Silent cerebrovascular lesions in patients with first-ever stroke

Of 200 patients admitted for first-ever stroke and no prior history of transient ischemic attacks, 33 (16.5%) were found to have evidence of prior subclinical cerebral infarction on computed tomography (CT) or autopsy, so-called "silent strokes." Nineteen had one additional lesion, eight had two, and six had three or more. Most were small, 84% involved less than half a lobe, and the majority of these were <1 cm. Silent lesions were significantly more prevalent in patients with atherothrombotic stroke and less prevalent in hemorrhagic stroke. Age and sex distribution were similar in both groups. Risk factor levels and 30-day outcome parameters were similar with the exception of average 30-day Mini-Mental State Examination scores, which were significantly lower in patients with two or more silent lesions compared with patients without silent lesions.