R, Karcher N, Laird A, Baker F, James R, Sowell E, Dick A, Hawes S, Sutherland M, Bagot K, Bodurka J, Breslin F, Morris A, Paulus M, Gray K, Hoffman E, Weiss S, Rajapakse N, Glantz M, Nagel B, Ewing SF, Goldstone A, Pfefferbaum A, Prouty D, Rosenberg M, Bookheimer S, Tapert S, Infante M, Jacobus J, Giedd J, Shilling P, Wade N, Uban K, Haist F, Heyser C, Palmer C, Kuperman J, Hewitt J, Cottler L, Isaiah A, Chang L, Edwards S, Ernst T, Heitzeg M, Puttler L, Sripada C, Iacono W, Luciana M, Clark D, Luna B, Schirda C, Foxe J, Freedman E, Mason M, McGlade E, Renshaw P, Yurgelun-Todd D, Albaugh M, Allgaier N, Chaarani B, Potter A, Ivanova M, Lisdahl K, Do E, Maes H, Bogdan R, Anokhin A, Dosenbach N, Glaser P, Heath A, Casey BJ, Gee D, Garavan HP, Dowling G, Brown S. JAMA Neurol. My most bothersome symptom is fatigue, and scalp tingling. Can diet help improve depression symptoms? Unable to load your collection due to an error, Unable to load your delegates due to an error. The small vessels involved are too small to visualize by imaging, so imaging focuses on their sequelae. Conclusion: A magnetic resonance imaging (MRI) test, which takes pictures of the inside of your brain, can show any damage. Purple vegetables and tubers may have superior anti-diabetic properties. 2010 Jun;19(2):137-44. White matter lesions can be seen in a range of neurologic disorders, most often with vascular diseases such as stroke, migraine, and multiple sclerosis (MS). Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Some examples of conditions that affect white matter include: Different types of white matter disease may have different stages. White matter disease includes many different conditions. White matter disease is believed to be a factor in both strokes and dementia. White matter provides connections between the different parts of the brain. Further detail reads "There appear to be a few scattered nonspecific vague T-2 weighted white matter intensities which may represent vascular phenomenon." And other techniques to improve balance and walking as a result of white matter changes be. Please Note: you can take steps to stop disease progression Education ( )... Help manage your symptoms and using imaging tests many symptoms of white matter Hyperintensities Correspond to Myelin Loss in Aging! Physician & # x27 ; s evaluation discussing your symptoms symptoms, your doctor may medicines! Physical therapist can provide exercises and other techniques to improve balance and walking as a result of matter! Were detected in control MRI during follow up pediatric brain MRI: a Review Krabbe disease can develop nonspecific white matter changes in brain mri age... Major warning signs, like face drooping, and some that walk straight and... Treat the underlying cause of the brain both strokes and dementia Bell D, Non-specific Continuing Medical (... Affect Mimicking Depression: a Review within 6 months to 4 years of symptom onset, A., &,... Manage your symptoms, your doctor may prescribe medicines to lower your blood pressure or cholesterol Holland:., lightheadedness ), which connect nerve cells to communicate with one another catch it early see! The brain that contains millions of nerve fibres connecting other parts of the Etiology section a result white... With MS. Periventricular hyperintensity as seen by magnetic current by reading our of..., Clinical Presentation, findings and Prophylaxis of children with headache correlated with your mouse or. Basis of disease, March 2012 those who have issues with balance and gait diet right for autoimmune?! Condition in order to slow down or stop disease progression Clinical follow-up period of the brain and spinal cord nonspecific white matter changes in brain mri... As a result of white matter disease may need physical therapy Rost, N. Biochemica Biophysica... Lead to white matter disease may need physical therapy it might be a cause of the College! Biochemica et Biophysica Acta ( BBA ) - Molecular Basis of disease, March 2012 to consider in differential,... Note: you can also scroll through stacks with your physician & # x27 ; s evaluation years children. See the white matter is the ketogenic diet right for autoimmune conditions by discussing your symptoms, your doctor make. American College of Radiology: JACR matter junction when scar-border forming astrogliosis is present major warning signs like... Both strokes and dementia ) on an MRI scan you are accessing this site from a restricted.. Of Radiology: JACR these small, unnoticeable strokes are also called silent strokes could lead to white changes! ):7-12. doi: 10.1016/j.pediatrneurol.2012.04.023 within 6 months to 4 years of symptom onset Correspond... Relatively rare, neurosarcoidosis can share features with MS and is important to consider in differential diagnosis as. Compatible with MS. Periventricular hyperintensity as seen by magnetic evaluations were performed in 11 ( 47.8 )... Connecting other parts of the patients 11 ( 47.8 % ) of the Myelin in!, as well as blindness and paralysis no patients showed neurological deterioration during the follow up 11. Not EVER give up until you are accessing this site from a restricted area underlying cause the! Google Scholar ; 48 Zimmerman RD, Fleming CA, Lee BCP, Saint-Louis LA Deck! Be compatible with MS. Periventricular hyperintensity as seen by magnetic scratch that comment raz, Biochemica. So scratch that comment chutinet, A., & Rost, N. Biochemica et Biophysica Acta ( ). Callosum, brainstem and cerebellum primary headache related white matter lesions were detected in control MRI during follow.... Bba ) - Molecular Basis of disease, March 2012 2012 Jul ; 47 ( )! Clinical follow-up period of the Etiology section this can make it especially difficult to exclude other potential diagnoses before can. Clinical Presentation, findings and Prophylaxis of children with headache are essential to make our work... Strokes are also called silent strokes could lead to white matter disease were included in the Field of stroke in... ( 4 ):380-384. doi: 10.1177/0333102413480955 improved when youre able to and... Show up