The prevalence and risk factor analysis of silent brain infarction in patients with first-ever ischemic stroke

Oh, Seung-Hun; Kim, Nam Keun; Kim, Sang-Heum; Kim, Jin-Kyeoung; Kim, Hyun‐Sook; Kim, Wonchan; Kim, Ok-Su

doi:10.1016/j.jns.2010.02.025

Cited by 21 publications

(23 citation statements)

References 37 publications

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“…This confirms previous studies which relate silent stroke, [26] TIA, [27] gait disturbance, [5] incontinence [6] and cognitive decline [8] to WMLs and lacunar infarcts. Seizures and vertigo may simply have not been examined in depth in the context of CM in previous studies [28], [29].…”

Section: Discussionsupporting

confidence: 92%

Clinical Symptoms and Risk Factors in Cerebral Microangiopathy Patients

et al. 2013

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ObjectiveAlthough the clinical manifestation and risk factors of cerebral microangiopathy (CM) remain unclear, the number of diagnoses is increasing. Hence, patterns of association among lesion topography and severity, clinical symptoms and demographic and disease risk factors were investigated retrospectively in a cohort of CM patients.MethodsPatients treated at the Department of Neurology, University of Bonn for CM (n = 223; 98m, 125f; aged 77.32±9.09) from 2005 to 2010 were retrospectively enrolled. Clinical symptoms, blood chemistry, potential risk factors, demographic data and ratings of vascular pathology in the brain based on the Wahlund scale were analyzed using Pearson's chi square test and one-way ANOVA.ResultsProgressive cognitive decline (38.1%), gait apraxia (27.8%), stroke-related symptoms and seizures (24.2%), TIA-symptoms (22%) and vertigo (17%) were frequent symptoms within the study population. Frontal lobe WMLs/lacunar infarcts led to more frequent presentation of progressive cognitive decline, seizures, gait apraxia, stroke-related symptoms, TIA, vertigo and incontinence. Parietooccipital WMLs/lacunar infarcts were related to higher frequencies of TIA, seizures and incontinence. Basal ganglia WMLs/lacunar infarcts were seen in patients with more complaints of gait apraxia, vertigo and incontinence. Age (p = .012), arterial hypertension (p<.000), obesity (p<.000) and cerebral macroangiopathy (p = .018) were positively related to cerebral lesion load. For increased glucose level, homocysteine, CRP and D-Dimers there was no association.ConclusionThis underlines the association of CM with neurological symptoms upon admission in a topographical manner. Seizures and vertigo are symptoms of CM which may have been missed in previous studies. In addition to confirming known risk factors such as aging and arterial hypertension, obesity appears to increase the risk as well. Since the incidence of CM is increasing, future studies should focus on the importance of prevention of vascular risk factors on its pathogenesis.

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Section: Discussionsupporting

confidence: 92%

Clinical Symptoms and Risk Factors in Cerebral Microangiopathy Patients

et al. 2013

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“…This association is more stronger in the periventricular WML than those of subcortical ones. 27 Periventricular WML was suggested to have somewhat different pathophysiology with a subcortical one. 28 It was suggested that traumatic damage to the loosely arranged network around the ventricle could be caused by increased intracranial pulse pressure based on the alterations in the signal of the ependymal wall through the detailed three-dimensional MR analysis.…”

Section: Pathophysiology Of Sbimentioning

confidence: 99%

Risk of “silent stroke” in patients older than 60 years: risk assessment and clinical perspectives

Lim¹,

Kwon²

2010

CIA

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Abstract:With the increasing size of the elderly population and evolving imaging technology, silent brain infarction (SBI) has garnered attention from both the public and the physicians. Over 20% of the elderly exhibit SBI, and the prevalence of SBI increases steadily with age, ie, 30%-40% in those older than 70 years. Well-known cardiovascular risk factors such as hypertension has been identified as a risk factor of SBI (odds ratio [OR] = 3.47) Besides this, blood pressure (BP) reactivity to mental stress, morning BP surges, and orthostatic BP changes have been demonstrated to contribute to the presence of SBI. Further, a metabolic syndrome not only as a whole syndrome (OR = 2.18) but also as individual components could have an influence on SBI. Increased C-reactive protein and interleukin-6, coronary artery disease, body mass index, and alcohol consumption have also been associated with SBI. The ORs and possible mechanisms have been discussed in this article. Overt stroke, dementia, depression, and aspiration pneumonia were all associated with SBI. (overt stroke: hazard ratio [HR] = 1.9, 95% confidence interval [CI]: 1.2-2.8; dementia: HR = 2.26, 95% CI: 1.09-4.70). We also looked into their close relationship with SBI in this review.

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“…Silent brain infarction (SBI) is a unique disease entity with pathological and clinical features differing from those of ischemic stroke, and has been defined as vascular brain lesions evident on MRI, but without an apparent clinical correlate [1,2]. SBI is more prevalent than symptomatic infarcts and has been associated with increased risk of subsequent symptomatic infarcts, cognitive deficit, and memory loss [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…SBI is more prevalent than symptomatic infarcts and has been associated with increased risk of subsequent symptomatic infarcts, cognitive deficit, and memory loss [2][3][4]. Accordingly, the proper identification of causes and risk factors for SBI is essential to prevent the progression to symptomatic infarction and make an adequate therapeutic decision in SBI subjects.…”

Section: Introductionmentioning

confidence: 99%

“…Among the many hypotheses on the pathogenesis of SBI, endothelial dysfunction of small vessels leading to the occlusion of small, deep, perforating arteries has been proposed as an important explanation for SBI [2,5,6]. Racial and ethnic differences in the incidence of SBI suggest that genetic components play a crucial role in the development of SBI [7].…”

Section: Introductionmentioning

confidence: 99%

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Association between kinase insert domain-containing receptor gene polymorphisms and silent brain infarction: A Korean study

Han

Kim

Ropper

et al. 2012

Journal of the Neurological Sciences

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The prevalence and risk factor analysis of silent brain infarction in patients with first-ever ischemic stroke

Cited by 21 publications

References 37 publications

Clinical Symptoms and Risk Factors in Cerebral Microangiopathy Patients

Clinical Symptoms and Risk Factors in Cerebral Microangiopathy Patients

Risk of “silent stroke” in patients older than 60 years: risk assessment and clinical perspectives

Association between kinase insert domain-containing receptor gene polymorphisms and silent brain infarction: A Korean study

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The prevalence and risk factor analysis of silent brain infarction in patients with first-ever ischemic stroke

Cited by 21 publications

References 37 publications

Clinical Symptoms and Risk Factors in Cerebral Microangiopathy Patients

Clinical Symptoms and Risk Factors in Cerebral Microangiopathy Patients

Risk of &ldquo;silent stroke&rdquo; in patients older than 60 years: risk assessment and clinical perspectives

Association between kinase insert domain-containing receptor gene polymorphisms and silent brain infarction: A Korean study

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Risk of “silent stroke” in patients older than 60 years: risk assessment and clinical perspectives