Causes of small deep infarcts detected by CT

Clinical data of 83 patients with symptomatic CT detected small deep infarcts in one of the cerebral hemispheres were retrospectively reviewed. 61 Percent had hypertension. In 15 percent a cardiac embolus was the most probable cause of a small deep infarct. In 22 cases angiography had been performed and ipsilateral internal carotid stenosis was present in 6 cases. It is suggested that small deep infarcts visible on CT may be caused by cardiac emboli and artery-to-artery emboli from carotid lesions, besides small vessel disease due to hypertension. Therefore anticoagulation or angiography, if need be, followed by carotid endarterectomy, may be indicated in a number of cases.