Evaluation of silent cerebral lesions in patients with first ischemic stroke attack

Abstract

Background: We aimed to evaluate the frequency of silent cerebral lesions (silent cerebral infarction (SCI) and leukoaraiosis (LA)) in first-ever ischemic stroke patients. We wanted to identify the risk factors related with silent cerebral lesions, and the impact of these lesions on the prognosis of patients. Materials and methods: A total of 114 (58 male/56 female) patients with first-ever ischemic stroke that underwent brain MRI were enrolled in this study. Clinical features, and laboratory results were compared in the patients with and without SCI. They were also compared with LA severity, and the risk factors were evaluated. Results: SCI was detected in 90 patients and the most common location was periventricular white matter (PWM) (33%). High body mass index (BMI), hypertension (HT), and hyperlipidemia (HL) were associated with SCI (p = 0.023, 0.012, and 0.019). No associations were detected with LA (p > 0.05). The cholesterol (p = 0.011) and LDL (p = 0.009) levels of the multiple-SCI group were higher than those of the single-SCI group. Lower ejection fraction (EF) was associated with SCI and the severity of LA (p = 0.029 and 0.036). Hemoglobin and hematocrit values were low in advanced-periventricular white matter hyperintensity (adv-PWMH).The presence of SCI had no effects, on stroke recurrence, mortality, or prognosis. Multiple logistic regression analysis showed that HL and the presence of adv-PWMH were independent risk factors for SCI. Conclusion: While some parameters are associated with presence of SCI and LA, other parameters are related only with presence of LA. Different factors may play a role in development of SCI and LA. Studies on larger populations are needed for further evaluation of this issue. © 2011 Elsevier GmbH. All rights reserved.