Silent brain infarcts are infarcts found by neuroimaging or necropsy without a history of stroke. The symptoms may have been unrecognized, forgotten by the patient, or ischemic symptoms may have been only transient. Silent infarcts are common. Infarcts are found on computed tomography (CT) in about 15% of patients with asymptomatic carotid artery lesions. Cerebral infarcts with transient signs (CITS) are noted on CT in about 25% of patients with spells of transient monocular blindness, and a comparable percentage of patients with transient hemispheric attacks. About 10% of patients with symptomatic strokes also have other infarcts found by CT that do not correlate with symptoms. Magnetic resonance imaging (MRI) is much more sensitive for detecting silent infarcts than CT. Among three series of transient ischemic attack (TIA) patients, 75% of 103 patients had silent infarcts on MRI compared to only 27% who had infarcts detected by CT. Many silent infarcts are small and deep; larger silent infarcts are probably more often found in the right cerebral hemisphere. In patients with CITS, infarction is more common when TIAs are longer than 1 h and clear slowly. In patients with carotid artery occlusive disease, silent infarcts correlate with the severity of stenosis and are probably more common in patients with ulcerative lesions. Embolism, both cardiac and intra-arterial, and lacunar infarction are probably the two most common mechanisms of silent infarction. Patients with silent infarcts differ little in respect to risk factors from patients with TIAs and from patients with symptomatic infarcts. The presence of silent and symptomatic brain infarcts gives clinicians some information about the natural history of the patient''s cerebrovascular disease. Patients with cerebrovascular disease should be characterized by: (1) symptoms (none, transient retinal, hemispheric, hemianopic, brainstem/cerebellar or strokes); (2) state of the brain (normal, stunned, infarcted), and (3) the nature, location, and severity of cardiovascular-blood diseases) that have caused or threaten stroke.

Keywords:
Silent infarcts, Brain, Prognosis, Computed tomography, Transient ischemic attack
© 1994 S. Karger AG, Basel
1994
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.