White matter disease derived from vascular and demyelinating origins

Stroke Vasc Neurol. 2024 Aug 27;9(4):344-350. doi: 10.1136/svn-2023-002791.

Abstract

Damage or microstructural alterations of the white matter can cause dysfunction of the intrinsic neural networks in a condition termed as white matter disease (WMD). Frequently detected on brain computed tomography and magnetic resonance imaging scans, WMD is commonly presented in inflammatory demyelinating diseases like multiple sclerosis (MS) and vascular diseases such as cerebral small vessel disease (CSVD). Prevention of MS and CSVD progression requires early treatments with drastically different medications and approaches, as such, early and accurate diagnosis of WMD, derived from vascular or demyelinating etiologies, is of paramount importance. However, the clinical and imaging similarities between MS, especially during the early stage, and CSVD, pose a significant dilemma in differentiating these two conditions. In this review, we attempt to summarize and contrast the distinguishing features of MS and CSVD for aiding accurate diagnosis to ensure timely corresponding management in the early stages of MS and CSVD.

Keywords: Cerebrovascular Disorders; Inflammation; Magnetic Resonance Imaging.

Publication types

  • Review

MeSH terms

  • Cerebral Small Vessel Diseases* / diagnostic imaging
  • Cerebral Small Vessel Diseases* / physiopathology
  • Cerebral Small Vessel Diseases* / therapy
  • Diagnosis, Differential
  • Disease Progression
  • Humans
  • Leukoencephalopathies* / diagnostic imaging
  • Leukoencephalopathies* / physiopathology
  • Leukoencephalopathies* / therapy
  • Magnetic Resonance Imaging
  • Multiple Sclerosis* / diagnostic imaging
  • Multiple Sclerosis* / physiopathology
  • Multiple Sclerosis* / therapy
  • Predictive Value of Tests*
  • Prognosis
  • White Matter* / diagnostic imaging
  • White Matter* / pathology