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Fuzzy lesions of white matter. |
| The presence of focal areas of hypodensity with indistinct boundaries was separately assessed in seven regions: frontal, temporal, parietal, and occipital lobes, basal ganglia, internal capsule, external capsule, and cerebellum. These usually stand out from a more or less homogenous background of leukoaraiosis in periventricular spaces and semioval regions. In the basal ganglia, the lesions of the lenticular nucleus often have an irregular contour and density – reminiscent of etat lacunaire – (lesions “b” in figure 1.2) while in the thalamus more often have a regular contour and density (lesions “c” in figure 1.3). Hypodensities of the internal capsule have a regular contour and involve both the anterior and posterior arm or are limited to the latter (lesions “d” in figure 1.4). In the cranial part of the external capsule the appearance is that of a hypodense wedge with the tip pointing backwards – reminiscent of a watershed infarction – (lesions “e” in figure 1.3, 1.4, and 1.5) and in the caudal part hypodensities have an irregular contour and density (lesions “f” in figure 1.3 and 1.4). All of the above are usually bilateral although often more marked in one hemisphere. The total score of fuzzy/patchy hypodensities was computed as the sum of the regions where one or more of the above lesions could be appreciated (range 0 to 14). Lacunes. These were assessed in the same seven regions as the fuzzy/patchy hypodensities and were defined as well-defined areas of marked and homogeneous hypodensity with a well-defined and regular contour measuring generally from 2 to 10 mm across (lesion “g” in figure 1.5). |
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