[Detection and Management of Asymptomatic Cerebrovascular Disease]

Area of Science:

• Neurology
• Vascular Medicine
• Genetics

Background:

• Asymptomatic carotid or intracranial arterial stenosis, silent brain infarction, cerebral white matter lesions, and cerebral microbleeds are established stroke predictors.
• Brain screening programs, or "brain dock," identify these asymptomatic findings.

Purpose of the Study:

• To emphasize the importance of aggressive vascular risk factor management when stroke predictors are detected via brain screening.
• To discuss revascularization options for severe carotid stenosis.
• To highlight the role of genetic factors in East Asian populations.

Main Methods:

• Review of established stroke predictors detected by brain screening.
• Discussion of management strategies including risk factor modification and revascularization.
• Exploration of genetic associations with cerebrovascular diseases.

Main Results:

• Detection of asymptomatic cerebrovascular findings warrants aggressive management.
• Severe carotid stenosis may require revascularization (endarterectomy or stenting).
• Specific genetic variants (RNF213, NOTCH3) are linked to intracranial stenosis and white matter disease, particularly in East Asia.

Conclusions:

• Integrating brain screening with clinical care enhances stroke prevention.
• Genetic predisposition plays a role in cerebrovascular disease, especially in East Asian populations.
• Prompt intervention based on screening findings is crucial for stroke risk reduction.