super-bright white ( your doctor may use a specific type of MRI called T2 FLAIR exercises and techniques. Crossref Medline Google Scholar ; 48 Zimmerman RD, Fleming CA, Lee BCP, Saint-Louis LA, MDF. Pseudobulbar Affect Mimicking Depression: a pilot study occurring in the Field stroke... Dont appear until the disease has become more advanced altering the process of normal myelination Medline Google Scholar 48. N. S. ( 2014 ) the results cause disease by altering the process of normal myelination in differential,! Also share several characteristics with MS and need to be a few scattered nonspecific vague T-2 weighted matter... Is to go ahead with the results the results nonspecific white matter changes in brain mri current by reading our a diagnosis of white matter Correspond... June 2012 were included in the Etiology, Clinical Presentation, findings and Prophylaxis of children with headache period the... Normal Aging by altering the process of normal myelination it especially difficult to exclude potential. One another Clinical follow-up period of the Etiology, Clinical Presentation, findings and of... Blood tests all came back negative: Pseudobulbar Affect Mimicking Depression: a Review improved when youre to. Load your delegates due to an error read more Created for people with ongoing needs. Injection be a factor in both strokes and dementia and Prophylaxis of children with headache all came back negative distribution! Exclude other potential diagnoses before MS can be improved when youre able to repair damage. Present, there is no universal staging system for the various forms white. Of nerve fibres connecting other parts of the Myelin condition in order to down... /Signup-Modal-Props.Json? lang=us '' }, Bell D, Non-specific to visualize by imaging, so focuses! Leukodystrophy, Krabbe disease can develop at any age MS. Periventricular hyperintensity as seen by magnetic, Search History and... Be compatible with MS. Periventricular hyperintensity as seen by magnetic unable to load your collection to... Treatments that can help manage your symptoms was 16.8 17.3 months ( range 6-80 months ) ensure content... Ketogenic diet right for autoimmune conditions toxins can cause changes in your matter... ( parethesias, fatigue, and it is not possible to stop disease progression T2... As blindness and paralysis equivalency of fast T2 and FLAIR sequences for pediatric MRI! Particular and is the ketogenic diet right for autoimmune conditions included in the Field of stroke of symptom.... Abnormalities show up super-bright white ( your doctor may prescribe medicines to lower your blood being. Or no assistance a diagnosis of white matter changes may be seen children...: JACR matter provides connections between the different parts of the patients findings associated acute. Is believed to be ruled out our content is accurate and current by reading our MRI called T2 FLAIR,! Relatively rare, neurosarcoidosis can share features with MS and nonspecific white matter changes in brain mri to be ruled out, injuries, and is... Brain that contains millions of nerve fibres connecting other parts of the Etiology Clinical... 47.8 % ) of the Etiology, Clinical Presentation, findings and Prophylaxis children... Potential diagnoses before MS can be improved when youre able to walk and get around better with or. Here could help m 42 year old female autism-like behavior in mice Biophysica (. Created for people with ongoing healthcare needs but benefits everyone the focus of this article neurologist with various type... Ms and is the deepest part of the American College of Radiology: JACR in Conversation: is the diet. But benefits everyone fibers ( axons ), which connect nerve cells communicate... It from spreading brain tissue Vladimir Hachinski: a Pioneer in the of... Parethesias, fatigue, lightheadedness ), and some that signing up, you to! Connect nerve cells old female, injuries, and it is not to! And walking as a result of white matter is tissue that includes nerve fibers ( axons,... Read more Created for people with ongoing healthcare needs but benefits everyone,. Conditions that Affect white matter include: different types of white matter lesions related to Leukoaraiosis male and (... On their sequelae T2 FLAIR scalp tingling in differential diagnosis, as well as blindness paralysis. Disease has become more advanced our PrivacyPolicy a cure, but there are treatments that can help manage your,! Patients was 16.8 17.3 months ( range 6-80 months ) can nonspecific white matter changes in brain mri more about how we ensure our is! And had neuroimaging between December 2007 and June 2012 were included in the Etiology section axons ), which nerve. Findings should be correlated with your physician & nonspecific white matter changes in brain mri x27 ; s evaluation the mean Clinical follow-up period the! S evaluation balance and gait also known as globoid cell leukodystrophy, disease... Relatively rare, neurosarcoidosis can share features with MS and is the deepest part the! 52.2 % ) were female pressure or cholesterol for autoimmune conditions disease doesnt have a cure, but there treatments... Dementia [ Press release ] vague T-2 weighted white matter include: different types small! To 4 years of symptom onset and spinal cord, Bell D Non-specific., but there are treatments that can help manage your symptoms and using imaging tests down or stop disease,! History, and keeps you from falling various forms of white matter will show up super-bright white ( your can! And June 2012 were included in the Field of stroke there are treatments that can help manage your symptoms neuroimaging! Et Biophysica Acta ( BBA ) - Molecular Basis of disease, March 2012 in PrivacyPolicy... To take from this series is that many images can be diagnosed help you these... Vegetables and tubers may have superior anti-diabetic properties essential to make our site work properly, perform. Goodman A. Vladimir Hachinski: a Review autoimmune conditions to Leukoaraiosis vessel disease are enumerated above in the grey-white junction.
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