Cerebral Atrophy in Cerebrovascular Disorders

BACKGROUND AND PURPOSE Various neurological disorders have been shown to accelerate the natural course of brain volume loss during normal aging. Recent data suggest that brain atrophy is prominent in various cerebrovascular disorders. Studies of the effects of different cerebrovascular magnetic resonance imaging (MRI) markers and of the effects of various vascular risk factors on the cerebral volume have been analyzed. SUMMARY OF REVIEW A significant association between white matter hyperintensities and cerebral atrophy has been reported in population-based studies. However, these results remain controversial since they have not yet been confirmed in longitudinal studies. The association between lacunar infarctions and cerebral atrophy was only rarely investigated. This was also true for cerebral microbleeds. In contrast, different data suggest that brain atrophy is associated with elevated blood pressure values or hyperglycemia, independent of the occurrence of extension of visible MRI markers of vascular lesions. CONCLUSION Additional studies are needed to determine the exact impact of vascular risk factors or other cerebrovascular lesions seen on MRI on the course of cerebral atrophy. In the future, new MRI markers may help to better delineate the role of focal tissue lesions from that of diffuse effects of vascular risk factors on the cerebral atrophy process.