White Matter Hyperintensities in Young Patients from a Neurological Outpatient Clinic: Prevalence, Risk Factors, and Correlation with Enlarged Perivascular Spaces

(1) Background: to investigate the prevalence of white matter hyperintensities (WMH), risk factors, and correlation with enlarged perivascular spaces (ePVS) among young patients (age, 16-45 years) in a neurological outpatient clinic. (2) Methods: a total of 887 young patients who underwent a head magnetic resonance imaging (MRI)examination between 1 June 2021, and 30 November 2021, were included in this study. Paraventricular WMH (PWMH), deep WMH (DWMH), ePVS in the centrum semiovale (CSO-ePVS), and basal ganglia (BG-ePVS) were rated. Logistic regression analysis was used to identify the best predictors for the presence of WMH and, for the association of the severity of ePVS with the presence of WMH. Goodman-Kruskal gamma test was used to assess the correlation between the severity of ePVS and WMH. (3) Results: the prevalence of WMH was 37.0%, with low severity. Age, hypertension (p < 0.001), headache (p = 0.031), syncope (p = 0.012), and sleep disturbance (p = 0.003) were associated with the presence of DWMH. Age, sex (p = 0.032), hypertension (p = 0.004) and sleep disturbance (p < 0.001) were associated with the presence of PWMH. The severity of CSO-ePVS was associated with the presence and the severities of DWMH. The severity of BG-ePVS was associated with the presence and severities of DWMH and PWMH. (4) Conclusions: the prevalence of WMH was 37% and mild in young patients without specific causes. Older age, female, hypertension, headache, syncope, and sleep disturbance were associated with WMH. The severity of ePVS had an impact on the presence and severity of WMH in the corresponding brain regions.