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Asymptomatic cerebral infarctions in patients with ischemic stroke
C Loeb1, C Gandolfo, M Del Sette
1Department of Neurological Sciences, University of Genoa, Italy.
European Neurology
|January 1, 1996
Summary
Asymptomatic cerebral infarction (ACI) affects 34% of stroke patients, often as small lacunes. Larger strokes are more frequently symptomatic cerebral infarctions (SCI), linked to cardioembolism.
Area of Science:
- Neurology
- Radiology
- Cerebrovascular Disease
Background:
- Stroke is a leading cause of disability and death.
- Cerebral infarction can be symptomatic (SCI) or asymptomatic (ACI).
- Understanding the characteristics and risk factors of ACI is crucial for stroke prevention and management.
Purpose of the Study:
- To investigate the prevalence, characteristics, and risk factors of asymptomatic cerebral infarction (ACI) in stroke patients.
- To differentiate between factors associated with symptomatic cerebral infarction (SCI) and ACI.
- To analyze the relationship between lesion volume, site, number, and clinical presentation.
Main Methods:
- Retrospective analysis of 383 consecutive stroke patients with ischemic lesions on CT scans.
- Evaluation of patient demographics, risk factors, and lesion characteristics (volume, site, number).
- Classification of lesions as symptomatic (SCI) or asymptomatic (ACI).
Main Results:
- Asymptomatic cerebral infarction (ACI) was present in 34% of patients (130/383).
- 88% of ACIs were small ( < 2 ml) lacunes or internal borderzone infarctions.
- Larger infarctions were asymptomatic in 20.8% of cases.
- Patients with multiple SCIs frequently had co-existing ACIs (68.7%).
- Lateral middle cerebral artery (MCA) territory lesions were typically SCIs, while medial MCA lesions were ACIs.
- Independent risk factors for ACI included age > 70 and smoking.
- Cardioembolism was the primary cause of SCI, whereas small vessel disease was linked to ACI.
- Higher levels of disability were associated with SCIs.
Conclusions:
- Asymptomatic cerebral infarction (ACI) is common in stroke patients, often presenting as small, lacunar lesions.
- Specific lesion locations (medial MCA) and underlying pathologies (small vessel disease) are associated with ACI.
- Risk factors like advanced age and smoking contribute to ACI development.
- The presence of ACIs may correlate with the etiology and severity of stroke, influencing disability levels.