• Sara Kaffashian, Christophe Tzourio, Yi-Cheng Zhu, Bernard Mazoyer, and Stéphanie Debette.
• From INSERM U1219 (S.K., C.T., S.D.) and CNRS-CEA UMR 5296 (B.M.), University of Bordeaux, Bordeaux Cedex, France; Department of Neurology, Peking Union Medical College Hospital, Beijing, China (Y.-C.Z.); and Department of Neurology, Bordeaux University Hospital, Bordeaux Cedex, France (S.D.).
• Stroke. 2016 Jul 1; 47 (7): 1923-5.

Background And PurposeWe examined the association of white-matter hyperintensity (WMH) volume and covert brain infarcts, which are the 2 major magnetic resonance imaging markers of covert cerebrovascular disease in older adults, with long-term risk of ischemic stroke and intracerebral hemorrhage (ICH) in the general population.MethodsParticipants were 1731 individuals aged ≥65 years from the Three-City Dijon study. We studied the association of WMH volume and brain infarct, with incident ischemic stroke overall, and by subtype, and with incident ICH.ResultsHigh total, periventricular, and deep WMHs were associated with incident ICH. Extensive periventricular WMH volume was associated with increased risk of ischemic stroke (hazard ratio, 1.94; 95% confidence interval, 1.12-3.35), particularly cardioembolic stroke. Covert brain infarcts were associated with incident ICH but not with incident ischemic stroke or its subtypes.ConclusionsAlthough of ischemic nature, both WMH volume and covert brain infarcts portend a major risk of ICH. If confirmed in independent studies, these findings could have important implications for the clinical management of covert vascular brain lesions.© 2016 American Heart Association, Inc.

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