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Subcortical silent brain infarction as a risk factor for clinical stroke
S Kobayashi1, K Okada, H Koide
1Department of Internal Medicine III, Shimane Medical University, Japan. skdr3nai@shimane-med.ac.jp
Stroke
|October 28, 1997
Summary
Subcortical silent brain infarction (SSBI) detected by MRI is a significant risk factor for clinical stroke. Individuals with SSBI face a substantially higher risk of experiencing stroke, including both ischemic and hemorrhagic types.
Area of Science:
- Neurology
- Radiology
- Epidemiology
Background:
- Subcortical silent brain infarction (SSBI) is often detected incidentally on MRI.
- Prospective studies on the stroke risk associated with SSBI in neurologically normal individuals are limited.
Purpose of the Study:
- To investigate subcortical silent brain infarction (SSBI) as a clinical stroke risk factor.
- To determine the rate of symptomatic ischemic or hemorrhagic stroke in patients with SSBI.
Main Methods:
- MRI scans were performed on 933 neurologically normal adults.
- Subcortical silent brain infarction (SSBI), focal white matter T2 hyperintensity lesions (FWT2HL), and periventricular hyperintensity (PVH) were identified.
- Clinical stroke onset was tracked via questionnaires over 1–7 years.
Main Results:
- The incidence of SSBI was 10.6%.
- Hypertension, diabetes, heavy alcohol consumption, retinal artery sclerosis, and age were independent risk factors for SSBI.
- The annual incidence of clinical stroke was significantly higher in subjects with SSBI (10.1%) compared to those without focal lesions (0.77%).
- SSBI demonstrated a strong association with clinical stroke onset (OR, 10.48).
Conclusions:
- SSBI is a significant predictor of clinical subcortical stroke and brain hemorrhage.
- Hypertension appears to be a common underlying mechanism for SSBI, FWT2HL, and PVH, likely related to small-vessel vasculopathy.
- Individuals with SSBI should be considered high-risk for future clinical stroke events.