Atrial fibrillation (AF) related embolism does not contribute to leukoaraiosis but AF-related perfusion changes might, by aggravating chronic microangiopathic ischemia.

White matter disease, also termed leukoaraiosis, is an established marker of cerebral small vessel disease load in older adults and it is an important predictor of incident stroke, cognitive impairment and poor outcomes after a stroke.1 First defined as periventricular hypodense regions on CT scans, research on white matter disease blossomed with frequent use of T2/fluid-attenuated inversion recovery (FLAIR) MRI sequences that are a lot more sensitive to show such chronic microangiopathic damage as hyperintense white matter regions, hence the term white matter hyperintensities (WMHs). When mapped using three-dimensional volumetric methods, the bulk of WMH is in the periventricular regions so voxel-based comparisons in different types of cerebral small vessel disease did not show significant topographic differences.1 A recent study introduced a number of visually identified WMH patterns and found robust associations between two patterns and common cerebral small vessel disease aetiologies of elderly: (1) multiple subcortical spots with cerebral amyloid angiopathy and (2) peribasal ganglia linear hyperintensities with hypertensive cerebral …