Medical Student Renaissance School of Medicine at Stony Brook University
Introduction: Leukoaraiosis, or white matter disease (WMD), is an unfortunate but common disorder with reported prevalence ranging from 5% to 90%. Previous studies have shown that WMD is a well-recognized risk factor for poor functional outcome following recovery from stroke. However, the role of WMD in recovery from traumatic brain injury (TBI), specifically severe TBI (sTBI), is less well documented. Consequently, we sought to investigate the role of leukoaraiosis in functional outcomes post-sTBI.
Methods: We retrospectively analyzed baseline CT scans from 633 sTBI patients admitted to Stony Brook University Hospital from 2010-2021. Eighty-seven patients were excluded due to extreme severity of injury causing improper visualization of WMD. To grade the degree of WMD, we utilized the Van Swieten Scale of 0-4 (0: none; 1: mild; 2: moderate; 3 or 4: severe). We used the Glasgow Outcome Scale - Extended (GOS-E) scores at discharge, 90, 180, and 365 days to identify patients with favorable functional outcomes (GOS-E ≥ 3 at discharge and GOS-E ≥ 5 at other timepoints). We conducted a propensity match based on age and Glasgow Coma Scale (GCS) on admission and utilized a binomial logistical regression model to assess the relationship between WMD severity and GOS-E at each interval.
Results: After controlling for age and GCS on admission, we found no association between moderate to severe white matter disease and favorable outcome at any of the time points (discharge P-value = 0.829, 90-day P-value = 0.095, 180-day P-value = 0.299, 365-day P-value = 0.265).
Conclusion : Moderate and severe leukoaraiosis do not play a significant role in functional recovery following sTBI. Additional studies are warranted to further confirm these findings.
