Stroke, Vol 20, 850-852, Copyright © 1989 by American Heart Association
CS Kase, PA Wolf, EH Chodosh, HB Zacker, M Kelly-Hayes, WB Kannel, RB D'Agostino and L Scampini
It is common to find computed tomography scan evidence of prior stroke
without a history of such an event. The frequency, risk factors for, and
relevance of silent strokes are unknown. The Framingham cohort of 5,184 men
and women aged 30-62 years and free of stroke at entry to the study have
been followed with periodic examinations since 1950. We studied the silent
strokes found on computed tomography scan of all initial strokes that
occurred between January 1, 1979, and July 31, 1987. During these 8 1/2
years, 164 initial strokes occurred; 124 had computed tomography scans
performed. There were 13 (10%) with silent stroke, 71 had abnormalities
related to their presenting acute stroke, and 40 had normal computed
tomography scans. There were 15 silent lesions; eight were lacunar infarcts
in the basal ganglia-internal capsule area, seven were small cortical
infarcts. Glucose intolerance was the sole risk factor that occurred
significantly more frequently (11 of 13) in the group with silent lesions
(p less than 0.04) than in the group with computed tomography evidence of
acute stroke. Silent stroke is not rare; it was present in at least 10% of
acute initial stroke patients arising in a general population. The relation
of these silent lesions to the development of "vascular" dementia and
poststroke disability deserves further study.
ARTICLES
Prevalence of silent stroke in patients presenting with initial stroke: the Framingham Study
Department of Neurology, Boston University School of Medicine, Massachusetts 02118.
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