Silent infarction in patients with first-ever stroke.
OBJECTIVE
Silent infarcts (SIs) are commonly found in brain computed tomography (CT) or magnetic resonance imaging (MRI) of elderly subjects. However, the prevalence of this silent infarction (SI) and risk factors for this entity are not entirely known. This study was aimed to evaluate the prevalence of silent infarcts in brain CT and risk factors in patients admitted with first-ever ischemic stroke or transient ischemic attack (TIA).


METHODS
From July 2003 to May 2005, a prospective study was performed for 446 patients admitted to our neurology service with a diagnosis of TIA or stroke. Two hundred and twenty-six patients did not have a history of stroke or TIA prior to the event. All patients received a brain CT on the day when they arrived at the hospital. Risk factors that are monitored included age, history of hypertension, diabetes mellitus, cardiovascular disease, stroke, smoking and alcohol use. Cholesterol and triglyceride levels were measured on the second day of admission.


RESULTS
The results showed that the frequency of SI among 226 patients with first-ever stroke or TIA was 20%. Most of the SIs were small and deep. Small-artery disease was more frequently observed in patients with silent infarction. Age, hypertension, diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, alcohol habit, smoking and atrial fibrillation were not significantly different between patients with silent infarct and patients without silent infarct.


CONCLUSIONS
The study shows small-artery disease is more frequent in patients with silent infarction. The clinical significance of silent infarct needs further study.
Ong
Cheung-Ter
CT
Departments of Neurology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan. ctong98@yahoo.com.tw
Chen
Wen-Pin
WP
Sung
Sheng-Feng
SF
Wu
Chi-Shun
CS
Hsu
Yung-Chu
YC
D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000150:complications*; D002544:Cerebral Infarction / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000150:complications*; D014057:Tomography, X-Ray Computed