Cerebral white matter lesions may be partially reversible in patients with carotid artery stenosis.

Contrary to the common belief that age-related WMLs (also known as leukoaraiosis) are a progressive condition, a case of partial reversal of WMLs shortly after carotid artery stenting is described. A 75-year-old man presented with frequent TIAs, which were attributed to right ICA stenosis. He subsequently underwent successful carotid artery stenting. Follow-up MR imaging a week after the procedure showed improvement of WMLs in the right cerebral hemisphere. Pixel-by-pixel image analysis showed that the reversed WMLs tended to have higher lambda1 and lower signal intensity on b = 0 images compared with nonreversed lesions, but by only approximately 10%.