부산대학교 도서관

QUESTION What are the frequency, risk factors, and consequences of magnetic resonance imaging (MRI)-defined silent brain infarcts? REVIEW SCOPE Selected studies were original MRI studies of silent brain infarcts (ie, infarcts without overt stroke-like symptoms) in adults. For risk factor assessment, only population-based studies were included. Autopsy and computed tomography studies were excluded. Outcomes were frequency, risk factors, and consequences of silent brain infarcts. REVIEW METHODS PubMed (1966 to November 2006) and reference lists of relevant studies were searched for English-language studies. 105 articles met the selection criteria, including 24 reports on risk factors (21 cross-sectional and 3 longitudinal, n = 128- 3397, mean age range 59-75 y) from 8 population-based cohorts. MAIN RESULTS Prevalence of silent brain infarcts in 8 population-based cohorts was between 8% and 28%, increasing with age (table). Age (11 reports) and hypertension (5 reports) were most often associated with silent infarcts, although 3 reports did not report hypertension as a risk factor. Other risk factors identified in those cohorts included severe white matter lesions (4 reports); and cardiovascular disease, creatinine concentrations, or retinal microvascular abnormalities (3 reports each). Risk of infarct was not increased based on sex (8 reports); cholesterol concentrations (6 reports); diabetes or smoking (5 reports each); alcohol use (4 reports); or fibrinogen or C-reactive protein concentrations (3 reports each). In 2 population-based cohorts (n = 4474), silent brain infarcts were associated with a 2-4 fold increase in risk of subsequent stroke, independent of cardiovascular risk factors, and in 1 cohort (n = 1077) infarcts were associated with double the risk of dementia. CONCLUSION Silent brain infarcts occur in 8-28% of the general population and are associated with subsequent stroke and dementia. [ABSTRACT FROM AUTHOR]