BACKGROUND AND PURPOSE: The prevalence of silent brain infarcts varies from 8% to 28% in the general elderly population. Silent brain infarcts are associated with increased risk of subsequent stroke and cognitive dysfunction. By definition, silent strokes lack clinically overt stroke-like symptoms and fail to come to clinical attention; however, impaired recall of symptoms may be a potential confounder. Our aim is to report a series of patients with incidentally detected acute and subacute strokes and examine whether they were truly asymptomatic. METHODS: Subjects included in this study were drawn from ongoing dementia research studies at the Memory Ageing and Cognition Center, in which all participants underwent a cranial MRI. Incidental hyperintense lesions on diffusion-weighted imaging with corresponding apparent diffusion coefficient defects indicative of acute/subacute silent stroke were identified. Clinical data for individuals with incidental hyperintense lesions on diffusion-weighted imaging were collated. RESULTS: Six of 649 subjects had incidental hyperintense lesions on diffusion-weighted imaging; on retrospective questioning, 3 recalled symptoms temporally correlated with MRI lesions, which had been reported to but ignored by family members. Two subjects had focal neurological signs. A majority of the subjects with incidental hyperintense lesions on diffusion-weighted imaging had significant cognitive impairment. CONCLUSIONS: A significant number of strokes may be "silent" due to lack of awareness of stroke-like symptoms in the elderly and their families. Enhanced stroke prevention education strategies are needed for the elderly population and, in particular, for their families.
BACKGROUND AND PURPOSE: The prevalence of silent brain infarcts varies from 8% to 28% in the general elderly population. Silent brain infarcts are associated with increased risk of subsequent stroke and cognitive dysfunction. By definition, silent strokes lack clinically overt stroke-like symptoms and fail to come to clinical attention; however, impaired recall of symptoms may be a potential confounder. Our aim is to report a series of patients with incidentally detected acute and subacute strokes and examine whether they were truly asymptomatic. METHODS: Subjects included in this study were drawn from ongoing dementia research studies at the Memory Ageing and Cognition Center, in which all participants underwent a cranial MRI. Incidental hyperintense lesions on diffusion-weighted imaging with corresponding apparent diffusion coefficient defects indicative of acute/subacute silent stroke were identified. Clinical data for individuals with incidental hyperintense lesions on diffusion-weighted imaging were collated. RESULTS: Six of 649 subjects had incidental hyperintense lesions on diffusion-weighted imaging; on retrospective questioning, 3 recalled symptoms temporally correlated with MRI lesions, which had been reported to but ignored by family members. Two subjects had focal neurological signs. A majority of the subjects with incidental hyperintense lesions on diffusion-weighted imaging had significant cognitive impairment. CONCLUSIONS: A significant number of strokes may be "silent" due to lack of awareness of stroke-like symptoms in the elderly and their families. Enhanced stroke prevention education strategies are needed for the elderly population and, in particular, for their families.
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Authors: Susanne J van Veluw; Andy Y Shih; Eric E Smith; Christopher Chen; Julie A Schneider; Joanna M Wardlaw; Steven M Greenberg; Geert Jan Biessels Journal: Lancet Neurol Date: 2017-07-14 Impact factor: 44.182
Authors: Una Clancy; Daniela Jaime Garcia; Michael S Stringer; Michael J Thrippleton; Maria C Valdés-Hernández; Stewart Wiseman; Olivia Kl Hamilton; Francesca M Chappell; Rosalind Brown; Gordon W Blair; Will Hewins; Emilie Sleight; Lucia Ballerini; Mark E Bastin; Susana Munoz Maniega; Tom MacGillivray; Kirstie Hetherington; Charlene Hamid; Carmen Arteaga; Alasdair G Morgan; Cameron Manning; Ellen Backhouse; Iona Hamilton; Dominic Job; Ian Marshall; Fergus N Doubal; Joanna M Wardlaw Journal: Eur Stroke J Date: 2020-06-05
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Authors: Susanne J van Veluw; Arne Lauer; Andreas Charidimou; Narimene Bounemia; Li Xiong; Gregoire Boulouis; Panagiotis Fotiadis; Alison Ayres; M Edip Gurol; Anand Viswanathan; Steven M Greenberg; Meike W Vernooij Journal: Neurology Date: 2017-10-25 Impact factor: 11.800
Authors: Joanna M Wardlaw; Eric E Smith; Geert J Biessels; Charlotte Cordonnier; Franz Fazekas; Richard Frayne; Richard I Lindley; John T O'Brien; Frederik Barkhof; Oscar R Benavente; Sandra E Black; Carol Brayne; Monique Breteler; Hugues Chabriat; Charles Decarli; Frank-Erik de Leeuw; Fergus Doubal; Marco Duering; Nick C Fox; Steven Greenberg; Vladimir Hachinski; Ingo Kilimann; Vincent Mok; Robert van Oostenbrugge; Leonardo Pantoni; Oliver Speck; Blossom C M Stephan; Stefan Teipel; Anand Viswanathan; David Werring; Christopher Chen; Colin Smith; Mark van Buchem; Bo Norrving; Philip B Gorelick; Martin Dichgans Journal: Lancet Neurol Date: 2013-08 Impact factor: 44.182