Silent Brain Infarcts

Caplan, Louis R.

doi:10.1159/000108559

Cited by 29 publications

(18 citation statements)

References 17 publications

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“…1 SBI is frequently seen on MRIs in healthy elderly people. The prevalence of these asymptomatic lesions increases with age from Ϸ5% at 60 years of age to 35% at 90 years of age.…”

Section: S Ilent Brain Infarction (Sbi) Is Defined As a Cerebralmentioning

confidence: 99%

Metabolic Syndrome as an Independent Risk Factor of Silent Brain Infarction in Healthy People

Kwon

Kim

Lee

et al. 2006

Stroke

139

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Background and Purpose-Metabolic syndrome (MetS) is associated with an increased risk of the subsequent development of cardiovascular disease or stroke. Moreover, a silent brain infarction (SBI) can predict clinical overt stroke or dementia. We examined the associations between SBI and MetS in apparently healthy individuals. Methods-We evaluated 1588 neurologically healthy subjects (927 males and 661 females) who underwent brain MRI at Seoul National University Hospital Healthcare System Gangnam Center. MetS was defined using the criteria of the National Cholesterol Education Program Adult Treatment Panel III. We examined associations between full syndrome (Ն3 of the 5 conditions) as well as its components and SBI by controlling possible confounders. Results-Eighty-eight (5.5%) were found to have Ն1 SBI on MRI. Age was found to be significantly related to SBI prevalence (odds ratio [OR], 1.06; 95% CI, 1.04 to 1.09). A history of coronary artery disease was associated with an elevated odds ratio of SBI (OR, 2.83; 95% CI, 1.38 to 5.82), and MetS was significantly associated with SBI (OR, 2.18; 95% CI, 1.38 to 3.44). The components model of MetS showed a strong significance between an elevated blood pressure (OR, 3.75; 95% CI, 2.05 to 6.85) and an impaired fasting glucose (OR, 1.74; 95% CI, 1.08 to 2.80) and the risk of SBI. Key Words: cerebral infarction Ⅲ magnetic resonance imaging Ⅲ metabolic syndrome x Ⅲ risk factors S ilent brain infarction (SBI) is defined as a cerebral infarction that is evident by brain imaging but that is without a clinical syndrome characterized by rapidly developing clinical symptoms and signs of focal and at times a global loss of brain function. 1 SBI is frequently seen on MRIs in healthy elderly people. The prevalence of these asymptomatic lesions increases with age from Ϸ5% at 60 years of age to 35% at 90 years of age. [2][3][4] The presence of an SBI can predict clinical overt stroke 2,5 or reduced cognitive functioning. 3,6 To prevent SBI, it is important that its risk factors be identified, especially treatable factors. It has been demonstrated that the risk factors of SBI are not necessarily the same as those of clinical stroke, 7 and several studies have consistently found that regardless of race, advanced age 2,5,8 -12 and hypertension 2,4 -11 are the most common risk factors for SBI. Conclusions-MetSThe combination of cardiovascular risk factors that compose metabolic syndrome (MetS) are receiving increasing attention from physicians, but no data are available on the association of the syndrome with SBI. A set of metabolic and physiological risk factors linked to cardiovascular disease has been variously defined as insulin resistance syndrome, syndrome X, the deadly quartet, MetS, dysmetabolic syndrome, and cardiovascular dysmetabolic syndrome. [13][14][15][16][17] Proposed definitions of MetS differ with respect to its components and component set points. However, recent attempts to define MetS have included 5 conditions: hyper-triglyceridemia (hyper-TG), low high-density li...

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“…1 SBI is frequently seen on MRIs in healthy elderly people. The prevalence of these asymptomatic lesions increases with age from Ϸ5% at 60 years of age to 35% at 90 years of age.…”

Section: S Ilent Brain Infarction (Sbi) Is Defined As a Cerebralmentioning

confidence: 99%

Metabolic Syndrome as an Independent Risk Factor of Silent Brain Infarction in Healthy People

Kwon

Kim

Lee

et al. 2006

Stroke

139

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“…57 None of the prospective studies on consecutive patients with ischemic stroke reported multivariate analysis accounting for collinearity between features related to silent infarcts 2 ' 3 -6 ' 7 except a recent study 1 in which different index-stroke subtypes were not distinguished. Although predominant in all of our four index-stroke subgroups, silent small deep infarcts were significantly more frequent in first-ever lacunar stroke.…”

mentioning

confidence: 99%

“…These findings suggest a similarity in the type of underlying mechanism in symptomatic and silent infarcts: small-vessel vasculopathy in most small deep infarcts and cardiogenic embolism or large-vessel thromboembolism in territorial infarcts. 57 Some patients may suffer from both because silent small infarcts are common among stroke patients with cardiogenic or large-vessel thromboembolism. This may reflect hypertension-related small-vessel vasculopathy because, other than age, hypertension was the only risk factor significantly associated with silent small deep but not territorial infarcts.…”

mentioning

confidence: 99%

Silent brain infarcts in 755 consecutive patients with a first-ever supratentorial ischemic stroke. Relationship with index-stroke subtype, vascular risk factors, and mortality.

Boon

Lodder

Raak

et al. 1994

Stroke

117

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Background and PurposeWe wanted to establish independent associations of various clinical variables, computed tomographic (CT) scan features, presenting stroke subtypes, and outcome with the presence of silent infarcts on CT.Methods We studied 755 consecutive patients in a prospective registration of patients with first-ever supratentorial atherothrombotic, cardioembolic, or lacunar stroke or stroke of undetermined cause by multiple logistic regression analysis.Results Two hundred six patients (27%) with a first symptomatic territorial or small deep ischemic stroke had one or more silent infarcts on CT. Of all silent lesions, 169 (82%) were small and deep. Silent infarcts were significantly more strongly associated with a lacunar than atherothrombotic (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.02 to 2.47; P=.O39) or cardioembolic (OR, 1.89; 95% CI, 1.2 to 2.99; P=.OO5) index stroke. Silent territorial lesions were more strongly associated with cardioembolic than with lacunar stroke but not with atherothrombotic stroke. In this respect, no differences were found between the atherothrombotic and undetermined-cause group. Advanced age and hypertension were the only risk factors that were significantly associated with silent infarcts (OR, 1.76; 95% CI, 1.14 to 2.71; P=.0U; and OR, 1.58; 95% CI, 1.13 to 2.21; P=.001; respectively), mainly because of a strong independent association of these risk factors with silent small deep infarcts (OR, 1.75; 95% CI,

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“…Furthermore, several recent studies showed that dementia after stroke does not necessarily appear to have "typical" vascular features, such as acute onset. In the present study we assessed the predictive value of SBI in relation to the development of cognitive decline in patients after what clinically appeared to be their firstever ischemic stroke [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Do Silent Brain Infarctions Predict the Development of Dementia After First Ischemic Stroke?

et al. 2013

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Silent Brain Infarcts

Cited by 29 publications

References 17 publications

Metabolic Syndrome as an Independent Risk Factor of Silent Brain Infarction in Healthy People

Metabolic Syndrome as an Independent Risk Factor of Silent Brain Infarction in Healthy People

Silent brain infarcts in 755 consecutive patients with a first-ever supratentorial ischemic stroke. Relationship with index-stroke subtype, vascular risk factors, and mortality.

Do Silent Brain Infarctions Predict the Development of Dementia After First Ischemic Stroke?

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