BACKGROUND: Cerebral white matter change (WMC) is usually seen in stroke patients. This study was aimed at determining whether there might be a relationship between the extent of WMC and whether to control hypertension or not and the frequency of previous stroke lesion. Stroke subtypes were also analyzed to elucidate WMC distribution. METHODS: We investigated demographic features, vascular risk factors, subtypes, and WMC in 339 ischemic stroke patients over forty years of age who had brain MRI from the Hallym Stroke Registry between January 1998 and December 2001. In hypertension, it was divided into with therapy and with no therapy. In frequency of previous stroke lesion, we subdivided the patients into three groups by number of frequency: 0, 1, and >or=2. Stroke subtypes were classified into large artery atherosclerosis (LAA), small artery occlusion (SAO), cardioembolism (CE), and stroke of undetermined etiology (SUE). WMC was quantitatively estimated by subdividing into 5 grades (0~IV). RESULTS: Age, female, hypertension, previous stroke lesion, and SAO correlated significantly with prevalence of WMC (p<0.001, =0.002, <0.001, <0.001 and <0.001, respectively). In hypertension, there was significant difference between normotensive and hypertensive (p=0.001). But there was no statistical difference between with therapy and with no therapy (p>0.05). In previous stroke lesion, it showed significant difference between 0 and (1 and >or=2) (p<0.001) and between 1 and >or=2 (p<0.001). In subtype, CE also correlated significantly with prevalence of WMC as well as SAO than LAA (p<0.001). CONCLUSIONS: WMC seen in patients with stroke is related with small-vessel disease and is mainly affected by age, female, hypertension, and previous stroke lesion.